bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sepsis prognostic scores accuracy in predicting adverse outcomes in children with sepsis admitted to the PICU from the Emergency Department: a 10-year single-center experience
Authors: Marchetto Luca , Comoretto Rosanna , Gregori Dario , Dalt Liviana Da , Amigoni Angela , Daverio Marco 
Published: September 2022

Abstract
PURPOSE: To compare the performance of several prognostic scores calculated in the first 24 hours of admission (“Day-1”) in predicting mortality and morbidity among critically ill children with sepsis presenting to the Pediatric Emergency Department (PED) and then admitted to the Pediatric Intensive Care Unit (PICU).
METHODS: Single-center, retrospective cohort study in patients < 18 years with a diagnosis of sepsis visiting the PED and then admitted to the PICU. Sepsis prognostic scores – pSOFA (Schlapbach, Matics, Shime versions), qSOFA, qSOFA-L, PELOD-2, qPELOD-2, P-MODS – were calculated and their performance compared to Systemic Inflammatory Response Syndrome (SIRS) and severe sepsis – International Consensus Conference on Pediatric Sepsis (ICCPS) derived criteria – using the area under the ROC curve (AUROC). Primary outcome was PICU mortality. Secondary outcomes were a composite of death and new disability (i.e., change from baseline admission POPC score ≥ 1), prolonged PICU Length of Stay (LOS) (> 5 days) and prolonged duration of invasive mechanical ventilation (MV) (> 3 days).
RESULTS: Among 60 patients with sepsis, 4 (6.7%) died, 7 (11.7%) developed new disability, 26 (43.3%) experienced prolonged LOS, 21 (35%) prolonged invasive MV. The prognostic ability in mortality discrimination was significantly higher for organ-dysfunction scores, with PELOD-2 showing the best performance (AUROC 0.924, 95% CI 0.837-1.000), significantly better than SIRS 3 criteria (0.924 vs 0.509, p=0.009), SIRS 4 criteria (0.924 vs 0.509, p<0.001) and severe sepsis (0.924 vs 0.527, p<0.001). Among secondary outcomes, PELOD-2 performed significantly better than SIRS and severe sepsis to predict prolonged duration of invasive MV, while better than severe sepsis to predict mortality or new disability.
CONCLUSIONS: Day-1 organ-dysfunction scores performed better in predicting mortality and morbidity outcomes than ICCPS derived criteria. PELOD-2 was the organ-dysfunction score with the best performance for all outcomes.
Comparing the effectiveness and lubricity of a novel Shea lubricant to 2% Lidocaine gel for digital rectal examination: a randomized non-inferiority trial
Authors: Adanu Kekeli Kodjo , Iroko Davidson , Amegan-Aho Kokou , Adedia David , Ndudiri Orish Verner , Ali Mahamudu Ayamba , Oyortey Mawuenyo Attawa , Kpodonu Jacques 
Published: September 2022

Abstract
This study compared the level of lubricity and pain reduction of a novel shea lubricant to 2% lidocaine gel during digital rectal examination (DRE).Our research group performed a 9-week single blind non-inferiority trial at the Ho Teaching Hospital involving 153 patients. Primary outcome measure was the mean pain difference during the procedure using a Visual Analogue Scale. 75 and 78 patients were randomized to the shea lubricant and 2% lidocaine gel groups respectively. Analysis considered the per protocol population. The mean pain difference at end point was Δ -0.01. The 95% lower confidence interval was a -0.595 difference in means, above the non-inferiority (NI) limit of -0.720, thus establishing non-inferiority (Δ -0.01, 95% CI -0.59–0.57, NI -0.72). With secondary outcome measures, perianal pruritus (p = 0.728), discomfort (p = 0.446), bowel urgency (p = 0.077) and urinary urgency (p = 0.841) were similar except for bowel urgency which was worse for shea lubricant 30 minutes after DRE (p = 0.018). Shea lubricant had a better lubricity and ease of use (p = 0.002). While the novel shea lubricant achieved similar level of pain reduction as obtained with 2% lidocaine gel, it had better ease of performance and lubricity. This trial was registered with the Pan African Clinical Trials Registry on the 18/11/2020 with the unique identification number PACTR202011687956222.
Trend Analysis of Multi-level Determinants of Maternal and Newborn Postnatal Care Utilization in Pakistan from 2006 to 2018
Authors: Iqbal Sarosh , Maqsood Sidra , Zakar Rubeena , Fischer Florian 
Published: September 2022

