bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Assessment of a 28-Day Mortality Risk Prediction Model Utilizing a Column Chart for Patients with Pneumocystis Disease in the Intensive Care Unit
Authors: Weng Yiru , Zhou Tingting , Ye Honghua 
Published: December 2024

Abstract

Purpose To develop and assess a predictive model utilizing column charts for evaluating the 28-day mortality risk in patients diagnosed with Pneumocystis who have been admitted to the intensive care unit (ICU).
Methods From 2008 to 2022, clinical data on patients with Pneumocystis were collected using the American Critical Care Medical Information Database IV (MIMIC-IV). Initially, 63 significant predictive indicators were included, with ICU admission as the time node and all-cause mortality within 28 days as the outcome. Using complete data modeling, the variable selection approach combines two methods: Lasso regression (glmnet package) and collinearity screening (car package). Use the bootstrap method 1000 times for internal validation. Calculate the AUC, mean sensitivity, and specificity of 1000 resamplings, as well as the 95% confidence interval, and then plot the ROC, calibration, and DCA curves.
Results The patients were split into two groups based on their 28-day survival status: 83 cases (67.48%) in the survival group and 40 instances (32.52%) in the death group. Five variables—the history of malignant tumors, Lods scores, Oasis scores, and complications of shock and severe renal injury—were eventually included in the entire sample after screening. According to Receiver Operating Characteristic (ROC) analysis, the model's sensitivity was 0.600 (95% CI 0.448-0.752), specificity was 0.904 (95% CI 0.840-0.967), and AUC was 0.814 (95% CI 0.732-0.897). The DCA curve indicates that the model application has high accuracy, which leads to a net benefit for population prediction, and the model calibration curve demonstrates good calibration accuracy. The bootstrap model's 1000 internal validation results demonstrate that the model's calibration performance is good and that its accuracy is highest when the probability of patient outcome events falls between 35% and 60%, which yields the highest net benefit for population prediction.
Conclusions With five factors and good discrimination and calibration, a column chart model for predicting the 28-day mortality risk of Pneumocystis patients based on MIMIC-IV clinical big data offers a useful new tool for assessing the prognosis of such patients.
Repeated sentinel lymph node biopsy for local recurrence after breast-conserving surgery
Authors: Matsubara Yuka , Suganuma Nobuyasu , Nakamoto Shogo , Kikawa Yuichiro , Iwamoto Takayuki , Yamashita Toshinari , Yoshida Tatsuya , Yamanaka Takashi , Saitou Aya 
Published: December 2024

Abstract

Background
Sentinel lymph node biopsy (SNB) has been established as a technique to evaluate early breast cancer. However, the clinical utility of repeated SNB (reSNB) for ipsilateral breast tumor recurrence (IBTR) remains unclear.
Methods
This retrospective study analyzed data from 52 patients who underwent reSNB for IBTR after initial breast-conserving surgery at Kanagawa Cancer Center between June 2012 and March 2019. reSNB was conducted using both the dye and radioactive isotope methods. The identification rate was defined as the number of cases in which sentinel lymph nodes were visualized on lymphoscintigraphy images divided by the total number of cases. The identification rate was compared according to the initial surgical procedure.
Results
Overall, the identification rate for reSNB was 94.2%. The identification rate for reSNB in the axilla was higher in patients who initially underwent SNB than in those who initially underwent axillary lymph node dissection (83.3% vs. 42.9%). ReSNB positivity was observed in three patients (6.7%) in the ipsilateral axilla, whereas no metastasis was detected in the contralateral axilla or internal mammary region. Although four cases of recurrence were observed after reoperation, there was no local recurrence in the ipsilateral axillary region.
Conclusions
reSNB demonstrated high identification rates, comparable to those of initial SNB, with a low rate of positive metastasis and no local recurrence in the ipsilateral axillary region. Despite the limited number of cases, these findings suggest the clinical significance of reSNB in IBTR cases.
Molecular Dynamics Simulation of the Atropine Drug Encapsulation inside Protein Origami Icosahedral Nanocages in Physiological Environment
Authors: Bahreini Maziar , Sabetvand Roozbeh 
Published: December 2024

