bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective study of Enterococcus faecalis infective endocarditis: comparison of clinical characteristics and outcomes associated with treatment
Authors: Vigneswaran Nilanthy , McKew Genevieve 
Published: April 2022

Abstract
Introduction:A synergistic antibiotic combination of a penicillin and gentamicin (AG) is recommended first line management of Enterococcus faecalis infective endocarditis (EFIE). We compare the treatment outcomes between the conventional AG regimen to those treated with a combination of penicillin and ceftriaxone (AC). Given reported beta lactam toxicity risks, we also examine the difference in treatment outcomes between regimens of low dose, 1g 12 hourly (ACL) and high dose ceftriaxone, 2g 12 hourly (ACN) in combination with penicillin.Methods:A retrospective cohort study of patients treated for EFIE at single tertiary centre (2012–2019). Outcome measures examined are 90 & 180-day mortality, treatment associated adverse events, and relapse of bacteremia (within 1 year).Results:39 patients were enrolled [59% given (AC) (n = 24), 24% received ACL (n = 10) and 34% received ACN (n = 14)]. 39% received AG (n = 15). We found no significant difference in the mortality outcomes at 90 and 180 days between: a) those treated with a gentamicin combination and ceftriaxone combination overall (P = .114, P = .061) and b) between high and low dose ceftriaxone (P = 1.0, P = .673). No significant difference was noted between the above groups in incidence of relapsed bacteremia (P = .662, P = .414). A greater number of adverse events was observed in the gentamicin group compared to the overall ceftriaxone group (P = .009), with no difference between the high and low dose ceftriaxone groups (P = .05).Conclusion:Combination treatment with penicillin/ceftriaxone appears to be as effective (using low and high dose ceftriaxone) as penicillin/gentamicin in EFIE, with a lower rate of adverse events.
Development of machine learning models to predict ambulation outcomes after spinal metastasis surgery
Authors: Chavalparit Piya , Wilartratsami Sirichai , Santipas Borriwat , Ittichaiwong Piyalitt , Luksanapruksa Panya 
Published: April 2022

Abstract
Background: Postoperative ambulation status after spinal metastasis surgery is currently difficult to predict. Improved ability to predict this important postoperative outcome would improve management decision-making and help in determining realistic goals of treatment. Accordingly, this study set forth to develop machine learning models to predict ambulation outcomes after surgery for spinal metastasis.Methods: This retrospective study included patients who underwent spinal metastasis at a university-based medical center in Thailand during January 2009-November 2021. Collected data included preoperative parameters, and ambulatory status at 90 and 180 days after surgery. Seven machine learning algorithms, including decision tree, random forest, XGBoost, logistic regression, support vector machine (SVM), neural network, and stochastic gradient descent (SGD), were developed to predict ambulatory status at 90-days and 180-days postoperation. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) and F1-score.Results: A total of 178 patients were enrolled. The number of patients classified as ambulatory at 90-days and 180-days after surgery was 150 (84.3%) and 145 (81.5%) respectively. The XGBoost algorithm was found to most accurately predict 180-day ambulatory outcome (AUC: 0.92, F1-score: 0.92), and the random forest algorithm was shown to most accurately predict 90-day ambulatory outcome (AUC: 0.95, F1-score: 0.94).Conclusion: Machine learning algorithms were shown to be effective for predicting ambulatory status after surgery for spinal metastasis. The XGBoost and random forest algorithms best predicted postoperative ambulatory status at 180-days and 90-days after spinal metastasis surgery, respectively.
Quorum sensing plays an important role in heteroresistance regulation of Pseudomonas aeruginosa
Authors: Lu Yang , Liu Yuyang , Zhou Chenxu , Long Yifei , Lin Dongling , Xiong Rui , Xiao Qian , Huang Bin , Chen Cha 
Published: April 2022