Abstract
Background
Postnatal care (PNC) is crucial for maternal and newborn health. Healthcare-seeking practices within the postpartum period help healthcare providers in early detection of complications related to childbirth and post-delivery period. This study aims to investigate trends of PNC utilization from 2006 to 2018, and to explore the effects of multi-level determinants of both maternal and newborn PNC in Pakistan.
Methods
Secondary data analysis of the last three waves of the nationally representative cross-sectional Pakistan Demographic and Health Surveys (PDHSs) was conducted, including wave 2 (2006-07), wave 3 (2012-13), and wave 4 (2017-18), using the datasets of women aged 15–49 years. Analysis was limited to all those women who had delivered a child during the last 5 years preceding each wave of PDHS, leading to a sample size of 5,677, 7,446, and 6,711 women for waves 2, 3, and 4, respectively. Bivariate and multivariate logistic regression was applied to determine the association of maternal and newborn PNC utilization with multi-level determinants at individual, community, and institutional levels.
Results
In Pakistan, an upward linear trend in maternal PNC utilization was found, with an increase from 43.5–63.6% from 2006 to 2018. However, a non-linear trend was observed in newborn PNC utilization, with an upsurge from 20.6–50.5% from 2006 to 2013, nonetheless a decrease of 30.7% in 2018. Furthermore, the results highlighted that the likelihood of maternal and newborn PNC utilization was higher amongst older age women, who completed some years of schooling, were employed, had domestic and emotional autonomy, had caesarean sections, and delivered at health facilities through skilled birth attendants.
Conclusion
A difference in maternal and newborn PNC utilization was found in Pakistan, attributed to multiple individual (socio-demographic and obstetrics), community, and institutional level determinants. Overall, findings suggest the need to promote the benefits of PNC for early diagnosis of postpartum complications and to plan effective public health interventions to enhance women’s access to healthcare facilities and skilled birth assistance to save mothers’ and newborns’ lives.
Discovery of a Pyrrole-pyridinimidazole Derivative as Novel SIRT6 Inhibitor for Sensitizing Pancreatic Cancer Cells to Gemcitabine
Authors: Song Nannan , Guan Xian , Zhang Siqi , Wang Xue-kai , Lu Zhongxia , Chong Daochen , Wang Jennifer Yiyang , Yu Ri-Lei , Yu Wengong , Gu Yuchao , Jiang Tao 
Published: September 2022

Abstract
Pancreatic cancer is a highly aggressive cancer, and is primarily treated with gemcitabine, with increasing resistance. SIRT6 as a member of sirtuin family plays important roles in lifespan and diverse diseases, such as cancer, diabetes, inflammation and neurodegenerative diseases. Considering the role of SIRT6 in the cytoprotective effect, it might be a potential anticancer drug target, and is associated with resistance to anticancer therapy. However, very few SIRT6 inhibitors have been reported. Here, we reported the discovery of a pyrrole-pyridinimidazole derivative, 8a, as a new non-competitive SIRT6 inhibitor, and studied its roles and mechanisms in the antitumor activity and sensitization of pancreatic cancer to gemcitabine. Firstly, we found a potent SIRT6 inhibitor compound 8a by virtual screening and identified by molecular and cellular SIRT6 activity assays. Then, we found that 8a can inhibit the proliferation, induce cell apoptosis and sensitize pancreatic cancer cells to gemcitabine treatment both in pancreatic cancer cells and xenograft models. Mechanistically, 8a inhibited the cell proliferation and survival signaling pathways, such as PI3K/AKT/mTOR and ERK signal pathway, and markedly exacerbated DNA damage induced by gemcitabine. Overall, we demonstrate that 8a, a novel SIRT6 inhibitor, could be a promising potential drug candidate for pancreatic cancer treatment.
Predictive value of indicators for left ventricular systolic dysfunction in HD patients
Authors: Liu Ying , He Zhangxiu , Xiu Hao , Ding Kai , Cao Jingsong , Hu Hengjing , Huang Hong , Tang Huifang 
Published: September 2022