Abstract

Atomic nanocages are innovative nanostructures with significant potential in drug delivery systems. Their unique properties enable effective encapsulation and controlled release of therapeutic agents, making them a focal point in modern biomedical applications. Here, we used molecular dynamics (MD) approach used to describe this atomic samples (protein origami icosahedral nanocage) in drug delivery process of the Atropine for clinical applications. Current MD simulations done in two main phases. Firstly, the equilibrium phase of designed system detected by their initial temperature convergence to 300 K and center of mass them to 2.21 and 1.15 Å. Next, the encapsulating process of designed system done for 100 ns. MD results shown the potential and total energy parameters reached to 7.93 and 12.97 (optimum values) in the final time step of simulations. These results predicted the modeled protein origami icosahedral nanocage-drug systems has appropriate structural stability and can be used for various drug delivery purposes in actual cases.
Association of Fluid Balance Index with In-Hospital Mortality in Critically Ill Patients with Acute Pancreatitis: A Multicenter Retrospective Cohort Study
Authors: Xu Zhihong , Liu Siyao , Liu Xiong , Hu Jun , Pan Mandong , Huang Xianwei , Lin Jiyan , Huang Xiaodong 
Published: December 2024

Abstract

Fluid resuscitation is critical in managing acute pancreatitis (AP), yet both excessive and insufficient resuscitation can lead to poor outcomes. This multicenter retrospective cohort study investigated the relationship between the fluid balance index (FBI) and in-hospital mortality in critically ill AP patients. In total, 547 AP patients from the MIMIC-IV database and 91 patients from our center were classified into high-risk (FBI ≥ 145) and low-risk (FBI < 145) groups. The primary outcome was all-cause in-hospital mortality. The in-hospital mortality rate observed in the MIMIC-IV cohort was 8.96%. Machine learning analysis identified FBI as a key predictor of mortality. Multivariable Cox regression showed that patients with an FBI ≥ 145 had significantly increased in-hospital mortality (HR = 1.99, 95% CI 1.08–3.69) and 28-day mortality (HR = 2.90, 95% CI 1.50–5.64). Propensity score matching minimized baseline differences, and Kaplan-Meier survival analysis demonstrated higher mortality in the high-risk group (p < 0.05), consistent in our center’s cohort. Restricted cubic spline analysis revealed a near-linear increase in mortality with rising FBI (p < 0.05), confirmed by subgroup analysis. In conclusion, FBI is strongly associated with in-hospital mortality in critically ill AP patients, underscoring its potential to inform fluid resuscitation strategies.
The Impact of Paraspinal Sarcopenia Compared to Generalized Sarcopenia on Conservative Treatment Outcomes in Degenerative Lumbar Spinal Stenosis
Authors: Jin Jinwoo , Wi Seung Myung 
Published: December 2024

Abstract

Purpose
To evaluate the concordance between assessment tools for generalized and paraspinal sarcopenia in patients with degenerative spinal stenosis, and to identify risk factors associated with conservative treatment failure and poor prognosis.
Methods
We retrospectively reviewed 101 patients with degenerative lumbar spinal stenosis who underwent MRI/whole-body DXA and at least three months of conservative treatment between 2013 and 2023. Patients were divided into two groups: 71 patients who continued with conservative treatment (Group A) and 30 patients who underwent surgery after conservative treatment failure (Group B). The decision to proceed with surgery was based on persistent or worsening symptoms despite comprehensive conservative management, and the surgical procedures performed included posterior decompressive laminectomy, with or without spinal fusion. Two independent reviewers assessed paraspinal and psoas muscle quality using axial T2 MRI. Paraspinal sarcopenia was determined by cross-sectional area (CSA) and the Goutalier classification of the paralumbar (PL) multifidus and erector spinae muscles. Generalized sarcopenia was assessed by normalized total psoas area (NTPA) and appendicular skeletal muscle mass (ASM) values by DXA. Patients were divided into two groups based on conservative treatment success or failure, and characteristics were compared using the Student t-test and chi-squared test. Logistic regression generated unadjusted odds ratios (OR) for conservative treatment failure. Spearman’s rank correlation coefficient (rho) was used to calculate the correlation between assessments of paraspinal and generalized sarcopenia.
Results
Patients who underwent surgery had a lower PL-CSA/BMI and higher fatty infiltration of PL muscles. No significant differences were found in generalized sarcopenia parameters between the groups. PL-CSA/BMI (OR: 0.983, p = 0.037) was independently associated with treatment failure. ASM/BMI had the highest correlation with PL-CSA/BMI (rho = 0.73, p < 0.001), though other correlations were significant but weaker.
Conclusion
Our study highlights the distinct role of paraspinal sarcopenia in degenerative lumbar spinal stenosis, showing a weak correlation with generalized sarcopenia. Paraspinal muscle health is crucial for predicting conservative treatment outcomes, emphasizing the need for specific diagnostic approaches. Future research should refine diagnostic criteria to improve patient management and outcomes.
Field experiment confirms high macroplastic trapping efficiency of wood jams in a mountain river channel
Authors: Liro Maciej , Mikuś Paweł , Zielonka Anna 
Published: December 2024

