bluuebunny/crossref_metadata_2025_split huggingface dataset:
Side-to-side reverse superficial temporal artery to M4 middle cerebral artery bypass for common carotid artery occlusion with bonnet collaterals: illustrative case
Authors: Daggubati Lekhaj C. , Padmanaban Varun , Church Ephraim W. 
Published: May 2021

BACKGROUND
The bonnet bypass was initially described for common carotid artery occlusion. Considered a second-generation bypass, it augments intracranial perfusion with contralateral external carotid artery flow through an interposition graft running over the scalp vertex. However, the traditional first-generation low-flow superficial temporal artery (STA)-M4 middle cerebral artery (MCA) bypass may be enhanced by performing a side-to-side (S-S) bypass with an intraluminal suture technique (fourth-generation bypass) to increase perfusion through antegrade and retrograde flow.

OBSERVATIONS
The authors present a reimagined S-S STA-M4 bypass in the case of a patient with symptomatic common carotid occlusion, in which the ipsilateral STA filled in a reverse fashion from the contralateral external carotid branches over the scalp vertex (bonnet collaterals). By performing an S-S anastomosis, the authors were able to improve cerebral perfusion and avoid the multiple anastomosis sites of the bonnet bypass.

LESSONS
The patient had a good recovery with resolution of his preoperative symptoms. Follow-up angiography showed a patent bypass supplying the MCA territory through retrograde flow in the frontal and parietal limbs of the STA, converging at the anastomosis site. In this report, the authors present a new fourth-generation bypass dubbed the “S-S reverse STA-M4 MCA bypass.”
In vivo transdifferentiation, osteoconductive and osteoinductive properties of experimental water-soluble organo-biomaterials – A Pilot Study
Authors: Crivellaro Viviane Rozeira , Spada Gilvan , Judachesci Cláudia Salete , Spada Paula Porto , Saling Luiza Rodrigues , Miranda Idélcena Tatiane , Deliberador Tatiana Miranda , Gabardo Marilisa Carneiro Leão , Scariot Rafaela , Leão Moira Pedroso , Storrer Carmen Lucia Mueller , Khajotia Sharukh Soli , Esteban Florez Fernando Luis , Zielak João César 
Published: May 2021

Inorganic bovine bone matrix (IBBM) is a biomaterial with proven osteoconductive functionalities. The objective of this study was to assess the in vivo bone regeneration functionalities of IBBM modified or not by an experimental MOE in sheep. MOE synthesis was performed by suspending nacre particles (0.05 g, diameters < 0.01 mm) in anhydrous acetic acid (pH 7, 5 mL, 25°C, 72 hours) using magnetic stirring. Polyethylene carriers (d= 5.0 mm, l= 10.0 mm, open ends) of negative control (sham) or experimental groups (IBBM or MOE-modified IBBM) were placed (n=3 conditions /animal; intramuscularly) adjacent to the lower spine of adult sheep (8 animals, » 45 Kg, 2 years old). Tissues were harvested (at 3 or 6 months) after implantation in preparation for histological (H), morphometrical (MM) and immunohistochemical analyses (IH; Wnt-3a, CD34, Vimentin and PREF-1). MM data were tested for normality and variance homogeneity using the Shapiro-Wilk and Levene tests, and Mann Whitney and Kruskal-Wallis, respectively. IM data were analyzed using two-way ANOVA and Tukey tests. Differences (p < 0.05) were observed between experimental groups (IBBM and IBBM+MOE at both 3 and 6 months) and controls (sham) for total area; Differences were not found for presence of remnant particles among experimental groups. The highest formation of bone was observed with IBBM+MOE (6-months). No differences (p > 0.05) were found on IM analysis (CD34, Vimentin, PREF-1, Wnt3a). Results indicated that experimental materials (IBBM+MOE) display promising functionalities. Additional studies are necessary to define biomaterials’ longitudinal effects and long-term biocompatibility properties.
Diagnostic and Prognostic Accuracy of Aortic Valve Calcium Scoring in Patients With Moderate-to-Severe Aortic Stenosis
Authors: Boulif Jamila , Slimani Alisson , Lazam Siham , de Meester Christophe , Piérard Sophie , Pasquet Agnès , Pouleur Anne-Catherine , Vancraeynest David , El Khoury Gébrine , de Kerchove Laurent , Gerber Bernhard L. , Vanoverschelde Jean-Louis 
Published: May 2021

