bluuebunny/crossref_metadata_2025_split huggingface dataset:
“I didn’t know it was going to be like this.”: End of Life Care Experiences of Care Aides Care in Long-term Care
Authors: Booi Laura , Sixsmith Judith , Chaudhury Habib , O'Connor Deborah , Surr Claire , Young Melanie , Sixsmith Andrew 
Published: August 2022

Abstract
Background: Care aides provide upwards of 90% of the direct care for residents in long-term care (LTC) and thus hold great potential in improving residents’ quality of life and end-of-life (EoL) care experiences. Although the scope and necessity of the care aide role is predicted to increase in the future, there is a lack of understanding around their perceptions and experiences of delivering EoL care in LTC settings.Methods: Data were collected over ten months of fieldwork at one long-term care home in western Canada; semi-structured interviews (70 hours) with 31 care aides; and naturalistic observation (170 hours). Data were analysed using Reflexive Thematic Analysis.Results: Three themes were identified: (i) the lack of training and preparedness for the role of EoL care; (ii) the emotional toll that delivering this care takes on the care aids and; (iii) the need for healing and support among this workforce. Findings show that the vast majority of care aides reported feeling unprepared for the delivery of the complex care work required for good EoL care. Findings indicate that there are not adequate resources available for care aides’ to support the mental and emotional aspect of their role in the delivery of EoL care in LTC. Participants shared unique stories of their own self-care traditions to support their grief, processing and emotional healing. Conclusions: The care aides’ role in LTC is of increasing importance, especially in relation to the ageing population and the delivery of EoL care. To facilitate the health and wellbeing of this essential workforce, care aides need to have appropriate training and preparation for the complex care work required for good EoL care. It is essential that mechanisms in LTC become mandatory to support care aides' mental health and emotional wellbeing in this role.
Forgetting provide a clue to sudden death due to acute aortic dissection
Authors: WANG Junwen , SUN Ziyi 
Published: August 2022

Abstract
Acute aortic dissection (ADD) is the frequently diagnosed lethal disease of the aorta. Some of the patients with acute aortic dissection is complicated by neurological symptoms. Although there are previous reports of the clinical characteristics of patients with aortic dissection presenting with neurological symptoms, acute aortic dissection with forgetting as first manifestation has not been well described. To increase the clinician awareness of AAD, we firstly reported one male Chinese patient to present with forgetfulness as an initial symptom as the first manifestation. A 53-year-old man presented at the emergency department with forgetting. First, stroke must be considered early in the differential diagnosis, as “time is brain.” Secondly, the diagnosis was acute myocardial infarction, and emergent coronary angiogram are examined. At long last, the ADD was diagnosed with enhanced CT. Thus, a much of valuable time is lost in diagnosis rather than for the treatment. Timing of surgery Optimal timing for surgery have already missed. patients while waiting for emergency surgery died following aortic dissection rupture. In patients presenting with cannot entirely account for forgetting, ADD should be considered. We believe this case report contains a worthwhile clinical lesson for clinicians.
Caspase-1 -dependent pyroptosis are associated with immune reconstruction failure in HIV-positive patients receiving antiretroviral therapy: a cross-sectional study
Authors: Lao Xiaojie , Mei Xinyin , Zou Jun , Xiao Qing , Ning Qiuyue , Xu Xianli , Zhang Chunlan , Ji Lei , Deng Shengwei , Lu Bingyang , Chen Maowei 
Published: August 2022

