bluuebunny/crossref_metadata_2025_split huggingface dataset:
Added Diagnostic Value of Biomarkers in Patients with Suspected Sepsis: A Prospective Cohort Study in Out-Of-Hours Primary Care
Authors: Loots Feike J , Smits Marleen , Jenniskens Kevin , van Zanten Arthur R H , Kusters Ron , Verheij Theo J M , Hopstaken Rogier M 
Published: April 2022

Abstract

Background
Point-of-care testing (POCT) has shown promising results in the primary care setting to improve antibiotic therapy in respiratory tract infections and it might also aid general practitioners (GPs) to decide if patients should be referred to a hospital in cases of suspected sepsis. We aimed to assess whether biomarkers with possible POCT use can improve the recognition of sepsis in adults in the primary care setting.

Methods
We prospectively included adult patients with suspected severe infections during out-of-hours home visits. Relevant clinical signs and symptoms were recorded, as well as the biomarkers C-reactive protein, lactate, procalcitonin, high-sensitive troponin I, N-terminal pro b-type natriuretic peptide, creatinine, urea, and pancreatic stone protein. We used a POCT device for lactate only, and the remaining biomarkers were measured in a laboratory from stored blood samples. The primary outcome was sepsis within 72 h of inclusion. The potential of biomarkers to either rule in or rule out sepsis was tested for individual biomarkers combined with a model consisting of signs and symptoms. Net reclassification indices were also calculated.

Results
In total, 336 patients, with a median age of 80 years, were included. One hundred forty-one patients (42%) were diagnosed with sepsis. The C statistic for the model with clinical symptoms and signs was 0.84 (95% CI 0.79–0.88). Both lactate and procalcitonin increased the C statistic to 0.85, but none of the biomarkers significantly changed the net reclassification index.

Conclusions
We do not advocate the routine use of POCT in general practice for any of the tested biomarkers of suspected sepsis.
Challenges and opportunities for advancing patient-centered clinical decision support: findings from a horizon scan
Authors: Dullabh Prashila , Sandberg Shana F , Heaney-Huls Krysta , Hovey Lauren S , Lobach David F , Boxwala Aziz , Desai Priyanka J , Berliner Elise , Dymek Chris , Harrison Michael I , Swiger James , Sittig Dean F 
Published: April 2022

AbstractObjectiveWe conducted a horizon scan to (1) identify challenges in patient-centered clinical decision support (PC CDS) and (2) identify future directions for PC CDS.Materials and MethodsWe engaged a technical expert panel, conducted a scoping literature review, and interviewed key informants. We qualitatively analyzed literature and interview transcripts, mapping findings to the 4 phases for translating evidence into PC CDS interventions (Prioritizing, Authoring, Implementing, and Measuring) and to external factors.ResultsWe identified 12 challenges for PC CDS development. Lack of patient input was identified as a critical challenge. The key informants noted that patient input is critical to prioritizing topics for PC CDS and to ensuring that CDS aligns with patients’ routine behaviors. Lack of patient-centered terminology standards was viewed as a challenge in authoring PC CDS. We found a dearth of CDS studies that measured clinical outcomes, creating significant gaps in our understanding of PC CDS’ impact. Across all phases of CDS development, there is a lack of patient and provider trust and limited attention to patients’ and providers’ concerns.DiscussionThese challenges suggest opportunities for advancing PC CDS. There are opportunities to develop industry-wide practices and standards to increase transparency, standardize terminologies, and incorporate patient input. There is also opportunity to engage patients throughout the PC CDS research process to ensure that outcome measures are relevant to their needs.ConclusionAddressing these challenges and embracing these opportunities will help realize the promise of PC CDS—placing patients at the center of the healthcare system.
Curcumin-Polyethylene Glycol Loaded on Chitosan-Gelatin Nanoparticles Enhances Burn Wound Healing in Rat
Authors: Ravanfar Kimia , Amniattalab Amir , Mohammadi Rahim 
Published: April 2022

