bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-dose intravenous plus inhaled versus intravenous polymyxin B for the treatment of extensive drug-resistant Gram-negative ventilator-associated pneumonia in the critical illnesses: a multi-center matched case–control study
Authors: Liu Jiao , Shao Min , Xu Qianghong , Liu Fen , Pan Xiaojun , Wu Jianfeng , Xiong Lihong , Wu Yueming , Tian Mi , Yao Jianying , Huang Sisi , Zhang Lidi , Chen Yizhu , Zhang Sheng , Wen Zhenliang , Du Hangxiang , TaoWang  , Liu Yongan , Li Wenzhe , Xu Yan , Teboul Jean-louis , Chen Dechang 
Published: August 2022

Abstract
Background
The mortality of extensively drug-resistant Gram-negative (XDR GN) bacilli-induced ventilator-associated pneumonia (VAP) is extremely high. The purpose of this study was to compare the efficacy and safety of inhaled (IH) plus intravenous (IV) polymyxin B versus IV polymyxin B in XDR GN bacilli VAP patients.

Methods
A retrospective multi-center observational cohort study was performed at eight ICUs between January 1st 2018, and January 1st 2020 in China. Data from all patients treated with polymyxin B for a microbiologically confirmed VAP were analyzed. The primary endpoint was the clinical cure of VAP. The favorable clinical outcome, microbiological outcome, VAP-related mortality and all-cause mortality during hospitalization, and side effects related with polymyxin B were secondary endpoints. Favorable clinical outcome included clinical cure or clinical improvement.

Results
151 patients and 46 patients were treated with IV polymyxin B and IH plus IV polymyxin B, respectively. XDR Klebsiella pneumoniae was the main isolated pathogen (n = 83, 42.1%). After matching on age (± 5 years), gender, septic shock, and Apache II score (± 4 points) when polymyxin B was started, 132 patients were included. 44 patients received simultaneous IH plus IV polymyxin B and 88 patients received IV polymyxin B. The rates of clinical cure (43.2% vs 27.3%, p = 0.066), bacterial eradication (36.4% vs 23.9%, p = 0.132) as well as VAP-related mortality (27.3% vs 34.1%, p = 0.428), all-cause mortality (34.1% vs 42.0%, p = 0.378) did not show any significant difference between the two groups. However, IH plus IV polymyxin B therapy was associated with improved favorable clinical outcome (77.3% vs 58.0%, p = 0.029). Patients in the different subgroups (admitted with medical etiology, infected with XDR K. pneumoniae, without bacteremia, with immunosuppressive status) were with odd ratios (ORs) in favor of the combined therapy. No patient required polymyxin B discontinuation due to adverse events. Additional use of IH polymyxin B (aOR 2.63, 95% CI 1.06, 6.66, p = 0.037) was an independent factor associated with favorable clinical outcome.

Conclusions
The addition of low-dose IH polymyxin B to low-dose IV polymyxin B did not provide efficient clinical cure and bacterial eradication in VAP caused by XDR GN bacilli.
Keypoints
Additional use of IH polymyxin B was the sole independent risk factor of favorable clinical outcome. Patients in the different subgroups were with HRs substantially favoring additional use of IH polymyxin B. No patients required polymyxin B discontinuation due to adverse events.
Effect of the Cement-to-Water Ratio and Fractal Granular Model on the Prediction of Concretes Compressive Strength
Authors: Abdeldjalil Mhammed , Chouicha Kaddour 
Published: August 2022

AbstractThe main objective of this work was to highlight the contribution of cement-to-water $$\mathrm{C}/\mathrm{W}$$

C
/
W

ratio and the fractal dimension $$\mathrm{FD}$$
FD
model to the prediction of the compressive strength of concrete. In particular, the fractal dimension $$\mathrm{FD}$$
FD
concept relative to the size distribution of the granular mixtures provided an insight into the fineness and compactness of the granular mixtures. The unconventional fractal granular model $${\mathrm{FGM}}_{\mathrm{g}}$$

FGM
g

also effectively contributed to highlight the correlation between cement-to-water ratio and compressive strength $${\mathrm{R}}_{\mathrm{C}28}$$