Abstract
BackgroundHighly Active Anti-Retroviral Therapy (HAART) can successfully suppress HIV-1 viral replication and reconstruct immune function reconstruction in HIV infected patients. However, about 15-30 % of HIV infected patients still fail to recover their CD4+T cell counts after HAART treatment, which means immune reconstruction failure. Pyroptosis plays an important role in the death of CD4+T cells in HIV infected patients. The study aims to explore the association between the expression of pyroptosis in peripheral blood and immune function reconstruction in HIV infected patients.MethodsOne hundred fifty-three HIV-infected patients including immunological nonresponders group (INR), immunological responders group (IR) and normal immune function control group (NC) were analyzed. The expression of GSDMD and Caspase-1 in peripheral blood of HIV infected patients were measured by qPCR. The concentrations of IL-1β and IL-18 in the peripheral serum were quantified by ELISA. The associations between the expression of pyroptosis in peripheral blood and immune function reconstruction were analyzed using multivariate logistic models.ResultsThe relative expression of GSDMD mRNA and caspase-1 mRNA in peripheral blood, as well as the expression of IL-18 cytokine in the INR, were significantly higher than those in the IR and NC(P<0.05). There was no significant difference in expression of IL-1β cytokine (P>0.05). Multivariate logistic analysis showed that the patients with baseline CD4+T cell counts less than 100 cells/μL (aOR=5.913, 95%CI=1.061-32.958, P=0.043), high level of expression of Caspase-1mRNA (aOR=2.833,95%CI=1.127-7.126, P=0.027) and IL-18 cytokine (aOR=8.569, 95%CI=1.661-44.195, P=0.010) had significant poor CD4+T cell recovery. ConclusionsThe pyroptosis was overactivated in peripheral blood in HIV infected patients with immune reconstitution failure. The baseline CD4+T cell count less than 100 cells/μL, high relative expression of Caspase-1 mRNA, and high expression of IL-18 cytokine are independent risk factors that affect the reconstruction of immune function.
Selenoprotein Sepp1 regulates Cysteine Dependence in Pancreatic Cancer
Authors: Amer Arslan , Alothaim Tahiyat , Tang Xiaohu 
Published: August 2022

Abstract
Metabolic deregulations frequently occur in various cancers and differentiate cancer cells from normal cells. Such changes predispose cancer cells to potential vulnerabilities. There is rising interest in developing novel therapies to target tumor metabolic vulnerability. Pancreatic ductal adenocarcinoma (PDAC) is the most common type of cancer in pancreas and ranks as the second most lethal cancer in USA due to lack of effective targeted therapy options. Targeting cysteine dependence of cancer cells by blocking cysteine uptake or inhibition of glutathione peroxidase 4 (GPX4) can eliminate many types of cancer cells via ferroptotic cell death. We observed that PDACs show differential vulnerability to cysteine depletion, which associates with the epithelial-mesenchymal transition (EMT) status of tumor cells. Two subtypes of PDAC are derived from these phenotypic disparities: The mesenchymal-type tumor cells are significantly sensitive to targeted cysteine therapy, while the epithelial-type responds reluctantly. We found that the selenoprotein Sepp1 expression is greatly reduced in mesenchymal tumor cells, and its suppression sensitizes epithelial-type tumor cells to ferroptosis inducers. Sepp1 is a major reservoir and transporter of selenium in plasma and functions as a tissue and cell antioxidant. In line with this, addition of selenium alleviates cell reliance on cysteine and protects mesenchymal-type tumor cells from ferroptosis inducers. We further revealed that loss of Sepp1 compromises activity of the thioredoxin system by gene regulation on both transcriptional and translational levels. Overall, our findings suggested that Sepp1 regulates cysteine-dependence by modulating the thioredoxin system. Also, the inhibition of thioredoxin reductases can synergize with targeted cysteine therapy to overcome drug resistance in epithelial-subtype pancreatic cancer.
Using neural networks to detect fire from overhead images
Authors: Kurasinski Lukas , Tan Jason , Malekian Reza 
Published: August 2022