AbstractThe aim of the present study was to evaluate effects of curcumin-polyethylene glycol loaded on chitosan-gelatin nanoparticles (C-PEG-CGNPs) on burn wound healing in rat as a model study. Sixty healthy male White Wistar rats were randomized into four experimental groups of 15 animals each: Control group (Control) was treated with normal saline. Carrier group was treated with CGNPs-based ointment (0.05 mg/ml). Silver sulfadiazine group was treated with silver sulfadiazine 1% ointment. Treatment group was treated with C-PEG-CGNPs (0.05 mg/ml). Wound size was measured on 7, 14, and 21 days after surgery. The expression of p53, Bcl-2, caspase-3 were evaluated using reverse transcription-polymerase chain reaction and immunohistochemical staining. Reduction in wound area indicated that there was significant difference between Treatment group and other groups (P &lt; .05). Quantitative histological and morphometric studies, and mean rank of the qualitative studies demonstrated that there was a significant difference between Treatment group and other groups (P &lt; .05). Observations demonstrated C-PEG-CGNPs significantly shortened the inflammatory phase and accelerated the cellular proliferation. Accordingly, the animals in Treatment group revealed significantly (P &lt; .05) higher fibroblast distribution/one mm2 of wound area and rapid reepithelialization. The mRNA levels of Bcl-2, p53, and caspase-3 were remarkably (P &lt; .05) higher in Treatment group compared to control animals. The immunohistochemical analyses confirmed the reverse transcription-polymerase chain reaction findings. C-PEG-CGNPs offered potential advantages in burn wound healing acceleration and improvement.
Inequities in Rural and Urban Health Care Utilization Among Individuals Diagnosed With Inflammatory Bowel Disease: A Retrospective Population-Based Cohort Study From Saskatchewan, Canada
Authors: Peña-Sánchez Juan Nicolás , Osei Jessica Amankwah , Rohatinsky Noelle , Lu Xinya , Risling Tracie , Boyd Ian , Wicks Kendall , Wicks, Mike , Quintin Carol-Lynne , Dickson Alyssa , Fowler Sharyle A 
Published: April 2022

AbstractBackgroundRural dwellers with inflammatory bowel disease (IBD) face barriers to accessing specialized health services. We aimed to contrast health care utilization between rural and urban residents diagnosed with IBD in Saskatchewan, Canada.MethodsWe completed a population-based retrospective study from 1998/1999 to 2017/2018 using administrative health databases. A validated algorithm was used to identify incident IBD cases aged 18+. Rural/urban residence was assigned at IBD diagnosis. Outpatient (gastroenterology visits, lower endoscopies, and IBD medications claims) and inpatient (IBD-specific and IBD-related hospitalizations, and surgeries for IBD) outcomes were measured after IBD diagnosis. Cox proportional hazard, negative binomial, and logistic models were used to evaluate associations adjusting by sex, age, neighbourhood income quintile, and disease type. Hazard ratios (HR), incidence rate ratios (IRR), odds ratios (OR), and 95% confidence intervals (95% CI) were reported.ResultsFrom 5,173 incident IBD cases, 1,544 (29.8%) were living in rural Saskatchewan at IBD diagnosis. Compared to urban dwellers, rural residents had fewer gastroenterology visits (HR = 0.82, 95% CI: 0.77–0.88), were less likely to have a gastroenterologist as primary IBD care provider (OR = 0.60, 95% CI: 0.51–0.70), and had lower endoscopies rates (IRR = 0.92, 95% CI: 0.87–0.98) and more 5-aminosalicylic acid claims (HR = 1.10, 95% CI: 1.02–1.18). Rural residents had a higher risk and rates of IBD-specific (HR = 1.23, 95% CI: 1.13–1.34; IRR = 1.22, 95% CI: 1.09–1.37) and IBD-related (HR = 1.20, 95% CI: 1.11–1.31; IRR = 1.23, 95% CI: 1.10–1.37) hospitalizations than their urban counterparts.ConclusionWe identified rural-urban disparities in IBD health care utilization that reflect rural-urban inequities in the access to IBD care. These inequities require attention to promote health care innovation and equitable management of patients with IBD living in rural areas.
Urban bias, migration control and rural land policy: the case of Hukou in China
Authors: Shifa Abdulaziz B , Xiao Wei 
Published: April 2022