Abstract
Background: The prevalence and genetic mechanism of antibiotic heteroresistance attracted more and more research attentions. However, its non-genenic mechanism is still largely unknown. As the most important mechanism that enable individual bacteria to coordinate their behavior in populations, the influence of Quorum sensing (QS) on heteroresistance was disclosed here. Results: We investigated the prevalence of heteroresistance in 170 clinical isolates of P. aeruginosa against 7 different antibiotics. The population analysis profiles showed that P. aeruginosa was frequently heteroresistant to meropenem (MEM), amikacin (AMK), ciprofloxacin (CIP) and Ceftazidime (CAZ), which was related to down-regulated expression of QS genes lasI and rhlI. Further loss-of-function studies revealed that deficiency of lasI/rhlI facilitated heteroresistance of P. aeruginosa to all the above four antibiotics, which was abrogated by overexpression of lasI/rhlI or treatment with 3-oxo-C12-HSL/C4-HSL. In addition, we found that the expression of oprD and efflux-associated genes was regulated by lasI/rhlI, while downregulation of oprD and upregulation of efflux-associated genes was observed in heteroresistant subpopulation. Conclusions: These data suggest that QS plays a crucial role in heteroresistance regulation, partially mediated by oprD and efflux-associated genes. Our findings highlight the new function of QS and provide new insight into the mechanism of heteroresistance in the context of non-genetic factor.
Implementing a home-based personalised cognitive rehabilitation intervention for people with mild-to- moderate dementia: GREAT into Practice
Authors: Clare Linda , Kudlicka Aleksandra , Collins Rachel , Evans Suzannah , Pool Jackie , Henderson Catherine , Knapp Martin , Litherland Rachael , Oyebode Jan , Woods Robert 
Published: April 2022

Abstract
BackgroundEvidence-based rehabilitative interventions, if widely implemented, could equip people with dementia and their families to manage life with the condition and reduce the need for health and care services. The aim of this translational study, building on evidence from the GREAT randomised controlled trial, was to develop a foundation for implementing the GREAT Cognitive Rehabilitation intervention in community-based services for people with mild-to-moderate dementia.MethodsThe implementation strategy drew on several theoretical frameworks; key elements were identifying and supporting managerial and clinical leadership, conducting collaborative planning and target-setting, training and supporting practitioners, and providing external facilitation. We developed implementation plans with, and trained staff in, 14 organisations. We subsequently worked closely with 11 of these, 10 National Health Service organisations and one private home care provider, to support practitioners to deliver GREAT Cognitive Rehabilitation over a 12-month period. Outcome evaluation examined the perspectives of local steering group members, practitioners and service users, and the reach, effectiveness and cost of the intervention.Results Implementation was disrupted by the COVID-19 pandemic, but six organisations completed at least six months of intervention delivery. Forty-one practitioners, mainly occupational therapists, provided the intervention, and 54 people with dementia completed a course of GREAT Cognitive Rehabilitation. Goal attainment by people with dementia exceeded levels of improvement seen in the original trial. People with dementia, carers and practitioners all evaluated the intervention positively. Economic analysis indicated that the intervention could be provided at modest cost. Local steering group members believed the intervention benefitted staff and led to better outcomes for people with dementia, but identified a range of organisational barriers that impeded implementation and limited the potential for sustainability.ConclusionsGREAT Cognitive Rehabilitation benefits people with dementia, can be delivered effectively at modest cost in routine services, and is viewed positively by people with dementia, family carers and practitioners. To fully realise these benefits and achieve widespread and sustainable implementation, however, requires sufficient resources and a reorientation of service priorities towards preventive and rehabilitative approaches.RegistrationNational Institute for Health Research (NIHR) Central Portfolio Management System, registration number 38994
Source apportionment and risk assessment of heavy metals in urban soils from a Central China city by using Positive matrix factorization model coupled with Monte Carlo simulation
Authors: Shen Lianfeng , Zeng Jin , Guo Erhui , Cheng Yongxia , Li Limei , Niu Cunyang , Yuan Yuan , Ma Li 
Published: April 2022

Abstract
Urban soils are an integral ingredient of the urban ecosystem, and whether heavy metals do harm to the city inhabitant health has been brought to the forefront. A total of 78 urban soil samples were collected from Zhengzhou, and the contamination level, source apportionment, concentration-oriented and source-oriented risk evaluation of pollution elements in the samples were carried out in the study. Results showed that Cd was the most serious contaminant and constituted considerable ecological risk compared to other elements. Four Factors (natural source, industrial production, agricultural activities and traffic discharges) were distinguished through the positive matrix factorization model in conjunction with correlation analysis, and their respective contribution rates were 18.73%, 33.22%, 23.91% and 24.14%. The probability distribution of health risk assessed by means of Monte Carlo simulation revealed that non-carcinogenic risks associated with heavy metals were acceptable for both adults and children, while the total carcinogenic risk values remained relatively high. Moreover, the children were more susceptible to health risks in comparison to adults, and the ingestion way was considered to be the major exposure pathway. The results of source-oriented health risk demonstrated that the agricultural source was the major contributor to health risks, which was characterized by As, Ni and Co.
Lacrimal gland measurements in patients with Graves’ ophthalmopathy
Authors: Yuksel Elmas , Sukun Abdullah 
Published: April 2022