R

C
28

of concretes. Initially, 99 granular mixtures of concretes composition available in literature were investigated and for which the granular distributions by means of the fractal dimension $$\mathrm{FD}$$
FD
model and the granular range $$\mathrm{D}/\mathrm{d}$$

D
/
d

were we determined. Then, 36 concrete mixtures endowed with different granular mixtures were elaborated and analysed. These enabled to validate and evaluate the reliability of the basic granular fractal model $${\mathrm{FGM}}_{\mathrm{g}}$$

FGM
g

and the influence of cement–water $$\mathrm{C}/\mathrm{W}$$

C
/
W

ratio of concretes mixtures when predicting the concretes compressive strength $${\mathrm{R}}_{\mathrm{C}28}.$$

R

C
28

.

The analytical model provided a close correlation with the experimental values of the compressive strength $${\mathrm{R}}_{\mathrm{C}28}$$

R

C
28

of all the concretes. The correlation highlighted the relevance of including fractal granular model $${\mathrm{FGM}}_{\mathrm{g}}$$

FGM
g

that denoted the skeleton of the concretes and the cement–water $$\mathrm{C}/\mathrm{W}$$

C
/
W

ratio that referred to the binders into concretes mixtures when predicting $${\mathrm{R}}_{\mathrm{C}28}$$

R

C
28

. The theoretical approach whose effectiveness was highlighted using a "limited" number of real case studies may pave the way for further studies, when selecting the two key-factors for the prediction of concretes compressive strength $${\mathrm{R}}_{\mathrm{C}28}$$

R

C
28

.
Weight gain and parental self-efficacy in a family-based partial hospitalization program
Authors: Van Huysse Jessica L. , Lock James , Le Grange Daniel , Rienecke Renee D. 
Published: August 2022

Abstract
Background
Family-based treatment (FBT) is an outpatient therapy, though FBT principles have been incorporated in higher levels of care (e.g., partial hospitalization programs, PHPs). It is unknown how participation in a family-based PHP impacts weight restoration and parental self-efficacy.

Methods
Weight gain and parental self-efficacy were examined in 98 participants with anorexia nervosa or atypical anorexia nervosa during the first five weeks of participation in a family-based PHP. Maternal self-efficacy was assessed using the Parent versus Anorexia Scale.

Results
Significant increases in weight, percent expected body weight (EBW), and maternal self-efficacy were observed, with large effect sizes. During the first five weeks of treatment, patients in the PHP gained an average of 4.5 kg, or 8.3% EBW. Maternal self-efficacy improved within two weeks of treatment.

Conclusions
Findings suggest that family-based PHPs may facilitate rapid weight restoration without decreasing parental self-efficacy. Randomized trials are needed to directly compare family-based PHPs to outpatient FBT and PHPs with alternate treatment approaches, including longer-term follow-up and cost-effectiveness modeling.
Study on digital protection and innovative design of Qin opera costumes
Authors: Liu Kaixuan , Gao Yuanyuan , Zhang Jiaqi , Zhu Chun 
Published: August 2022

Abstract
Qin opera culture has a long history in China for thousands of years. It is the ancestor of Chinese opera. However, with the development of modern technology and the rise of new media, the protection and inheritance of traditional Qin opera culture is facing a new challenge and opportunity, its costume culture is the same. This paper analyzes the style and structure of Qin opera costumes, extracts the colors of the costumes, summarizes the costume patterns, and then uses the three-dimensional (3D) virtual visualization technology to virtually restore the Qin opera costume, and innovates the Qin opera costume. In this paper, twelve sets of traditional Qin opera costumes are virtually restored, and on this basis, the digital protection and innovative design of Qin opera series costumes are carried out, and all the restored costumes are displayed digitally in an all-round way. The combination of Qin opera costume and digital protection extends the application scope of virtual visualization technology and enriches the transmission mode of Qin opera costume. This study inherits and protects the traditional Qin opera costume culture better.
Stereolithography (STL) measurement rubric for the evaluation of craniomaxillofacial STLs
Authors: Muller Henra , Fossey Annabel 
Published: August 2022

Abstract
Background
Facial deformities often demand reconstructive surgery and the placement of three-dimensional (3D) printed craniomaxillofacial prostheses. Prostheses manufacturing requires patients’ computed tomography (CT) images. Poor quality images result in incorrectly sized prostheses, necessitating repeat imaging and refitting. The Centre for Rapid Prototyping and Manufacturing (CRPM) produces most facial prostheses in South Africa but does not have a prescribed optimised CT protocol. Therefore, this study was undertaken.