Abstract
The use of artificial intelligence (AI) is increasing in our everyday applications. One emerging field within AI is image recognition. Research that has been devoted to predicting fires involves predicting its behaviour. That is, how the fire will spread based on environmental key factors such as moisture, weather condition, and human presence. The result of correctly predicting fire spread can help firefighters to minimise the damage, deciding on possible actions, as well as allocating personnel effectively in potentially fire prone areas to extinguish fires quickly. Using neural networks (NN) for active fire detection has proven to be exceptional in classifying smoke and being able to separate it from similar patterns such as clouds, ground, dust, and ocean. Recent advances in fire detection using NN has proved that aerial imagery including drones as well as satellites has provided great results in detecting and classifying fires. These systems are computationally heavy and require a tremendous amount of data. A NN model is inextricably linked to the dataset on which it is trained. The cornerstone of this study is based on the data dependencieds of these models. The model herein is trained on two separate datasets and tested on three dataset in total in order to investigate the data dependency. When validating the model on their own datasets the model reached an accuracy of 92% respectively 99%. In comparison to previous work where an accuracy of 94% was reached. During evaluation of separate datasets, the model performed around the 60% range in 5 out of 6 cases, with the outlier of 29% in one of the cases.
How inappropriate cabling prevents hospitals from becoming "smart" and future communication system management concerns
Authors: HANADA Eisuke , KUDOU Takato 
Published: August 2022

Abstract
Most hospitals have introduced Information and Communication Technology (ICT), and the COVID-19 pandemic has resulted in the increased use of wireless communication to achieve a more “contactless” medical environment. The most common applications of wireless communication systems in hospitals include patient data collection and sharing, voice communication, and authentication. Transmission of physician's instructions that are input to the hospital information system can now be done through wireless LAN functions in medical settings. Such systems can be expected to greatly expand in the future. However, problems with the reliability of data transmission in wireless communication systems have arisen. In a survey by the Japanese government, nearly half of the hospitals answered that they had experienced problems with wireless communication. Here, we describe architectural problems that may become obstacles to the future expansion of wireless communication, then propose countermeasures.
Quality of medicines in Sri Lanka: A retrospective review of safety alerts
Authors: Janani Tharmalinga Sharma Jegath , Ketharam Madumai , Herath Kaumada Binoli , Shobia Senathiraja Sherley 
Published: August 2022

Abstract
Background
Quality of medicines is necessary to ensure patient safety. Quality failures of medicines could result in patient harm. Many medicine quality problems are detected after they arrive at health facilities. Medicine withholds and recalls are conducted for critically defective medicines that pose health risks to patients.
Aims
To investigate the withheld and recalled medicines in relation to the types of defects, their frequencies, therapeutic categories, pharmaceutical dosage forms, and country of manufacturer.
Methods
A retrospective review was done on withheld and recalled medicines published on the publicly available National Medicines Regulatory Authority (NMRA) official website, Sri Lanka between June 2018 and January 2022. Two categories of defective medicine alerts were identified: falsified medicines (FM) and substandard medicines (SM), out of which SM were extracted and included as none of the FM was reported in Sri Lanka. Each record of SM was individually reviewed to determine the type of defect, therapeutic category, pharmaceutical dosage form, manufacturer with respect to his country and respective frequencies.
Results
Among 163 total defects reported, the most common types of defects were contamination (N = 59, 36.2%), stability defects (N = 41, 25.2%), packaging and labelling defects (N = 27, 16.6%) and Active Pharmaceutical Ingredient (API) defects (N = 26, 15.9%). Out of 143 total defective medicines identified, anti-infectives (for systemic use) accounted for 42.2%, while parenteral preparations (N = 63, 44.0%) were found to be frequently defective. Nearly 70% of the recalled and withheld medicines were of Indian origin and seven manufacturers were identified as repeatedly involved with medicine withholds and recalls.
Conclusions
Substandard medicines are a problem in Sri Lanka and have resulted in an increasing number of withheld and recalled medicines. This study revealed that contaminations were the most frequent cause of defective medicines while parenteral preparations and anti-infectives were the most susceptible pharmaceutical dosage form as well as therapeutic category to be substandard. In addition, some manufacturers were accountable for repetitive withholds and recalls. Therefore, this review highlights the need of investigating the underlying causes and preventive measures to be implemented by manufacturers and regulatory authorities to avoid similar episodes in future.
Integrative snRNA-seq and snATAC-seq profiling revealed the dynamic nuclear heterogeneity and lineage-specific regulatory architecture of the human placental syncytiotrophoblast
Authors: Wang Hongmei , Wang Meijiao , Liu Yawei , run sun , Liu Fenting , Zhang Jixiang , Yan Long , Wang Yiming , Li Shiwen , Zhu Xili , Li Rong , Lu Falong , Xiao Zhenyu 
Published: August 2022