Abstract
Purpose
Lacrimal gland sizes are increased in Graves' ophthalmopathy. Lacrimal gland herniation has been reported to be a simple radiological marker. This study aimed to investigate the relationship of lacrimal gland herniation (LGH) with lacrimal gland dimensions, proptosis, and hormonal parameters.
Methods
Sixty-eight eyes of 34 patients with Graves' ophthalmopathy were evaluated. Lacrimal gland herniation, proptosis, the long and short axis of the lacrimal gland were measured in mm on the right and left sides. TSH, FT4, FT3, Anti-TPO and Anti-TG values of each patient were recorded. Multiple linear regression was applied to determine the factors affecting lacrimal gland herniation.
Results
21 female 13 male 34 patients were included in this study. The mean age of the patients was found to be 37.29 ± 11.91 years The regression model for LGH was found to be statistically significant. (R2 right eye :0.57 R2 left eye 0.51 p < 0.001). The predictive variables for LGH were short diameter of the lacrimal gland and proptosis. No statistical significance was found in other variables (p < 0.05). The equation showing right LGH in millimeters was found as-5.268 + Lacrimal gland short-axis x 1.271 + Proptosis x 0.284. The equation showing left LGH in millimeters was found as-3.598 + lacrimal gland short-axis x 0.937 + Proptosis x 0.292.
Conclusions
Lacrimal gland herniation is associated with lacrimal gland short diameter and proptosis. Our findings support that lacrimal gland herniation may be an important and useful radiological marker in Graves' ophthalmopathy.
The prevalence of multimorbidity and its associations in community-dwelling older adults in rural Tanzania; a cross- sectional study
Authors: Lewis Emma Grace , Gray William K. , Walker Richard , Urasa Sarah , Witham Miles , Dotchin Catherine 
Published: April 2022

Abstract
Objectives: This paper aims to describe the prevalence, patterns and factors associated with multimorbidity, by both self-report and clinical assessment/screening methods in community-dwelling older people living in rural Tanzania. Methods: A randomised frailty-weighted sample of non-institutionalised adults aged ≥60 years underwent comprehensive geriatric assessment and in-depth assessment. The comprehensive geriatric assessment consisted of a history and focused clinical examination. The in-depth assessment included standardised questionnaires, screening tools and blood pressure measurement. The prevalence of multimorbidity was calculated for self-report and non-self-reported methods (clinician diagnosis, screening tools and direct measurement). Multimorbidity was defined as having two or more conditions. The socio-demographic associations with multimorbidity were investigated by multivariate logistic regression.Results: A sample of 235 adults participated in the study, selected from a screened sample of 1207. The mean age was 75 years (range 60 to 110) and 136 (57.8%) were women. Adjusting for frailty-weighting, the prevalence of self-reported multimorbidity was 26.1% (95% CI 16.7-35.4), and by clinical assessment/screening was 67.3% (95% CI 57.0-77.5). Adjusting for age, sex, education and frailty status, multimorbidity by self-report increased the odds of being financially dependent on others threefold (OR 3.3 [95% CI 1.4-7.8]), and of a household member reducing their paid employment nearly fourfold (OR 3.8. [95% CI 1.5-9.2]).Conclusions: Multimorbidity is prevalent in this rural lower-income African setting and is associated with evidence of household financial strain. Multimorbidity prevalence is higher when not reliant on self-reported methods, revealing that many conditions are underdiagnosed and undertreated.
Designed Rubredoxin miniature in a fully artificial electron chain triggered by visible light
Authors: Chino Marco , Costanzo Luigi Di , Leone Linda , Gatta Salvatore La , Famulari Antonino , Chiesa Mario , Lombardi Angela , Pavone Vincenzo 
Published: April 2022

Abstract
Designing metal sites into de novo proteins has significantly improved, recently. However, identifying the minimal coordination spheres, able to encompass the necessary information for metal binding and activity, still represents a big challenge, today. Here, we tested our understanding with a benchmark, nevertheless difficult, case. We assembled in a small 28-residue peptide the quintessential elements required to correctly fold around a single iron redox center, coordinated to four cysteinyl thiolates (FeCys4 site), and to efficiently function in electron-transfer. This study represents a milestone in de novo protein design: for the first time the crystal structure of a designed tetra-thiolate metal-binding protein is reported within sub-Å agreement with the intended design. This allowed us to well correlate structure to spectroscopic and electrochemical properties. Given its high reduction potential compared to natural and designed FeCys4-containing proteins, we exploited it as terminal electron acceptor of a fully artificial chain triggered by visible light.
The influence of a single water molecule on the reaction of BrO + HO2
Authors: Ma Lu , He Bing , Zhao Meilian , Liu Yongguo , Song Ruojing , Du Huaming , Li Huirong , Zhang Yunju 
Published: April 2022