Abstract
Background: To evaluate the role of dialysis duration, creatine, cardiac troponin T (cTnT) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) for predicting left ventricular systolic dysfunction (LVSD) in hemodialysis (HD) patients. Methods: Participants with regular hemodialysis for more than three months between January 2017 and January 2022 were enrolled. Correlation analysis was used to assess the correlations among the clinical, serological and echocardiographic variables. The risk factors of LVSD were discussed by univariate and multivariate logistic regression analysis. Receiver-operating characteristic curve (ROC) was constructed to evaluate their predictive value.Results: The 237 HD patients were divided into two groups, NT-pro-BNP > 35000 pg/ml vs. NT-pro-BNP ≤ 35000 pg/ml. In HD patients with NT-pro-BNP ≤ 35000 pg/ml group, cTnT (r = -0.222, P = 0.011) and NT-pro-BNP (r = -0.248, P = 0.002) were significantly correlated with EF. Factors associated with LVSD and corresponding odds ratios (ORs) with 95% CI by multivariate analysis were dialysis duration [0.158 (0.036, 0.689), P ＝ 0.010], creatine [0.255 (0.078, 0.833), P ＝ 0.020] and cTnT [10.858 (2.278, 51.758), P ＝ 0.000] in HD patients with NT-pro-BNP > 35000 pg/ml. In HD patients with NT-pro-BNP ≤ 35000 pg/ml, dialysis duration [0.266 (0.075, 0.938), P ＝ 0.034] and NT-pro-BNP [11.132 (2.904, 42.679), P ＝ 0.000] were both independent risk factors of LVSD in multivariate analysis. In HD patients with NT-pro-BNP > 35000 pg/ml group, the combination of dialysis duration and creatinine [(area under the curve (AUC): 0.664); P ＝ 0.002], dialysis duration and cTnT (AUC: 0.690 ; P ＝ 0.000), creatinine and cTnT (AUC: 0.702; P ＝ 0.000) and dialysis duration, creatinine and cTnT (AUC: 0.753; P ＝ 0.000) had the significantly statistic value to predict LVSD; In HD patients with NT-pro-BNP ≤ 35000 pg/ml group, the combination of dialysis duration and NT-pro-BNP had the best diagnostic value (AUC: 0.802; sensitivity: 89.55%; P < 0.000). Conclusion: Our results implicated that the combination of dialysis duration, creatine cTnT and NT-pro-BNP might be used for early prediction and management of LVSD in HD patients.
Identification and Characterization of the PAP Gene Family in wheat (Triticum aestivum L.)
Authors: Hou Lijiang , Wu Qiufang , Shang Zengzhen , Wang Jingshun , Gao Xinqiang 
Published: September 2022

Abstract
Purple acid phosphatases (PAPs), which are a family of metallo-phosphoesterase enzymes, are involved in phosphorus nutrition in plants. In this study, 9 low molecular weight (LMW) PAPs and 30 high molecular weight (HMW) PAPs were found, and these PAPs were classified into four subfamilies: 5 in sub. Ia-2, 9 in sub. Ib-1, 16 in sub. Ib-2, and 9 in sub. IIIb. Similar gene structures and conserved protein motifs of TaPAPs in wheat were identified in the same subfamilies. Bioinformatic analyses revealed that the functions of different subgroup TaPAPs in wheat were multiple, and 9 TaPAPs could be secretory phosphatase due to its coding region contain a signal peptide and an N-terminal transmembrane helix. The expression patterns analysis showed that 17 TaPAP genes were constitutive expressed in wheat different tissues, the others were expressed in a tissue-specific manner. Interestingly, we found that one triplet TaPAPs named TaPAP4-4A/4B/4D, which belong to sub. IIIb, were highly expressed in root, spike, leaf and seed. The TaPAP4-4A gene was cloned and transplanted to Arabidopsis to assess the roles of sub. IIIb memebers. The results showed that TaPAP4-4A not only promote growth and development, but also increases the resistant to Pi-deficient stress by secreting more phosphatase. The aforementioned findings offer a scientific basis for the thorough comprehension of the wheat TaPAP gene family, which is beneficial for screening further candidate genes and developing new low phosphorus tolerant wheat types.
Provision of information by midwives for pregnant women in England on guidance on foods/drinks to avoid or limit
Authors: Lucy Beasant , Ingram Jenny , Tonks Rachel , Taylor Caroline 
Published: September 2022

Abstract
Background
The NHS website gives guidance for pregnant women in England on foods/drinks to avoid or limit because of microbiological, toxicological or teratogenic hazards. These include, for example, some types of soft cheeses, fish/seafood and meat products. This website and midwives are trusted sources of information for pregnant women, but the ways in which midwives can be supported to provide clear and accurate information are unknown.
Aims
The aims were to: (1) determine midwives’ accuracy of recall of information and confidence in delivering the guidance to women; (2) identify barriers to provision; (3) identify the ways in which midwives provide this information to women.
Methods
Registered Midwives practicing in England completed an online questionnaire. Questions included those on what information they provided and their confidence in delivering it, the ways they provided information on foods to avoid/limit, and what resources they used. Ethics approval was given by the University of Bristol.
Results
>10% of midwives (n = 122) were ‘Not at all confident’ in providing advice about seven items, including game meat/gamebirds (38% and 39%, respectively), herbal teas (13%) and cured meats (12%). Only 32% correctly recalled overall advice on eating fish, and only 38% the advice on tinned tuna. The main barriers to provision were lack of time in appointments and lack of training. The most usual methods of disseminating information were verbal (79%) and signposting to websites (55%).
Conclusion
Midwives were in general knowledgeable about foods and drinks to avoid/limit during pregnancy, but there were some foods for which they were unconfident, and some for which recall was mistaken. Delivery of guidance by midwives on foods to avoid or limit needs to be supported by appropriate training and access to resources. Further research on barriers to the delivery and implementation of the NHS guidance is needed.
Lagrangian duality in convex conic programming with simple proofs
Authors: Trnovska Maria , Hrdina Jakub 
Published: September 2022