Methods
A collection of CRPM STLs used in the design and manufacturing of craniomaxillofacial prostheses is available. The image quality of stereolithography (STL) files of CRPM CT scans was evaluated to determine what constitutes good image quality. This collection was scrutinised for inclusion in the image quality evaluation. After scrutiny, 35 STLs of individuals ≥15 years of age were selected and included metadata attached to the DICOM file. Furthermore, only STLs created without manipulation by the same designer were included in the collection. Before the qualitative evaluation of the STLs, eight different critical anatomical reference points (CARPs) were identified with the assistance of an expert team. A visual acuity rating scale of three categories was devised for each CARP, where 1 was allocated to poor visual acuity, 2 to partial, and 3 to good visual acuity. Similarly, rating scales were devised for the presence of concentric rings and the overall impression score awarded by the two designers involved in the design and manufacturing of the prostheses. This stereolithography measurement rubric (SMR) was then applied to the 35 STLs by a team of three experts, including the two designers, during a structured evaluation session. The scores were used to calculate summary and inferential statistics.

Results
Scores grouped around the central rating of partial visual acuity. The three evaluators’ mean total CARP scores ranged from 13.1 to 14.4 (maximum possible score 24), while the mean total CARP + ring scores ranged from 15.8 to 17.1 (maximum possible score 27). No significant differences were detected between the evaluators’ scores.

Conclusion
This SMR appears to be the first of its kind. This image quality assessment of STLs provides the groundwork for finer CT image quality evaluation to formulate a CT imaging protocol for the CRPM to design and manufacture accurate internal cranial prostheses.
Neuroinflammation in autism spectrum disorders: potential target for mesenchymal stem cell-based therapy
Authors: Wong Rebecca S. Y. 
Published: August 2022

Abstract
Background
Autism spectrum disorders (ASD) include a group of neurodevelopmental disorders characterised by repetitive behaviours and impairments in communication, emotional and social skills. This review gives an overview of ASD, focusing on the aetiological and clinical aspects. It also discusses the role of neuroinflammation in ASD, critically examines the current evidence on the therapeutic effects of MSCs in ASD and consolidates key findings in this area of research.

Results
Many environmental and genetic factors have been linked to the aetiology of ASD. It has become increasingly evident that neuroinflammation plays a role in ASD. Conventional treatment of ASD revolves around psychosocial approaches whereas recent studies have turned to alternative approaches such as mesenchymal stem cell (MSC)-based therapy, owing to the well-recognised immunomodulatory characteristics of MSCs. Preclinical and clinical studies have shown that MSCs were able to exert anti-inflammatory effects and alleviate ASD symptoms.

Conclusions
There are many preclinical studies that support the use of MSCs in ASD. However, there are relatively fewer clinical studies concerning the safety and efficacy of MSCs in ASD, which warrants more large-scale clinical studies for future research.
New concepts in neurology education: successful implementation of flipped classroom lectures
Authors: Mosene Katharina , Heitmann Henrik , Pötter Dennis , Schmidt-Graf Friederike 
Published: August 2022

AbstractIn order to inspire and attract young people to Neurology, we must offer high-quality and attractive teaching! To improve neurological education at our Medical School (Technical University of Munich), we converted the main lecture into an e-learning concept using a flipped classroom model. Students had to prepare with a video and a text as well as answering multiple choice questions before each lecture. As a further incentive, students with ≥ 80% right answers in multiple choice questions received a bonus for the final exam. During the lectures, predominantely patient cases were discussed to apply, improve and enhance the previously acquired knowledge. The realignment of the main lecture in Neurology into a flipped classroom model was very successful and was further optimized in the following semesters based on the evaluations obtained for the new concept. Moreover, this enabled us to quickly switch to remote teaching during the COVID-19 pandemic, while still offering lectures of high quality. In addition, this new teaching concept attracts students for Neurology. Furthermore, the exemplary conversion of the Neurology main lecture to a flipped classroom concept also serves as best practice and motivation to adapt other courses in our faculty and far beyond.
Multiomic approaches reveal novel lineage-specific effectors in the potato and tomato early blight pathogen Alternaria solani
Authors: Wang Jinhui , Xiao Siyu , Zheng Lijia , Pan Yang , Zhao Dongmei , Zhang Dai , Li Qian , Zhu Jiehua , Yang Zhihui 
Published: August 2022