Abstract

Identifying macroplastic deposition hotspots in rivers is essential for planning cleanup efforts and assessing the risks to aquatic life and the aesthetic value of river landscapes. Recent fieldwork in mountain rivers has shown that wood jams retain significantly more macroplastic than other emergent surfaces within river channels. Here, we experimentally verify these findings by tracking the deposition of 64 PET bottles after 52–65 days of transport in the mid-mountain Skawa River (Polish Carpathians) under low to medium flow conditions. Despite variations in river channel management and the resulting morphological patterns along the study reach, the majority (71.9%, n = 46) of tracked bottles were trapped by wood jams near the low-flow channel. Interestingly, the trapping efficiency was three times higher in the straight, regulated reach (14.8% per km) compared to the highly sinuous, unregulated reach (4.5% per km). In the regulated reach, water inundations and wood jams are confined to a narrow zone near the low-flow channel, which may explain the high macroplastic trapping efficiency under low to medium flow conditions. In contrast, in the unmanaged, seminatural reach, where wood jams and water inundation occur over broader areas formed by extensive gravel bars, the trapping potential is lower under similar flow conditions. Our findings confirm that wood jams and channel morphology are key predictors of macroplastic trapping in mountain rivers. Together with previous observations, this underscores the significant role of flow conditions in shaping riverine macroplastic hotspots across reaches with different morphologies. Specifically, regulated mountain river reaches show a higher potential for hotspot formation during low to medium flows, while unregulated reaches tend to form hotspots during flood events.
Association between the triglyceride-glucose index and contrast-induced nephropathy in chronic total occlusion patients undergoing percutaneous coronary intervention Running title: TyG index and Contrast-induced nephropathy
Authors: Söner Serdar , Aktan Adem , Kılıç Raif , Güzel Hamdullah , Taştan Ercan , Okşul Metin , Cömert Adnan Duha , Coşkun Mehmet Sait , Söner Hülya Tosun , Güzel Tuncay 
Published: December 2024

Abstract

Objective
The triglyceride glucose (TyG) index is a biomarker of insulin resistance and is associated with an increased risk of cardiovascular events. In this study, we aimed to investigate the relationship between the TyG index and contrast-induced nephropathy (CIN) and mortality in patients who underwent percutaneous coronary intervention (PCI) due to chronic total coronary occlusion (CTO).
Methods
218 individuals from three separate medical centers who underwent procedural PCI between February 2010 and April 2012 and had a CTO lesion in at least one coronary artery were recruited. According to the TyG index, patients were divided into two groups. Patients with a TyG index ≥ 8.65 were included in Group 1, and patients with a TyG index < 8.65 were included in Group 2. Patients were followed up for 96 months. The main outcome was the development of CIN and mortality.
Results
The mean age of the patients (65.8 ± 10.94 vs. 61.68 ± 11.4, p = 0.009), diabetes mellitus (60 [44.8%] vs. 11 [13.1%], p < 0.001), and dyslipidemia rates (52 [38.8%] vs. 21 [25%], p = 0.036) were higher in group 1. In multivariable logistic regression analysis, it was seen that age (OR = 1.04, 95% CI = 1.01–1.08, p = 0.020), chronic kidney disease (OR = 2.34, 95% CI = 1.02–5.33, p = 0.044), peripheral artery disease (OR = 5.66, 95% CI = 1.24–25.91, p = 0.026), LVEF (OR = 0.95, 95% CI = 0.92–0.99, p = 0.005), LDL cholesterol levels (OR = 1.00, 95%CI = 1.00-1.02, p = 0.024) and TyG index (OR = 2.17, 95% CI = 1.21–3.89, p = 0.009) were independent predictors of the development of CIN.
Conclusion
Our study demonstrates a correlation between the TyG index and the prevalence of CIN in patients with CTO undergoing PCI. Adding the TyG index to the routine clinical evaluation of patients with CTO undergoing PCI may help protect patients from the development of CIN.
Dupilumab dampens mucosal type 2 response during acetylsalicylic acid challenge in N-ERD patients
Authors: Schneider Sven , Eckl-Dorna Julia , Morgenstern Christina , Poglitsch Katharina , Quint Tamara , Gangl Katharina , Bartosik Tina , Campion Nicholas , Tu Aldine , Stanek Victoria , Bangert Christine 
Published: December 2024