AbstractUrban-biased politics often drives distortionary policies in many countries. We develop a political economy model in which the government faces a trade-off between retaining urban support and expanding its industrial rent base. The model shows that while an increase in urbanization strengthens the government’s incentives to adopt rural land reform and to encourage rural–urban migration, an increase in urban productivity has the opposite effect. These effects are mediated by the income share of labor in the rural sector, the political power of urban residents and the labor elasticity of urban output. Using China’s context, we illustrate that the model’s predictions are consistent with the observed policies on land ownership and rural–urban migration.
‘Manufacturers without factories’ and economic development in the Global South: India’s pharmaceutical firms
Authors: Rault-Chodankar Yves-Marie , Kale Dinar 
Published: April 2022

AbstractGlobal value chain/global production network studies have extensively documented the role of lead firms from the Global North in economic development in the Global South, including as ‘manufacturers without factories’ (MWFs). However, the role of local firms in sourcing from suppliers has been overlooked. In this article, we report the findings of a qualitative study and demonstrate that the local MWFs helped establish India as the leading supplier of pharmaceuticals worldwide and in the Global South. We show how the different types of local MWFs (‘propagandists’, ‘pioneers’, ‘connectors’ and ‘adaptors’) impact the strategic coupling, industrial upgrading and governance in South–South value chains and contribute to regional economic development.
Fecundity of First-Generation Captively Reared Heterelmis comalensis (Coleoptera: Elmidae)
Authors: Kosnicki Ely 
Published: April 2022

Abstract
The Comal Springs riffle beetle Heterelmis comalensis Bosse, Tuff, and Brown is listed as endangered by the U.S. Fish and Wildlife Service. Rearing this species in captivity is important to maintaining a refuge which is a goal of the Edwards Aquifer Habitat Conservation Plan. Although captive larval production has been observed for years, the production of larvae per female has been relatively unknown. Production chambers were constructed from PVC to house one female and male and the production of larvae was monitored ca. monthly until the female died. Females were found to be iteroparous and produced 29.3 ± 37.1 larvae. The number of larvae produced was found to be a function of female longevity rather than size. Other aspects of captive production and observations from the study are discussed.
Prognostic significance of visceral pleural invasion in patients with surgically resected small-cell lung cancer: a population-based study
Authors: Yang Hao , Mei Tonghua 
Published: April 2022

Abstract

Objective
Visceral pleural invasion is an adverse prognostic factor in non-small-cell lung cancer, but its value in small-cell lung cancer remains unclear. Thus, we investigated the prognostic impact of visceral pleural invasion in patients with surgically resected small-cell lung cancer.

Methods
We queried the Surveillance, Epidemiology and End Results Program database for patients diagnosed with stages I–III (excluding N3 and nodal metastasis cannot be evaluated (NX)) small-cell lung cancer from 2004 to 2016, who underwent surgery. To minimize unbalanced baseline characteristics between the visceral pleural invasion and non-visceral pleural invasion groups, one-to-one propensity score matching was employed. A Kaplan-Meier curve was used to compare the overall survival of the two cohorts. A Cox proportional hazards model was adopted to determine the impact of visceral pleural invasion on survival.

Results
Of the 1416 patients included, 372 (26.27%) presented with visceral pleural invasion. Patients with visceral pleural invasion showed significantly worse overall survival (P &lt; 0.001) both before and after propensity score matching. Multivariable analysis indicated that visceral pleural invasion was an independent adverse factor affecting survival. Patients with visceral pleural invasion showed poorer overall survival (hazard ratio: 1.44; 95% confidence interval: 1.17–1.76; P &lt; 0.001). Subgroup analyses revealed that the non-visceral pleural invasion group was associated with favourable overall survival in N0 patients (P = 0.003) but not in N1 or N2 patients (P = 0.774 and 0.248, respectively). Patients diagnosed at younger ages, females, lower N stage, resection with a lobectomy and adjuvant chemotherapy were associated with improved overall survival in the visceral pleural invasion group.