AbstractThe effectome of the necrotrophic fungal pathogen, Alternaria solani, was determined using multiomics. In total, 238 effector candidates were predicted from the A. solani genome, and apoplastic effectors constitute most of the total candidate effector proteins (AsCEPs). Comparative genomics revealed two main groups of AsCEPs: lineage-specific and conserved effectors. RNA-Seq analysis revealed that the most highly expressed genes encoding AsCEPs were enriched with lineage-specific forms. Two lineage-specific effector genes, AsCEP19 and AsCEP20, were found to form a ‘head-to-head’ gene pair located near an AT-rich region on the chromosome. To date, AsCEP19 and AsCEP20 have been found only in a few fungal species. Phylogenetic inference revealed that AsCEP19 and AsCEP20 were likely acquired by the common ancestor of A. solani and A. tomatophila via horizontal gene transfer, probably mediated by long terminal repeat retrotransposon. RT-qPCR analysis showed that AsCEP19 and AsCEP20 are tightly coexpressed in a host-specific manner and that they are upregulated at advanced stages of A. solani infection only in solanaceous hosts. Transient expression of AsCEP19 and AsCEP20 in Nicotiana benthamiana plants showed that these effectors could promote Phytophthora infestans infection. AsCEP19 and AsCEP20 were required for the full virulence of A. solani on host potato, because deletion of this gene pair significantly reduced the size of necrotic lesions on potato leaves. Transient expression of AsCEP20 could elicit plant cell death depending on the presence of its signal peptide, indicating that AsCEP20 is a necrosis-inducing apoplastic effector with the mature form localized specifically in chloroplasts. Our work provides a better understanding of the function and evolution of necrotrophic fungal effectors, and helps explain the high aggressiveness of A. solani against solanaceous crops.
Treatment and Survival Outcomes of Waldenstrom Macroglobulinemia in Latin American Patients: A Multinational Retrospective Cohort Study
Authors: Riva Eloísa , Duarte Patricio José , Valcárcel Bryan , Remaggi Guillermina , Murrieta Ivan , Corzo Ariel , del Carpio Daniel , Peña Camila , Vásquez Jule , Bove Virginia , Teixeira Larissa , Fleury-Perini Guilherme , Yantorno Sebastian , Samánez César , Lopresti Sergio , Altamirano Milagros , Villela Luis , Ruiz-Arguelles Guillermo J. , Ruiz-Delgado Guillermo J. , Montaño Efreen , Verri Verónica , Zamora Pérez Elia , Pérez Jacobo Fernando , Idrobo Henry , Martínez-Cordero Humberto , Beltran Brady E. , Ramírez Jhoanna , Castillo Jorge J. , Malpica Castillo Luis E. 
Published: August 2022

PURPOSE Waldenstrom Macroglobulinemia (WM) is a rare lymphoma with distinct clinical features, and data from Latin American patients are lacking. Therefore, we aim to investigate the clinical, therapy, and outcome patterns of WM in Latin America. METHODS We retrospectively analyzed patients with WM diagnosed between 1991 and 2019 from 24 centers in seven Latin American countries. The study outcomes were overall survival (OS) and progression-free survival (PFS). RESULTS We identified 159 cases (median age 67 years, male 62%). Most patients (95%) were symptomatic at diagnosis. The International Prognostic Scoring System for WM (IPSSWM) at diagnosis was available in 141 (89%) patients (high-risk 40%, intermediate-risk 37%, and low-risk 23%). Twenty-seven (17%) patients were tested for MYD88L265P, with 89% (n = 24 of 27) carrying the mutation. First-line and second-line therapies were administered to 142 (89%) and 53 (33%) patients, respectively. Chemoimmunotherapy was the most commonly used first-line (66%) and second-line (45%) approach; only 18 (11%) patients received ibrutinib. With a median follow-up of 69 months, the 5-year OS rate was 81%. In treated patients, the 5-year OS and PFS rates were 78% and 59%, respectively. High-risk IPSSWM at treatment initiation was an independent risk factor for OS (adjusted hazard ratio: 4.73, 95% CI, 1.67 to 13.41, P = .003) and PFS (adjusted hazard ratio: 2.43, 95% CI, 1.31 to 4.50, P = .005). CONCLUSION In Latin America, the management of WM is heterogeneous, with limited access to molecular testing and novel agents. However, outcomes were similar to those reported internationally. We validated the IPSSWM score as a prognostic factor for OS and PFS. There is an unmet need to improve access to recommended diagnostic approaches and therapies in Latin America.
Disparities in Psychosocial Distress Screening and Management of Lung and Ovarian Cancer Survivors
Authors: Rohan Elizabeth A. , Gallaway M. Shayne , Huang Grace C. , Ng Diane , Boehm Jennifer E. , Samarasinha Ruvini , Stachon Karen 
Published: August 2022