Abstract
The significance of the placenta in success pregnancy outcome has been generally acknowledged. Despite our growing understanding of placenta cellular compositions and function, the heterogeneity among billions of nuclei within the syncytiotrophoblast (STB), a multinucleated entity primarily responsible for placental function, remains largely understudied. To better understand the identity of nuclei within STB, we applied integrated single-nucleus RNA-seq (snRNA-seq) and single-nucleus sequencing assay for transposase-accessible chromatin (snATAC-seq) on human placentas at early and late pregnancy. We inferred dynamic STB nuclear-heterogeneity, lineage-determining enhancer gene-regulatory networks and differentiation trajectories of STB nuclei and revealed their crucial biological features. Intriguingly, we found that nascent STB nuclei were involved in diverse biosynthetic processes that might be coordinated by MAPK and Erbb siganling cascades, and STBFLT1 represented mature nuclei exhibited high expression of genes associated with oxygen response and extracellular matrix organization. Gene expression in STBPAPPA represented ones was associated with a wide variety of hormone production. We identified mature lineage biased master TFs such as JUNB and STAT5A. Through STAT5A deletion in the hTSCs, we verified the regulatory roles of it in down-regulation of STBPAPPA nucear associated gene expressions. Our data paves the way for charting human STB development and its related diseases.
Modified rock slope equivalent Mohr-Coulomb strength parameters satisfying the Hoek-Brown criterion
Authors: Song Yanhui , Feng Man , Chen Peng 
Published: August 2022

Abstract
The most critical parameter for determining equivalent values for the Mohr-Coulomb friction angle and cohesion from the nonlinear Hoek-Brown criterion is the upper limit of confining stress. For rock slopes, this value is the maximum value of the minimum principal stress (σ'3,max) on the potential failure surface. In this contribution, the existing problems in the existing research are analyzed and summarized. Using the finite element method (FEM), the location of potential failure surfaces for a wide range of slope geometries and rock mass properties are calculated using the strength reduction method, and a corresponding finite element elastic stress analysis was carried in order to determine (σ'3,max) of the failure surface. Through a systematic analysis of 425 different slopes, it is found that slope angle (β) and geological strength index (GSI) have the most significant influence on (σ'3,max) while the influence of intact rock strength and the material constant mi are relatively small. According to the variation of (σ'3,max) with different factors, two new formulas for estimating (σ'3,max) are proposed. Finally, the proposed two equations were applied to 31 real case studies to illustrate the applicability and validity.
Matrix is everywhere: extracellular DNA is a link between biofilm and mineralization in Bacillus cereus planktonic lifestyle
Authors: Kulminskaya Anna , Ivanova Lyubov , Egorov Vladimir , Zabrodskaya Yana , Shaldzhyan Aram , Baranchikov Alexander , Tsvigun Natalia , Lykholay Anna , Yapryntsev Alexey , Lebedev Dmitry 
Published: August 2022

Abstract
To date, the mechanisms of biomineralization induced by bacterial cells in context of biofilm formation remain unclear. Even less information is available on the biofilm formation in planktonic cells with relation to calcifying microorganisms. In this study, we show the details of the first hours of Bacillus cereus growth in a Ca2+- and urea-rich liquid medium, in which the formation of mineral calcium carbonate precipitates was induced. These precipitates were localized in the extracellular matrix (ECM) formed in planktonic culture at the stage of exponential growth and comprised of extracellular DNA, amyloid proteins and polysaccharides. While accumulation of extracellular polysaccharides and amyloids appeared to be independent of the presence of calcium and urea during the growth, accumulation of eDNA required the presence of both Ca and urea in the medium. Removal of eDNA, which was sensitive to treatment by DNase, did not affect other matrix components, but resulted in disruption of cell network formation and strong inhibition of the mineral formation.
Our results indicate that the mechanism of biomineralization by planktonic B. cereus cells appeared to involve a combination of factors including changes in protein expression pattern in response to stress, accumulation of extracellular polysaccharides, protein amyloids and eDNA leading to formation of ECM, and changes in cell metabolism and the medium pH. It was eDNA in extracellular matrix that appeared to provide centers for calcium carbonate precipitation, thus being a necessary factor for triggering the biomineralization. Precipitation of amorphous CaCO3 on ECM was followed by crystal formation via the ACC-vaterite-calcite/aragonite pathway and formation of larger mineral aggregates in complex with extracellular polymeric substances.
Varying outcomes of triple-negative breast cancer in different age groups - prognostic value of clinical features and proliferation
Authors: Vihervuori Hilda , Korpinen Katarina , Autere Tuomo-Artturi , Repo Heli , Talvinen Kati , Kronqvist Pauliina 
Published: August 2022

