bluuebunny/crossref_metadata_2025_split huggingface dataset:
La región como entidad territorial en el marco del estado unitario y su forma de consolidación
Authors: Villarreal Ramos Piedad , Gerónimo Malaver Luis 
Published: December 2024

El objeto del presente artículo es determinar cuáles han sido los factores políticos, administrativos y jurídicos, que han incidido para que no se haya consolidado la región como verdadera entidad territorial con todas sus atribuciones; para ello se desarrollan tres ejes temáticos. El primero se desarrolla en el contexto del ordenamiento territorial colombiano, comenzando con la comprensión de Colombia como un Estado Unitario. En el segundo, se examina la importancia del territorio y su relación con la autonomía territorial, tal como se establece en la Constitución Política de 1991. El tercero destaca la necesidad de comprender el territorio como una herramienta fundamental para dimensionar las regiones como entidades territoriales desde la perspectiva constitucional y normativa. En este eje temático se analizan las disposiciones constitucionales relevantes, además de la Ley 1454 de 2011, que establece los lineamientos para la creación de las regiones administrativas y de planificación en el país. También se examina la Ley 1962 de 2019, que introduce el concepto de RET como un nuevo enfoque de planificación y administración territorial y en general el impacto de estas leyes en la conformación de las regiones y cómo han influido en la reorganización del territorio colombiano. Finalmente, se realizan unas conclusiones y recomendaciones, destacando los factores políticos, administrativos y jurídicos que han incidido para que a la fecha no se hayan consolidado las RET.
Injectable MXene/Ag-HA composite hydrogel for enhanced alveolar bone healing and mechanistic study
Authors: Li Jialing , Fan Zilu , Guan Zhenju , Ruan Jianping 
Published: December 2024

IntroductionAlveolar bone defects pose significant challenges in dentistry. Due to the complexity of alveolar bone anatomy and insufficient repair mechanisms, large bone defects are difficult for the body to heal naturally. Clinical treatment typically involves the use of bone substitute materials. However, current substitutes often suffer from limitations such as insufficient osteoinductivity, rapid degradation, inflammatory responses, and poor mechanical properties. Additionally, the irregular morphology of alveolar bone defects complicates the application of solid bone substitutes, potentially leading to secondary damage at the repair site.MethodsTo address these challenges, this study introduces an innovative approach by integrating MXene nanomaterials into Ag-HA/GelMA hydrogels to create an injectable MXene/Ag-HA composite hydrogel. MXene nanomaterials are renowned for their excellent biocompatibility, antibacterial properties, and mechanical strength.ResultsThe results indicate that the MXene/Ag-HA composite hydrogel exhibits satisfactory mechanical and biological properties. Specifically, it demonstrates excellent antibacterial, antioxidant, and osteogenic activities. Gene expression analysis further reveals that the MXene composite hydrogel promotes osteogenesis by regulating the expression of Dmp1 and Dusp1.DiscussionThe findings of this study suggest that the MXene/Ag-HA composite hydrogel is a promising candidate for alveolar bone repair and regeneration. The integration of MXene nanomaterials into the hydrogel enhances its mechanical and biological properties, making it well-suited for the treatment of irregular alveolar bone defects. Furthermore, the study underscores the vast potential of MXene nanomaterials in the biomedical field, hinting at potential applications beyond alveolar bone repair.
Artificial intelligence-assisted echocardiographic monitoring in pediatric patients on extracorporeal membrane oxygenation
Authors: Chen Weiling , Wu Jinhui , Zhang Zhenxuan , Gao Zhifan , Chen Xunyi , Zhang Yu , Lin Zhou , Tang Zijian , Yu Wei , Fan Shumin , Zhang Heye , Xia Bei 
Published: December 2024