PURPOSE: Since 2016, the American College of Surgeons' Commission on Cancer (CoC) has required routine distress screening (DS) of cancer survivors treated in their accredited facilities to facilitate early identification of survivors with psychosocial concerns. Lung and ovarian cancer survivors have relatively low 5-year survival rates and may experience high levels of distress. We examined the extent to which ovarian and lung cancer survivors received CoC-mandated DS and whether DS disparities exist on the basis of diagnosis, sociodemographic factors, or facility geography (urban/rural). METHODS: This study included a quantitative review of DS documentation and follow-up services provided using existing electronic health records (EHRs). We worked with 21 CoC-accredited facilities across the United States and examined EHRs of 2,258 survivors from these facilities (1,618 lung cancer survivors and 640 ovarian cancer survivors) diagnosed in 2016 or 2017. RESULTS: Documentation of DS was found in half (54.8%) of the EHRs reviewed. Disparities existed across race/ethnicity, cancer type and stage, and facility characteristics. Hispanic/Latino and Asian/Pacific Islander survivors were screened at lower percentages than other survivors. Patients with ovarian cancer, those diagnosed at earlier stages, and survivors in urban facilities had relatively low percentages of DS. Non-Hispanic Black survivors were more likely than non-Hispanic White survivors to decline further psychosocial services. CONCLUSION: Despite the mandate for routine DS in CoC-accredited oncology programs, gaps remain in how many and which survivors are screened for distress. Improvements in DS processes to enhance access to DS and appropriate psychosocial care could benefit cancer survivors. Collaboration with CoC during this study led to improvement of their processes for collecting DS data for measuring standard adherence.
Virtual Tumor Board Increases Provider Attendance and Case Presentations
Authors: Davis Catherine H. , Ho Jason , Stephenson Ryan , August David A. , Gee Heather , Weiner Joseph , Alexander H. Richard , Pitt Henry A. , Berger Adam C. 
Published: August 2022

PURPOSE: Many cancer centers engage in multidisciplinary tumor board meetings to determine the optimal approach to complex cancer care. With the onset of the COVID-19 pandemic, many institutions changed the format of these meetings from in-person to virtual. The aim of this study was to determine if the change to a virtual meeting format had an impact on attendance and cases presented. METHODS: Tumor board records were analyzed to obtain attendance and case presentation information at a National Cancer Institute–designated Comprehensive Cancer Center. Twelve-month in-person tumor board data were compared with 12-month virtual tumor board data to assess for difference in attendance and case presentation patterns. RESULTS: Seven separate weekly tumor board meetings at the beginning of the study (breast, GI, gynecology, liver, lung, melanoma, and urology) were expanded to nine meetings on the virtual platform (+endocrine and pancreas). Overall attendance increased by 46% on the virtual platform compared with in-person meetings (4,030 virtual attendances v 2,753 in-person, P < .001). Increased attendance was present across all specialties on the virtual platform. In addition, the number of patient cases discussed increased from 2,127 in in-person meeting to 2,656 on the virtual platform (a 20% increase, P < .001). CONCLUSION: A significant increase was observed in overall tumor board attendance and in case presentations per meeting, requiring the expansion of additional weekly meetings. Furthermore, in a major cancer center with multiple community affiliates, virtual tumor boards may encourage increased participation from remote sites with the benefit of obtaining expert specialist advice as compared with geographically challenging in-person meetings.