Abstract
In this paper we study Lagrangian duality aspects in convex conic programming over general convex cones. It is known that the duality in convex optimization is linked with specific theorems of alternatives. We formulate and prove strong alternatives to the strict feasibility and analyze the relation between the boundedness of the optimal solution sets, and the existence of the relative interior points in the feasible set. We also provide sufficient conditions under which the duality gap is zero and the optimal solution sets are unbounded. As a consequence, we obtain several new sufficient conditions that guarantee the strong duality between primal and dual convex conic programs. Our proofs are based only on fundamental convex analysis and linear algebra results.
Randomized phase III trial of a neoadjuvant regimen of four cycles of adriamycin plus cyclophosphamide followed by four cycles of docetaxel (AC4-D4) versus a shorter treatment of three cycles of FEC followed by three cycles of docetaxel (FEC3-D3) in node-positive breast cancer (Neo-Shorter; NCT02001506)
Authors: Hwang Inhwan , Kim Jeong Eun , Jeong Jae Ho , Ahn Jin-Hee , Jung Kyung Hae , Son Byung Ho , Kim Hak Hee , Shin Junyoung , Lee Hee Jin , Gong Gyungyub , Kim Sung-Bae 
Published: September 2022

Abstract
Purpose

To determine whether six cycles of FEC3-D3 has a comparable efficacy to eight of AC4-D4.

Methods

The enrolled patients (pts) were clinically diagnosed with stage II or III breast cancer. The primary endpoint was a pathologic complete response (pCR), and the secondary endpoints were 3-year disease-free survival (3Y DFS), toxicities, and health-related quality of life (HRQoL).

Results

Among the 248 pts enrolled, one case was ineligible for screening; 10 discontinued treatment due to progressive disease (7 and 3 in the AC4-D4 and FEC3-D3 arms), 16 dropped out due to a withdrawal of consent, and 3 were unable to complete the study (2 and 1 in the AC4-D4 and FEC3-D3 arms). The 218 pts who completed the surgery were included in the current analysis. The baseline characteristics of these subjects were well balanced between the two arms. By ITT analysis, pCR was achieved in 15/121 (12.4%) pts in the FEC3-D3 arm and 18/126 (14.3%) in the AC4-D4 arm (P = 0.40). With a median follow up of 64.1 months, the 3-year DFS was comparable between the two arms (77.0% in FEC3-D3 vs. 74.9% in AC4-D4; P = 0.82). The most common adverse event (AE) was Grade 3/4 neutropenia, which arose in 27/126 (21.4%) AC4-D4 arm pts vs 23/121 (19.0%) FEC3-D3 arm cases. The primary HRQoL domains were similar between the two groups (FACT-B scores at baseline, P = 0.35; at the midpoint of NACT, P = 0.20; at the completion of NACT, P = 0.44).

Conclusion

Both NACT AC4-D4 and FEC3-D3 show comparable outcomes in terms of pCR, three-year DFS, toxicities, and QoL Shorter neo-adjuvant FEC3-D3 could be an alternative to AC4-D4 for stage II or III operable breast cancer.
Trial registration
ClinicalTrials.gov NCT02001506. Registered December 5,2013
https://clinicaltrials.gov/ct2/show/NCT02001506
Photocatalytic antiviral activity of zinc hydroxide for H1N1 virus under weak visible light
Authors: Ouyang Feng , Ren Zhaoyong , Liu Jingyuan , Li Hangliang , Gong Zhengya , Fan Youhua , Zha Xiaoxiong , Cao Gang , Bharti Bandna 
Published: September 2022