Abstract
The influence of a single water molecule on the BrO + HO2 hydrogen extraction reaction has been explored by taking advantage of CCSD(T)/aug-cc-pVTZ//B3LYP/6-311++G(d,p) method. The reaction in the absence of water have two distinct kinds of H-extraction channels to generate HOBr + O2 and HBr + O3, and the channel of generation of HOBr + O2 occupied the BrO + HO2 reaction. The rate coefficient of the most feasible channel for the BrO + HO2 reaction in the absence of water is estimated to be 1.44 ´ 10-11 cm3 molecule-1 s-1 at 298.15 K, which is consistent with the experiment. The introduction of water made the reaction more complex, but the products are unchanged. Four distinct channels, beginning with HO2…H2O with BrO, H2O…HO2 with BrO, BrO…H2O with HO2, H2O…BrO with HO2 are researched. The most feasible channels, stemming from H2O…HO2 with BrO, and BrO…H2O with HO2, are much slower than the reaction of BrO + HO2 without water, respectively. Thus, the existence of water molecule takes a negative catalytic role for BrO + HO2 reaction.
Suprachoroidal Injection of Triamcinolone Acetonide Plus Intravitreal Bevacizumab in Diabetic Macular Edema: A Randomized Pilot Trial
Authors: FAZEL FARHAD , MALEKAHMADI MOHAMMAD , FEIZI AWAT , OLIYA BEHROOZ , DINANI MEHDI TAVAKKOLI , FAZEL MOHAMMADREZA 
Published: April 2022

Abstract
Background: to investigate the efficacy of injecting suprachoroidal triamcinolone acetonide (SCTA) plus intravitreal bevacizumab (IVB) into patients with center-involving diabetic macular edema (CI-DME).Methods: In this phase 2/3 randomized controlled pilot trial, sixty-six eyes with CI-DME and best-corrected visual acuity (BCVA) of at most 20/50 Snellen chart were randomly assigned into two groups. Monotherapy arm received sham injection plus 3 monthly IVB doses and combination arm received a single dose of SCTA and 3 monthly IVB doses. The mean improvements in BCVA and Central subfield thickness (CST), over the three-month was considered the main efficacy outcomes. Results: The mean BCVA improvements were obtained respectively as -0.20±0.20 log [minimum angle of resolution (MAR)] (P=0.004) and 0.37±0.24 log MAR (P<0.001) in monotherapy and combination arms [between-group analysis (P=0.014)]. Significant improvements were also observed in CST (P=0.019) in the combination arm compared to the other. No adverse events (elevated intraocular pressure, cataract) were observed in any of the study arms.Conclusion: Significant improvements in BCVA and retinal anatomical outcomes demonstrated the additive effects of SCTA to those of anti-vascular endothelial growth factors with no short-term side effects and this combination appears to be a promising option in the management of patients with CI-DME.Trial Registration: The trial was registered in Iranian Registry of Clinical Trials (IRCT20200314046761N1).
Synthesis of Amino Acids by Electrocatalytic Reduction of CO2 on Chiral	Cu	Surfaces
Authors: Fang Yuxi , Liu Xi , Liu Zhipan , Han Lu , Ai Jing , Zhao Gui , Terasaki Osamu , Cui Cunhao , Yang Jiuzhong , Liu Chengyuan , Zhou Zhongyue , Chen Liwei , Che Shunai 
Published: April 2022