Conclusions
Visceral pleural invasion was an indicator of a poor prognosis for small-cell lung cancer, especially in those with N0 disease. Adjuvant chemotherapy significantly improves patient outcomes for patients with visceral pleural invasion.
Trees, owls, worms, and crevices: which habitat factors predict local woodrat demographics?
Authors: Gooley Aaron C , Schauber Eric M 
Published: April 2022

Abstract
Hypothesized reasons for the decline of many woodrat populations in the eastern United States include parasitism by raccoon roundworm (Baylisascaris procyonis; Ascaridida: Ascarididae), hard mast shortages, owl predation, and reductions in suitable structures (e.g., rock crevices) for nest construction. We investigated whether abundance and apparent survival of eastern woodrats (Neotoma floridana) within a successfully reintroduced metapopulation in southern Illinois could be predicted by factors underlying these hypothesized reasons for woodrat declines. We analyzed capture histories of 205 eastern woodrats from eight rock outcrop sites in summers of 2013 and 2014 to estimate local population size and apparent survival. We then used repeated-measures models to test how woodrat abundance and apparent survival were associated with availability of mast trees, owl abundance, risk of raccoon roundworm infection, and crevice availability. Mean monthly estimated woodrat abundance at sites ranged from 0.78 to 21.58 in 2013 and 0.48 to 18.08 in 2014, while monthly apparent survival ranged from 0.00 to 0.76 during the summers and 0.05 to 0.90 during the trapping intersession. Crevice availability was positively associated both with abundance and apparent survival of woodrats. Our results did not support the hypothesis that owls reduce woodrat populations because woodrat abundance was positively associated with owl abundance across sites. No raccoon roundworm eggs were found at any site. We conclude that crevice availability was the best predictor of woodrat population success in our study area, while owl abundance may be a proxy for other habitat variables or a response to woodrat abundance. Our findings suggest measures that could be taken to benefit woodrat survival and abundance.
Availability of medical schemes’ formulary medicines in community pharmacies in Durban, South Africa
Authors: Haripersad Bernita , Padayachee Neelaveni , Bangalee Varsha 
Published: April 2022

Abstract

Objectives
This study aimed to calculate the percentage availability of medicine brands for 24 active ingredients across community pharmacies, to establish which brands are listed on medical scheme (MS) formularies and to determine availability trends and patterns among the findings.

Methods
A quantitative cross-sectional survey was carried out at 30 community pharmacies located in the eThekwini area of Durban, KwaZulu-Natal. The basket of medicines included 24 active ingredients randomly selected from the Abbreviated Primary Health Care Essential Medicines List of South Africa. Medicine formularies from South Africa’s top five MSs, according to the number of dependants, were investigated. Data were collected using an electronic survey and distributed via e-mail to participating pharmacies. All statistical analyses, observations and data collation were performed using tools on Google Forms and Microsoft Excel 2015.

Key findings
A total of 188 medicine brands were found to be available for sale at 30 community pharmacies. Only 71 medicine brands were on the formulary across all the investigated MSs, indicating that only 37.8% of the available brands were reimbursable. Of the 71 formulary-listed medicine brands, only 17 presented with high percentage availabilities (80% and over). This indicates that only 9.04% of the available medicine brands showed the most desirable results, which is the high availability of formulary medicines that would likely not result in any extra out-of-pocket payments to patients.

Conclusions
The majority of medicine brands that were identified as available were in fact not reimbursable by the five investigated MSs. Patient confidence in the use of generic medicines should be addressed with the intention of lowering their health expenses and improving treatment adherence. Further studies on formulary medicine availability are encouraged to include a larger basket of medicines, a wider geographical area and more MS plans.
Targeted delivery and apoptosis induction activity of peptide-transferrin targeted mesoporous silica encapsulated resveratrol in MCF-7 cells
Authors: Li Dongning , Song Chengzhu , Zhang Jie , Zhao Xiaoyan 
Published: April 2022

Abstract

Objectives
Resveratrol (Res) was a naturally occurring polyphenol compound. It has various beneficial effects, including anti-inflammatory, anti-oxidant and anti-cancer effects. However, the anti-cancer activity was hindered by its low targeting and drug release performance. Thus, we synthesized transferrin-cathepsin B cleavable peptide modified mesoporous silica nanoparticle encapsulated Res (Tf-Res-MSN).

Methods
Res was encapsulated in mesoporous silica nanoparticles (MSN), which was a kind of drug carrier complex. Tf was modified to recognize the cancer cells. Cathepsin B cleavable peptide (Pep) was used to combine Res-MSN complex and Tf to construct the final product. Pep was used as linker and trigger for Res release.