BackgroundPercutaneous extracorporeal membrane oxygenation (ECMO) is administered to pediatric patients with cardiogenic shock or cardiac arrest. The traditional method uses focal echocardiography to complete the left ventricular measurement. However, echocardiographic determination of the ejection fraction (EF) by manual tracing of the endocardial borders is time consuming and operator dependent. The standard visual assessment is also an inherently subjective procedure. Artificial intelligence (AI) based machine learning-enabled image analysis might provide rapid, reproducible measurements of left ventricular volumes and EF for ECMO patients.ObjectivesThis study aims to evaluate the applicability of AI for monitoring cardiac function based on Echocardiography in patients with ECMO.Materials and methodsWe conducted a retrospective study involving 29 hospitalized patients who received ECMO support between January 2017 and December 2021. Echocardiogram was performed for patients with ECMO, including at pre-ECMO, during cannulation, during ECMO support, during the ECMO wean, and a follow up within 3 months after weaning. EF assessment of all patients was independently evaluated by junior physicians (junior-EF) and experts (expert-EF) using Simpson's biplane method of manual tracing. Additionally, raw data images of apical 2-chamber and 4-chamber views were utilized for EF assessment via a Pediatric ECMO Quantification machine learning-enabled AI (automated-EF).ResultsThere was no statistically significant difference between the automated-EF and expert-EF for all groups (P &gt; 0.05). However, the differences between junior-EF and automated-EF and expert-EF were statistically significant (P &lt; 0.05). Inter-group correlation coefficients (ICC) indicated higher agreement between automated-EF and expert manual tracking (ICC: 0.983, 95% CI: 0.977∼0.987) compared to junior assessments (ICC: 0.932, 95% CI: 0.913∼0.946). Bland–Altman analysis showed good agreements among the automated-EF and the expert-EF and junior-EF assessments. There was no significant intra-observer variability for experts' manual tracking or automated measurements.ConclusionsAutomated EF measurements are feasible for pediatric ECMO echocardiography. AI-automated analysis of echocardiography for quantifying left ventricular function in critically ill children has good consistency and reproducibility with that of clinical experts. The automated echocardiographic EF method is reliable for the quantitative evaluation of different heart rates. It can fully support the course of ECMO treatment, and it can help improve the accuracy of quantitative evaluation.
Prevalence and risk factors of osteopenia in adults with short bowel syndrome: a retrospective longitudinal cohort study
Authors: Sun Guangming , Xia Yufei , Wang Haoyang , Xiao Yaqin , Zhang Li , Zhang Yupeng , Gao Xuejin , Wang Xinying 
Published: December 2024

BackgroundMetabolic Bone Disease (MBD) is common in patients with short bowel syndrome (SBS). This study was to investigate the incidence and risk factors of osteopenia in adult SBS patients.MethodsHospital records from January 2010 to December 2019 were used to identify all eligible patients. Logistic regression and a nomogram were used to analyze the data.ResultsA total of 120 patients with SBS were included in this study, and 76 patients (63.3%) developed osteopenia during the 10-year observation period, The multivariate analysis using the logistic regression model demonstrated that age (OR = 1.070; 95%CI: 1.016–1.126, p = 0.010), female (OR = 5.098; 95%CI: 1.211–21.456, p = 0.026), tumor history (OR = 4.481; 95%CI: 1.125–17.854, p = 0.033), duration of SBS (OR = 1.0862; 95%CI: 1.022–1.103, p = 0.002) and remnant ileum (OR = 4.260; 95%CI: 1.210–15.002, p = 0.024) were independent risk factors for osteopenia in adults with SBS. The area under the curve (AUC) for the joint model (age, female, tumor history, duration of SBS, remnant ileum) was 0.848 and the corresponding sensitivity and specificity were 0.855 and 0.705, respectively. The C-index was 0.849 (95% CI: 0.778–0.917); thus, the predictions made by the model were close to the actual outcomes. In the decision curve analysis, the nomogram performed well and was feasible to make beneficial clinical decisions.ConclusionThis study reveals the high prevalence of osteopenia in SBS patients and highlights the importance of early identification and treatment of osteopenia. A nomogram may provide personalized prediction and guidance for medical intervention.
The endothelial activation and stress index is a potential prognostic indicator for patients with acute pancreatitis managed in the intensive care unit: a retrospective study
Authors: Wang Jianjun , Chen Xi , Qin Chuan , Zeng Xintao , Du Xiaobo , Wang Decai 
Published: December 2024