Abstract
CO2 reduction and fixation products ranging from small molecules to biomolecules, are highly diverse in natural systems. Athough various multicarbon products of CO2 reduction were artificially obtained, the C3+ products with various functional groups (e.g., C-N and C=O bonds), especially biomolecules, have never been reported. Herein, we synthesized C3+ amino acids via electrocatalytic reduction from CO2 and NH3 using chiral Cu films (CCFs) as electrodes. Electron microscopy and theoretical calculations suggested that chiral kink sites Cu(653) is the most likely formed on the surface of CCFs fabricated by electrodeposition in the presence of Histidine (His). Serine (Ser), with an enantiomeric excess (ee) greater than 90% is the main component of various amino acids. Experimental and computational data showed that the 3-hydropyruvic acid formation from OCH2CO* is the stereo-determining step in the Ser formation pathway. The Cu(653) was speculated to be restricting the configuration changes of C3+ intermediates to involve a thermodynamically and kinetically favourable formation of enantiomeric Ser.
DDIT4 overexpression promotes cervical cancer metastasis via the activation of an epithelial–mesenchymal transition
Authors: Lin Xinxin , Yoshikawa Nobuhisa , Liu Wenting , Matsukawa Tetsuya , Nakamura Kae , Yoshihara Masato , Koya Yoshihiro , Sugiyama Mai , Tamauchi Satoshi , Ikeda Yoshiki , Yokoi Akira , Kajiyama Hiroaki 
Published: April 2022

Abstract
Metastasis is a major challenge in the treatment of cervical cancer patients. This study was aimed to identify a novel metastasis-promoting molecule and elucidate its functional role in cervical cancer. Multiple databases was used to identify molecules associated with metastasis of cervical cancer. DDIT4 (DNA-damage-inducible transcript 4), a hypoxia-inducible gene, was identified in this analysis. Correlation between DDIT4 expression and lymph node metastasis was evaluated by immunohistochemistry. Transwell® assay and wound-healing assay to determine cell migration and invasion was performed. DDIT4 was knocked down using siRNA and lentiviral vectors. The potential downstream effects of DDIT4 were explored and verified by a gene set enrichment analysis and western blotting. The in vivo metastatic capability of cervical cancer regulated by DDIT4 was determined with the use of an intraperitoneal-injection mouse model. DDIT4 was an independent prognostic factor for patients with early-stage cervical cancer, according to both public database and our cohort. In our clinical samples, the expression of DDIT4 in immunohistochemistry was strongly associated with metastasis and hypoxia. The knockdown of DDIT4 attenuated the migration and invasion activity of tumor cells in vitro, and reduced the expression of epithelial–mesenchymal transition (EMT) related proteins and the NF-κB pathway in cervical cancer cells. DDIT4 also promoted metastasis in the mouse model. Our results define the DDIT4 as a novel metastasis-promoting pathway of EMT and NF-κB pathway that mediates cancer migration and invasion. DDIT4 may thus become a prognostic marker and a potential target for cervical cancer metastasis.
Modeling a BCG Birth Dose-based Vaccination Program for Improved Hepatitis B Control in Uganda: Mixed-methods study
Authors: Makhoba Anthony , Nakibuuka Victoria , Mugenyi Martin , Nanjobe Plaxeda , Lwetabe Michael , Nyaranga⁶ Felistas , Kyoyagala Stella , Kumbakumba⁷ Elias , Scheifele David 
Published: April 2022

Abstract
Background: Hepatitis B virus (HBV) is mainly transmitted perinatally. Delaying the first dose of HBV vaccine to 6 weeks of age as is the current practice in Uganda may increase the risk of perinatal transmission. In this study, we aimed to assess the uptake of BCG vaccine within 24 hours after birth and to assess the feasibility of BCG/HBV vaccine co-administration in Uganda.Methods: This was a mixed-methods study. We retrospectively collected data on BCG vaccine uptake, the timing of vaccination, and reasons for missed/delayed vaccination, at two hospitals: capital city-based St. Francis Hospital Nsambya (SFHN), and upcountry-based Mbarara Regional Referral hospital. We also conducted a cross-sectional study at SFHN to explore factors associated with delayed or missed BCG vaccination within 24 hours after birth.Results: Of the 2,002 newborn babies randomly sampled, 1,534 (76.5%) received BCG vaccine within 24 hours. On chart review, 140 participants had identifiable reasons for delayed BCG vaccination as follows: admission to neonatal unit with birth asphyxia (56.2%, n= 73), and birth weight <2.5kg (30.8%, n=40). On interviewing 73 mothers at vaccination clinics, admission to a neonatal unit for prematurity (n= 42, 57.5%), birth asphyxia (n= 73, 56.2%) or birth weight < 2.5kg (n=40, 30.2%) were the reasons for missed/delayed vaccination. The median human cost for the BCG vaccination process was $0.14.Conclusions: Over three-fourth of neonates received their BCG vaccine within 24 hours after birth, providing a convincing basis for co-administration of BCG and HBV vaccines.