Key findings
The smart nanocarriers were increased the drug release performance of Res in human breast cancer (MCF-7) cells. The physicochemical properties of Tf-Res-MSN were assessed by zeta potential, UV-Prove, diffraction scanning calorimetry (DSC), nitrogen physisorption analysis and transmission electron microscope (TEM). MTT assay, AO and Annexin V-FITC/PI staining were performed to explore the anti-tumour activity of Tf-Res-MSN. The results showed that Tf-Res-MSN significantly decreased cell viability and increased cell apoptosis. The inhibition rate and apoptotic rate of Tf-Res-MSN in MCF-7 cells were 95.75% and 80.8%, respectively.

Conclusion
Our study demonstrated that Tf-Res-MSN was a valuable technique with potential value in breast cancer applications.
Making ‘The Process’: Sexual Vulnerability and Burundian Refugee Boys and Young Men’s Strategies for Onward Migration from Nakivale Refugee Settlement in Uganda
Authors: Ruzibiza Yvette , Berckmoes Lidewyde H 
Published: April 2022

AbstractBased on ethnographic research among Burundian refugee boys and young men in Nakivale refugee settlement in Uganda, we explore how boys and young men in the camp, guided by the longing for a better life, aspire for onward migration and develop strategies based on their knowledge of relevant legal frameworks. Given that onward migration under the UNHCR framework is possible for only the most ‘vulnerable’, we highlight the negotiation strategies adopted by some boys and young men to support their ‘process’, based on sexual vulnerability related to being in same-sex relationships. Notwithstanding the deprivation and bleak prospects, we thus propose to look at the refugee settlement also as a space opening chance for vital transformation. At the same time, we point out that the restricting frameworks seeking to foster protection of refugees, may, in an environment hostile to same-sex relations, unintentionally render refugee boys and young men more vulnerable to gendered exploitation.
Genome-wide H3K9 acetylation level increases with age-dependent senescence of flag leaf in rice
Authors: Zhang Yu , Li Yanyun , Zhang Yuanyuan , Zhang Zeyu , Zhang Deyu , Wang Xiaonan , Lai Binfan , Huang Dandan , Gu Lianfeng , Xie Yakun , Miao Ying 
Published: April 2022

Abstract
Flag leaf senescence is an important biological process that drives the remobilization of nutrients to the growing organs of rice. Leaf senescence is controlled by genetic information via gene expression and histone modification, but the precise mechanism is as yet unclear. Here, we analysed genome-wide acetylated lysine residue 9 of histone H3 (H3K9ac) enrichment by chromatin immunoprecipitation-sequencing (ChIP-seq), and examined its association with transcriptomes by RNA-seq during flag leaf aging in rice (Oryza sativa). We found that genome-wide H3K9 acetylation levels increased with age-dependent senescence in rice flag leaf, and there was a positive correlation between the density and breadth of H3K9ac with gene expression and transcript elongation. During flag leaf aging, we observed 1249 up-regulated differentially expressed genes (DEGs) and 996 down-regulated DEGs, showing a strong relationship between temporal changes in gene expression and gain/loss of H3K9ac. We produced a landscape of H3K9 acetylation-modified gene expression targets that include known senescence-associated genes, metabolism-related genes, as well as miRNA biosynthesis-related genes. Our findings reveal a complex regulatory network of metabolism- and senescence-related pathways mediated by H3K9ac, and elucidate patterns of H3K9ac-mediated regulation of gene expression during flag leaf aging in rice.
Welcome in my back yard? Explaining cross-municipal opposition to refugees through outgroup size, outgroup proximity, and economic conditions
Authors: De Coninck David , Meuleman Bart 
Published: April 2022

AbstractThis study explores contextual sources of attitudes towards refugees by investigating the impact of outgroup size, outgroup proximity (or the presence of an asylum seekers centre), economic conditions, and their interaction on individuals’ attitudes. We analyse data from a cross-sectional survey of the Belgian adult population in October 2017, enriched with municipality-level indicators of intergroup context and economic conditions. Drawing on multilevel regression analyses, our findings show that proximity to an asylum seekers centre and a higher average taxable income of residents are associated with positive individual attitudes towards refugees, while (changes in) outgroup size are not linked with attitudes among this sample. Additionally, our findings indicate that the positive impact of educational attainment on attitudes is amplified (weakened) in municipalities with a larger (smaller) refugee and asylum seeker group size. In summary, these results highlight the relevance of including outgroup proximity at the local level and interactive relations in contextual studies of outgroup attitudes.