Abstract

Non-steroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD) is characterized by the clinical triad of hypersensitivity to NSAIDs, nasal polyposis, and asthma. The cells and immune mediators causing acute symptoms when driving the hypersensitivity reaction to acetylsalicylic acid (ASA) ingestion, remain poorly defined. Here we investigate the dynamics of nasal immune mediators during ASA provocation in N-ERD patients before and twenty-four weeks after therapy with the IL-4 receptor alpha-blocking antibody dupilumab. Nasal mucosal lining fluids of patients with N-ERD, chronic rhinosinusitis patients with nasal polyps (CRSwNP) and healthy disease controls were collected at defined time points up to two hours after ASA provocation and analysis of thirty-three different inflammatory mediators as well as transcriptomic profiling was performed. We observed that N-ERD patients showed a significant increase in type 2 associated cytokines sixty minutes after ASA provocation as compared to the other patient groups. This effect was diminished after twenty-four weeks of dupilumab therapy and was independent of the development of ASA tolerance. Transcriptomics revealed dampened upregulation of type 2 associated pathways genes as well as enhanced downregulation of lipid and peroxisome metabolisms at ASA provocation after dupilumab therapy. Thus, treatment with dupilumab leads to reduced nasal type 2 cytokine secretion and distinct changes in the transcriptomic profile during ASA provocation, but changes in type 2 mediators show no association with tolerance development.
Proteome Profiling of Serum Reveals Pathological Mechanisms and Biomarker Candidates for Cerebral Small Vessel Disease
Authors: Wang Yun-chao , Zhu Hang-hang , He Liu-Chang , Yao Ya-ting , Zhang Lei , Xue Xin-li , Li Jing-yi , Zhang Li , Chen Jin-feng , Song Bo , Shi Chang-he , Li Yu-sheng , Gao Yuan , Yang Jing-hua , Xu Yu-ming 
Published: December 2024

Abstract

Background
Cerebral small vessel disease (CSVD) is a global brain disorder that is characterized by a series of clinical, neuroimaging, and neuropathological manifestations. However, the molecular pathophysiological mechanisms of CSVD have not been thoroughly investigated. Liquid chromatography-tandem mass spectrometry-based proteomics has broad application prospects in biomedicine. It is used to elucidate disease-related molecular processes and pathophysiological pathways, thus providing an important opportunity to explore the pathophysiological mechanisms of CSVD.
Methods
Serum samples were obtained from 96 participants (58 with CSVD and 38 controls) consecutively recruited from The First Affiliated Hospital of Zhengzhou University. After removing high-abundance proteins, the serum samples were analyzed using high-resolution mass spectrometry. Bioinformatics methods were used for in-depth analysis of the obtained proteomic data, and the results were verified experimentally.
Results
Compared with the control group, 52 proteins were differentially expressed in the sera of the CSVD group. Furthermore, analyses indicated the involvement of these differentially expressed proteins in CSVD through participation in the overactivation of complement and coagulation cascades and dysregulation of insulin-like growth factor-binding proteins. The proteomic biomarker panel identified by the machine learning model combined with clinical features is expected to facilitate the diagnosis of CSVD (AUC = 0.947,95% CI = 0.895–0.978).
Conclusions
The study is the most in-depth study on CSVD proteomics to date, and suggests that the overactivation of the complement cascade and the dysregulation of IGFBP on- IGF may be closely correlated with the occurrence and progression of CSVD, offering the potential to develop peripheral blood biomarkers and providing new insights into the biological basis of CSVD.
Systemic Inflammatory Response Markers Improve the Discrimination for Prognostic Model in Hepatocellular Carcinoma
Authors: Rocco Alba , Sgamato Costantino , Pelizzaro Filippo , Simeon Vittorio , Coccoli Pietro , Compare Debora , Elisa Pinto , Palano Giorgio , Foschi Francesco Giuseppe , Raimondo Giovanni , Missale Gabriele , Svegliati-Baroni Gianluca , Trevisani Franco , Caturelli Eugenio , Brunetto Maurizia Rossana , Vidili Gianpaolo , Masotto Alberto , Magalotti Donatella , Campani Claudia , Gasbarrini Antonio , Azzaroli Francesco , Rapaccini Gian Ludovico , Stefanini Bernardo , Sacco Rodolfo , Mega Andrea , Giannini Edoardo Giovanni , Cabibbo Giuseppe , Marco Maria Di , Guarino Maria , Chiodini Paolo , Farinati Fabio , Nardone Gerardo 
Published: December 2024