Abstract
Viral infections mainly occur in indoor environments, it is suggested that visible light-sensitive antiviral photocatalyst is highly desired. Here we developed a photocatalysis system based on zinc hydroxide (Zn(OH)2) to efficiently generate antiviral radicals on mask surface under weak visible light. The weak visible light induced the Zn(OH)2 photocatalysis and completed the inactivation of H1N1 virus for short time. In addition, the inactivating efficiency was improved greatly by adding a natural washing agent layer. Our system could inactivate H1N1 influenza virus completely rapidly under the irradiation of weak visible light. The discovery will open up a new research field, and enrich and promote the development of photocatalysis theory and practice.
The aqueous extract of You-Gui-Yin improves renal microcirculatory disturbances in chronic renal failure rats by activating the EPO/PI3K/AKT/VEGF pathway
Authors: Xu Xiaogang , Chen Yijin , Yuan Zhiying , Wang Hongjin , Xu Xiaoyu 
Published: September 2022

Abstract
Background
You-Gui-Yin (YGY) is a traditional Chinese recipe used for treating renal function diseases which is recorded in Jingyue Quanshu written by Zhang Jingyue in Ming dynasty. According to traditional Chinese medicine theory,Insufficient kidney yang leads to blood blockage and tends to create localised blood microcirculation disorders. However, the mechanism by which Right Return Drink improves microcirculatory disorders has not been discovered.
Methods
The potential therapeutic effects of YGY extract on chronic renal failure were investigated in vivo using adenine-induced chronic renal failure rats. Firstly, we observed the therapeutic effects of YGY extract on renal impairment, histopathological patterns and serum biochemical parameters in adenine-induced chronic renal failure rats. Secondly, in pre-laboratory data, YGY was found to promote EPO production in rats and mice. Modern pharmacological studies have found that EPO has a role in angiogenesis, and that normal microvascular function and morphology are directly related to the performance of the renal microcirculation. Subsequently, to assess the effect of EPO on renal microcirculation, we monitored changes in renal microcirculation using EPO cKO mice, using photoacoustic imaging (PAI). Finally, the expression of renal EPO, EPOR, PI3K, p-PI3K (p110), AKT, p-AKT (Ser473), and VEGF proteins was examined by Western blot and other techniques to investigate the possible mechanisms of EPO-induced renal microcirculatory disorders and the possible intrinsic mechanisms of YGY extracts to improve microcirculation, and whether they are related to the promotion of angiogenesis and improving vascular function.
Results
EPO−/− mice produce significant pathological damage to the mouse kidney due to low levels of EPO protein, and the damage to their renal microcirculation is manifested by abnormal renal hemodynamics, and significant abnormalities in renal blood supply and oxygen saturation. YGY extract ameliorated the microcirculatory impairment in rats with chronic renal failure. In detail, YGY extract improved renal function by restoring the damaged renal capillary network, increasing renal blood flow, and expanding renal blood distribution to maintain vascular function. In addition, the expression of PI3K/AKT/VEGF pathway was significantly reduced in the kidney of EPO−/− mice, indicating that this pathway may be a relevant pathway for renal microcirculatory disorders caused by the lack of EPO. And the potential mechanism of YGY to improve microcirculatory disorders may be related to the activation of EPO/PI3K/AKT/VEGF pathway.
Conclusions
YGY extract was shown to prevent the deterioration of renal function and renal microcirculation in rats with adenine-induced chronic renal failure, possibly by a mechanism related to the activation of the EPO/VEGF signalling pathway.
Hope for a new knee: a qualitative study on decision-making process for total knee replacement in Taiwanese women
Authors: Huang Ching Han , Wang Chen Ti , Lin Mei Hsiang , Chen Yun Yee , Chen Shu Wen 
Published: September 2022

Abstract
Background: Total knee replacement (TKR) can alleviate knee osteoarthritis (OA) effectively. Many women undergo TKR; however, research on women’s decision-making process remains scant. This study aimed to explore the decision-making process for undergoing TKR among Taiwanese women.
Methods: A qualitative approach was used. Through purposive sampling, a total of 20 women aged > 40 years with knee OA undergoing TKR were recruited from a teaching hospital of Northern Taiwan. Data were collected 3–5 days and 6–8 weeks after TKR through in-depth interviews, observation, and field records and analyzed with constant comparative analysis.
Results: “Hope for a new knee,” the core theme for TKR-related decision-making, comprised three stages (including six themes): before decision (impacts of pain and seeking nonsurgical methods), decision (intrinsic and extrinsic motivation), and after decision (assessing physical function and achieving the golden phase of rehabilitation).
Conclusion: Women expected to have a new life after undergoing TKR. Impacts of pain and concern of becoming a burden on the family were main factors influencing the Taiwanese women’s decision for a TKR. These women strove to overcome difficulties related to post-TKR rehabilitation. An individual teaching programs and psychological support for women is imperative. The findings of women’s values and preferences for a TKR surgery will be helpful to develop an interventional decision support for shared decision-making.