BackgroundThe endothelial activation and stress index (EASIX) serves as a dependable and efficient surrogate marker for endothelial dysfunction, which plays an essential role in the pathophysiology of acute pancreatitis (AP). Hence, we investigated the prognostic value of EASIX in AP.MethodsThis was a retrospective study, using patient information obtained from the Medical Information Market for Intensive Care-IV (MIMIC-IV) database. EASIX was calculated using lactate dehydrogenase, serum creatinine, and platelet counts obtained during the first measurement within 24 h of admission. Patients were grouped into three cohorts based on log2-transformed EASIX. The main endpoint of the study was 28-day all-cause mortality (ACM) in AP patients, with the secondary endpoint being 90-day ACM. The relationship between EASIX and prognosis in patients with AP was evaluated using Cox proportional hazards models, Kaplan–Meier curves, restricted cubic spline (RCS) curves, and subgroup analyses. Receiver operating characteristic (ROC) curves were constructed to evaluate the predictive performance of EASIX compared to other indicators.ResultsThe study cohort comprised 620 patients in total. Multivariate Cox proportional hazards analysis indicated that an increased log2 (EASIX) was linked to a higher risk of 28-day ACM in AP patients (HR, 1.32; 95% CI: 1.14–1.52; p &lt; 0.001). The risk of 28-day ACM was higher in Tertiles 2 and 3 compared with Tertile 1 [(HR, 2.80; 95% CI: 1.21–6.45); (HR, 3.50; 95% CI: 1.42–8.66)]. Comparable findings were noted for 90-day ACM. Kaplan–Meier curves demonstrated that patients with elevated log2 (EASIX) had lower 28- and 90-day survival rates. The RCS curves suggested a non-linear relationship between log2 (EASIX) and 28- and 90-day ACM. ROC curves indicated that log2 (EASIX) was not inferior to sequential organ failure assessment and systemic inflammatory response syndrome scores in predicting the prognosis of patients with AP. Subgroup analyses demonstrated no interaction between log2 (EASIX) and any subgroup.ConclusionElevated EASIX levels were significantly correlated with a heightened risk of 28- and 90-day ACM in AP patients.
Developmental deglutition and intrinsic tongue muscle maturation phenotypes in the Ts65Dn mouse model of Down syndrome
Authors: Glass Tiffany J. , Chatwin Benjamin A. , Fisher Erin H. , Hang Kabao K. , Yang Qiuyu , Brutto Riley , Waghray Rohan , Connor Nadine P. 
Published: December 2024

IntroductionDown syndrome (DS) is associated with difficulties with feeding during infancy and childhood. Weaning, or transitioning from nursing to independent deglutition, requires developmental progression in tongue function. However, little is known about whether postnatal tongue muscle maturation is impacted in DS. This study tested the hypothesis that the Ts65Dn mouse model of DS has developmental delays in deglutition, comprised of differences in eating and drinking behaviors relative to euploid controls, coinciding with atypical measures of intrinsic tongue muscle microanatomy.MethodsThe Ts65Dn mouse model of DS and euploid controls were evaluated at 7 days of age (p7; nursing), p21 (weaning), and p35 (mature deglutition) (n = 13–18 mice per group). Eating behavior, drinking behavior, and body weight changes were quantified in p21 and p35 mice through the use of automated monitoring over 24 h. Intrinsic tongues of mice at all three ages were sectioned and stained to permit quantification of the sizes of the four major intrinsic tongue muscles. Transverse intrinsic tongue muscles were evaluated for myofiber size (average myofiber cross sectional area (CSA) of all fibers, MyHC2a fibers, MyHC 2b fibers, and minimum Feret fiber diameter), and percentage of MyHC isoforms (%MyHC2a + fibers, and %MyHC 2b + fibers) in anterior, middle, and posterior regions.ResultsTs65Dn showed significant differences from euploid in deglutition measures. Compared to euploid, Ts65Dn also showed differences in intrinsic tongue muscle microanatomy and biology. Specifically, Ts65Dn intrinsic tongues had smaller transverse muscle myofiber size measures than control in the anterior and middle tongue, but not in the posterior tongue.ConclusionDifferences in intrinsic tongue muscles coincide with feeding phenotypes in the Ts65Dn mouse model of DS.
Effectiveness and safety of acupuncture for cancer-related hiccups: a systematic review and meta-analysis
Authors: Guo Zining , Liang Ying , Liu Wenhao , Huang Bingjing , Zheng Huiyan , Cui Shaoyang , Xu Nenggui 
Published: December 2024