Abstract

Background/purpose of the study: We aimed to evaluate the performance of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and their combination (combined NLR-PLR, CNP) on overall survival (OS) and recurrence-free survival (RFS) in a large cohort of unselected hepatocellular carcinoma (HCC) patients.
Methods: Training and validation cohort data were retrieved from the Italian Liver Cancer (ITA.LI.CA) database. The optimal cut-offs of NLR and PLR were calculated according to the multivariable fractional polynomial and the minimum p-value method. The continuous effect and best cut-off categories of NLR and PLR were analyzed using multivariable Cox regression analysis. A shrinkage procedure adjusted over-fitting HR estimates of best cut-off categories. C-statistic and integrated discrimination improvement (IDI) were calculated to evaluate the discrimination properties of the biomarkers when added to clinical survival models.
Results: 2,286 patients were split into training (n=1,043) and validation (n=1,243) cohorts.The optimal cut-offs for NLR and PLR were 1.45 and 188, respectively. NLR (HR 1.58, 95%CI 1.11-2.28, p=0.014) and PLR (HR 1.79, 95%CI 1.11-2.90, p=0.018) were independent predictors of OS. When added to the clinical prognostic model, including age, alpha-fetoprotein (AFP), CHILD-Pugh score and Barcelona Clinic Liver Cancer (BCLC) staging system, CNP had a significant incremental value in predicting OS (IDI 1.3%, p=0.04). Data were confirmed in the validation cohort. NLR (p=0.027) and CNP (p=0.023) predicted RFS in the training cohort.
Conclusions: NLR, PLR, and CNP independently predicted shorter OS in HCC patients. The addition of CNP into the survival prediction model significantly improved the model's predictive accuracy for OS.
The clinical application value of a formula in the diagnosis of thalassemia and iron deficiency anemia
Authors: Zhang Yan , Wu Weiqing , Luo Mingyue , Zhang Hu , Song Chunli , Liu Wenlan 
Published: December 2024

Abstract

BACKGROUND
To explore the clinical application value of RDW-SD/RDW-CV ratio in the diagnosis of thalassemia.
METHODS
A retrospective analysis of 174 thalassemia patients (thalassemia group), 103 iron-deficiency anemia patients (iron-deficiency anemia group), and 196 healthy people (healthy control group) diagnosed Blood routine related indicators MCV, MCH, RBC, RDW-SD, RDW-CV,use receiver operating characteristic curve (ROC) to analyze RDW-SD/RDW-CV and previously known formulas MCV/RBC, MCH/RBC ratio in the diagnosis of thalassemia and iron deficiency anemia,apply the area under the curve (AUC), sensitivity and specificity to compare the diagnostic efficacy of the three formulas in the differential diagnosis of anemia.
RESULTS
The ratios of the three formulas of RDW-SD/RDW-CV, MCV/RBC, and MCH/RBC in the identification of thalassemia are 0.936, 0.879, 0.875, respectively. When the best cutoff value of RDW-SD/RDW-CV is 2.94. The sensitivity for diagnosing thalassemia is 82.70%, and the specificity is 90.8%.The AUCs of these three formulas in differentiating iron deficiency anemia are 0.954, 0.912, 0.915, and the AUCs for differentiating thalassemia and iron deficiency anemia are 0.748, 0.673, 0.668, apart, and the AUCs for differentiating α and β thalassemias They are 0.748, 0.673, and 0.668 separately.
CONCLUSIONS
Our new formula RDW-SD/RDW-CV ratio has fine clinical screening value in the diagnosis of thalassemia and iron deficiency anemia, and its diagnostic efficiency is better than the previously known formula MCV/RBC, MCH/RBC ratio, and It can be used for the differential diagnosis of iron deficiency anemia and thalassemia, to a certain extent, it can also distinguish between α and β two kinds of thalassemia.