Abstract
Purpose: Triple-negative breast cancer (TNBC) is an aggressive disease lacking specific biomarkers to guide treatment decisions. We evaluated the combined prognostic impact of clinical features and novel biomarkers of cell cycle-progression in age-dependent subgroups of TNBC patients. Methods: 147 TNBC patients with complete clinical data and up to 18-year follow-up were collected from Turku University Hospital, Finland. Eight biomarkers for cell division were immunohistochemically detected to evaluate their clinical applicability in relation to patient and tumor characteristics. Results: Age at diagnosis was the decisive factor predicting disease-specific mortality in TNBC (p = 0.002). The established prognostic features, nodal status and Ki-67, predicted survival only when combined with age. The outcome and prognostic features differed significantly between age groups, middle-aged patients showing the most favorable outcome. Among young patients, only lack of basal differentiation predicted disease outcome, indicating 4.5-fold mortality risk (p=0.03). Among patients aged >57, the established prognostic features predicted disease outcome with up to 3.0-fold mortality risk for tumor size ≥2cm (p=0.001). Concerning cell proliferation, Ki-67 alone was a significant prognosticator among patients aged > 57 years (p=0.009). Among the studied cell cycle-specific biomarkers, only geminin predicted disease outcome, indicating up to 6.2-fold increased risk of mortality for tumor size <2cm (p=0.03). Conclusions: Traditional clinical features do not provide optimal prognostic characterization for all TNBC patients. Young age should be considered as an additional adverse prognostic feature in therapeutic considerations. Increased proliferation, as evaluated using Ki-67 or geminin immunohistochemistry, showed potential in detecting survival differences in subgroups of TNBC.
Lipid Accumulation Product, Visceral Adiposity Index and Risk of Chronic Kidney Disease
Authors: Bullen Alexander L. , Katz Ronit , Kumar Ujjala , Gutierrez Orlando M. , Sarnak Mark J. , Kramer Holly J. , Shlipak Michael G. , Ix Joachim H. , Judd Suzanne E. , Cushman Mary , Garimella Pranav S. 
Published: August 2022

Abstract
Background: Lipid accumulation product (LAP) and visceral adiposity index (VAI) are novel, non-imaging markers of visceral adiposity that are calculated by using body mass index (BMI), waist circumference (WC) and serum lipid concentrations. We hypothesized that LAP and VAI are more strongly associated with adverse kidney outcomes than BMI and WC.Methods: Using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, we used multivariable logistic regression to evaluate associations of LAP, VAI, BMI and WC with incident chronic kidney disease (CKD), (incident eGFR <60ml/min/1.73m2 and > 25% decline).Results: Among the overall cohort of 27,550 participants, the mean baseline age was 65 years; 54% were women; and 41% were African American. After a median of 9.4 years (IQR 8.6, 9.9) of follow-up, a total of 1127 cases of incident CKD were observed. Each two-fold higher value of VAI (OR 1.12, 95% CI 1.04, 1.20), LAP (OR 1.21, 95% CI 1.13, 1.29), WC (OR 2.10, 95% CI 1.60, 2.76) and BMI (OR: 2.66, 95% CI 1.88, 3.77,) was associated with greater odds of incident CKD. Conclusions: LAP and VAI as measures of visceral adiposity are associated with higher odds of incident CKD but may not provide information beyond WC and BMI.