BackgroundThe use of acupuncture in cancer treatment is expanding. Nevertheless, the efficacy and safety of acupuncture in alleviating cancer-related hiccups remains uncertain and inconclusive.MethodsWe conducted a systematic search across eight databases: PubMed, China National Knowledge Infrastructure Database, WanFang, China Science and Technology Journal Database, SinoMed, Web of Science, Cochrane, and Embase, covering the period from their inception to July 2023. Literature was screened based on predefined PICOS inclusion and exclusion criteria, and the risk of bias was assessed using the Cochrane Risk of Bias tool. Data synthesis was performed using Review Manager 5.3 software and R studio 4.4. Additionally, we conducted a frequency analysis of acupoint usage.ResultsA total of nine randomized controlled trials (RCTs) involving 580 patients were included in the analysis. The risk of bias assessment indicated a high risk of bias in all nine RCTs, primarily due to blinding of participants and personnel and random sequence generation (selection bias). The meta-analysis revealed that acupuncture significantly reduced the symptoms of cancer-related hiccups compared to pharmacological treatment (relative risk (RR) = 1.83, 95% confidence interval (CI) [1.53, 2.20], p &lt; 0.001, I2 = 27%). In terms of onset time, acupuncture demonstrated a shorter duration of onset compared to pharmacological treatment (mean difference (MD) = −8.71, 95% CI [−23.32 5.89], p &lt; 0.01, I2 = 100%). Furthermore, acupuncture exhibited a significant improvement in sleep, eating, and appetite scores compared to pharmacological treatment (MD = 0.68, 95% CI [0.07, 1.29], p = 0.03; MD = 0.68, 95% CI [0.07, 1.30], p = 0.03; MD = 0.66, 95% CI [0.08, 1.25, p = 0.03]). The frequency of acupoint usage was analyzed, with ST36 and PC6 being the most frequently used acupoints. Regarding adverse events, acupuncture exhibited favorable safety profiles compared to other control groups.ConclusionThe meta-analysis results suggest that acupuncture has a positive effect on the efficacy rate for cancer-related hiccups, as well as improvements in quality of life and time to effect response. However, due to the high risk of bias and quality limitations of the included studies, no conclusive evidence currently supports the efficacy of acupuncture. High-quality, evidence-based research is still needed to confirm the effectiveness of acupuncture in treating cancer-related hiccups.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, CRD42023451403.
sTREM2 cerebrospinal fluid levels are a potential biomarker in amyotrophic lateral sclerosis and associate with UMN burden
Authors: Jiao Lin , Yang Jing , Wang Wenjing , Liu Xiangyi , Fu Yu , Fan Dongsheng 
Published: December 2024

ObjectivesThe aims of this study were to investigate whether CSF sTREM2 may be a potential marker of disease monitoring for amyotrophic lateral sclerosis (ALS).MethodsWe investigated whether CSF sTREM2 levels are altered in ALS patients and are correlated with upper motor neuron (UMN) burden and disease progression.ResultsCSF sTREM2 was greater in the ALS patients than in the controls (p = 0.002). Elevated CSF sTREM2 was associated with the UMN score (r = 0.38, p = 0.009), ΔFS (r = 0.30, p = 0.04) and serum NFL (lg) (r = 0.35, p = 0.015). As the motor band sign (MBS) score increased, the CSF sTREM2 level increased (p-trend = 0.014). Furthermore, the correlations became stronger (UMN score (r = 0.50, p = 0.01) ΔFRS (r = 0.52, p = 0.008) and serum NFL (lg) (r = 0.55, p = 0.004) when estimated only among patients with a disease duration &gt;12 months.ConclusionWe found that CSF sTREM2 is elevated in ALS patients and may be a novel marker, probably reflecting upper motor unit severity and prognosis.
An exploratory cluster-randomized controlled trial on mindfulness yoga’s effectiveness in school-refusing children: reductions in SCAS-C physical injury fears and pulse rate
Authors: Kawazu Suguru , Amitani Marie , Suzuki Hajime , Amitani Haruka , Monuki Takako , Wada Midori , Toyohira Satomi , Hamada Kazumasa , Yamamoto Takako , Yoshimura Takuya , Mizuma Kimiko , Nishida Yuko , Watanabe Hiroko , Hirose Masayuki , Tagawa Koshiro , Ota Keiko , Asakawa Akihiro , Owaki Tetsuhiro 
Published: December 2024

IntroductionSchool refusal is one of the serious problems with children’s mental health, and various studies have examined its prevalence and factors among students. Although many studies suggested that anxiety and depression are deeply associated with school refusal, there is little agreement as to effective interventions. The purpose of this paper is to evaluate the efficacy and safety of mindfulness yoga intervention in children with school refusal.MethodThis study is a multicenter, exploratory, open cluster-randomized controlled trial. 43 participants aged 10–15 years with school refusal were randomly assigned to a non-yoga group with treatment as usual (TAU) which includes cognitive behavioral therapy based on self-monitoring, or a yoga group (4-week mindfulness yoga program provided by video sessions + TAU). The primary outcome was symptoms of anxiety evaluated by Spence Children’s Anxiety Scale-Children (SCAS-C). Participants were assessed in four time periods: a 2-week baseline (Day −14), a baseline (Day 1), a post-test after 4 weeks of treatment (Day 29), and an 8-week follow-up (Day 85). Statistical analysis was conducted by a linear mixed effect model using SAS version 9.4.Results43 participants were included in the Full-analysis set (FAS) (21 in the mindfulness yoga group and 22 in the non-yoga group). The estimates of SCAS-C at post-test adjusted for baseline values in each treatment group were 39.9 in the mindfulness yoga group and 39.4 in the non-yoga group. The between-group difference for the estimates was 0.4 (80%CI −4.8 to −5.6, p = 0.54), which indicated mindfulness yoga program has no significant effect on anxiety compared with TAU. However, on an exploratory analysis of the subscale of SCAS-C, significant improvement was observed on the Physical Injury Fears subscale. The pulse rate was significantly lower in the yoga group compared to the non-yoga group.ConclusionThis study indicated the safety of a mindfulness yoga intervention for children with school refusal, but the effectiveness of the intervention for anxiety was limited. Further research is needed to determine the long-term effects of yoga and how it can best be integrated with other therapies.
Prediction of HIF-1α expression in endometrial carcinoma by enhanced T2∗ weighted angiography and dynamic contrast-enhanced magnetic resonance imaging
Authors: Xie Zongyuan , Lin Liangjie , Ma Changjun , Liu Ailian 
Published: December 2024

PurposeTo explore the value of quantitative imaging parameters by enhanced T2* weighted angiography (ESWAN) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for evaluating the expression of Hypoxia-inducible factor-1α (HIF-1α) in endometrial carcinoma (EC).MethodsData from 122 patients with EC confirmed by clinical pathology were retrospectively analyzed. According to the number of positive cells stained with HIF-1α by immunohistochemistry, patients were divided into two groups: 65 cases with high expression of HIF-1α and 57 cases with low expression of HIF-1α. Clinical data included age, FIGO stage, menopausal status, abnormal uterine bleeding, and pathological type. All patients underwent preoperative 1.5T MRI scans, including ESWAN and DCE-MRI. The amplitude, phase, and R2* values derived from ESWAN and the volume transfer constant (Ktrans), rate constant (Kep), and extravascular volume fraction (Ve) values derived from DCE-MRI were measured by two observers, respectively. The intra-class correlation coefficient (ICC) was used to assess the measurement of reproducibility across observers, and the differences in imaging parameters between the two groups were compared using the independent sample t-test or Mann-Whitney U-test. Binary logistic regression analysis was used to find independent risk factors for HIF-1α expression. The efficacy of selected imaging parameters for predicting HIF-1α expression was assessed using receiver operating characteristic (ROC) curves, and the Delong test was used to compare the area under ROC curves (AUC).ResultsThe consistency between the two observers was good (ICC&gt;0.75). The R2*, Ktrans, and Kep values of the HIF-1α high expression group were higher than those of the HIF-1α low expression group (14.59 ± 4.06 vs. 11.99 ± 2.84 Hz, 0.45 ± 0.18 vs. 0.36 ± 0.14/min, and 2.17 ± 1.10 vs. 1.54 ± 0.80/min) (P&lt; 0.001, P = 0.011, and P =0.001). Binary logistic regression analysis revealed that R2* and Kep values were independent risk factors for HIF-1α expression. The AUC values of R2*, Kep, and their combination for prediction of HIF-1α expression were 0.697, 0.677, and 0.781, respectively. The diagnostic efficacy was significantly improved with combination of R2* and Kep.ConclusionsQuantitative parameters by ESWAN and DCE-MRI showed significant differences between EC patients with low and high expression of HIF-1α, and the combination of ESWAN and DCE-MRI improves the efficacy in prediction of HIF-1α expression in EC, which has an excellent clinical application prospect.