Background: Assessing the true severity of aortic stenosis (AS) remains a challenge, particularly when echocardiography yields discordant results. Recent European and American guidelines recommend measuring aortic valve calcium (AVC) by multidetector row computed tomography (MDCT) to improve this assessment.Aim: To define, using a standardized MDCT scanning protocol, the optimal AVC load criteria for truly severe AS in patients with concordant echocardiographic findings, to establish the ability of these criteria to predict clinical outcomes, and to investigate their ability to delineate truly severe AS in patients with discordant echocardiographic AS grading.Methods and Results: Two hundred and sixty-six patients with moderate-to-severe AS and normal LVEF prospectively underwent MDCT and Doppler-echocardiography to assess AS severity. In patients with concordant AS grading, ROC analysis identified optimal cut-off values for diagnosing severe AS using different AVC load criteria. In these patients, 4-year event-free survival was better with low AVC load (60–63%) by these criteria than with high AVC load (23–26%, log rank p &lt; 0.001). Patients with discordant AS grading had higher AVC load than those with moderate AS but lower AVC load than those with severe high-gradient AS. Between 36 and 55% of patients with severe LG-AS met AVC load criteria for severe AS. Although AVC load predicted outcome in these patients as well, its prognostic impact was less than in patients with concordant AS grading.Conclusions: Assessment of AVC load accurately identifies truly severe AS and provides powerful prognostic information. Our data further indicate that patients with discordant AS grading consist in a heterogenous group, as evidenced by their large range of AVC load. MDCT allows to differentiate between truly severe and pseudo-severe AS in this population as well, although the prognostic implications thereof are less pronounced than in patients with concordant AS grading.
Fault Triggering Mechanisms for Hydraulic Fracturing-Induced Seismicity From the Preston New Road, UK Case Study
Authors: Kettlety Tom , Verdon James P. 
Published: May 2021

We investigate the physical mechanisms governing the activation of faults during hydraulic fracturing. Recent studies have debated the varying importance of different fault reactivation mechanisms in different settings. Pore pressure increase caused by injection is generally considered to be the primary driver of induced seismicity. However, in very tight reservoir rocks, unless a fracture network exists to act as a hydraulic conduit, the rate of diffusion may be too low to explain the spatio-temporal evolution of some microseismic sequences. Thus, elastic and poroelastic stress transfer and aseismic slip have been invoked to explain observations of events occurring beyond the expected distance of a reasonable diffusive front. In this study we use the high quality microseismic data acquired during hydraulic fracturing at the Preston New Road (PNR) wells, Lancashire, UK, to examine fault triggering mechanisms. Injection through both wells generated felt induced seismicity—an ML 1.6 during PNR-1z injection in 2018 and an ML 2.9 during PNR-2 in 2019—and the microseismic observations show that each operation activated different faults with different orientations. Previous studies have already shown that PNR-1z seismicity was triggered by a combination of both direct hydraulic effects and elastic stress transfer generated by hydraulic fracture opening. Here we perform a similar analysis of the PNR-2 seismicity, finding that the PNR-2 fault triggering was mostly likely dominated by the diffusion of increased fluid pressure through a secondary zone of hydraulic fractures. However, elastic stress transfer caused by hydraulic fracture opening would have also acted to promote slip. It is significant that no microseismicity was observed on the previously activated fault during PNR-2 operations. This dataset therefore provides a unique opportunity to estimate the minimum perturbation required to activate the fault. As it appears that there was no hydraulic connection between them during each stimulation, any perturbation caused to the PNR-1z fault by PNR-2 stimulation must be through elastic or poroelastic stress transfer. As such, by computing the stress transfer created by PNR-2 stimulation onto the PNR-1z fault, we are able to approximate the minimum bound for the required stress perturbation: in excess of 0.1 MPa, orders of magnitude larger than stated estimates of a generalized triggering threshold.
Association of RYR2 Mutation With Tumor Mutation Burden, Prognosis, and Antitumor Immunity in Patients With Esophageal Adenocarcinoma
Authors: Liu Zaoqu , Liu Long , Jiao Dechao , Guo Chunguang , Wang Libo , Li Zhaonan , Sun Zhenqiang , Zhao Yanan , Han Xinwei 
Published: May 2021

Background: Esophageal adenocarcinoma (EAC) remains a leading cause of cancer-related deaths worldwide and demonstrates a predominant rising incidence in Western countries. Recently, immunotherapy has dramatically changed the landscape of treatment for many advanced cancers, with the benefit in EAC thus far been limited to a small fraction of patients.Methods: Using somatic mutation data of The Cancer Genome Atlas (TCGA) and the International Cancer Genome Consortium, we delineated the somatic mutation landscape of EAC patients from US and England. Based on the expression data of TCGA cohort, multiple bioinformatics algorithms were utilized to perform function annotation, immune cell infiltration analysis, and immunotherapy response assessment.Results: We found that RYR2 was a common frequently mutated gene in both cohorts, and patients with RYR2 mutation suggested higher tumor mutation burden (TMB), better prognosis, and superior expression of immune checkpoints. Moreover, RYR2 mutation upregulated the signaling pathways implicated in immune response and enhanced antitumor immunity in EAC. Multiple bioinformatics algorithms for assessing immunotherapy response demonstrated that patients with RYR2 mutation might benefit more from immunotherapy. In order to provide additional reference for antitumor therapy of different RYR2 status, we identified nine latent antitumor drugs associated with RYR2 status in EAC.Conclusion: This study reveals a novel gene whose mutation could be served as a potential biomarker for prognosis, TMB, and immunotherapy of EAC patients.
Lactobacillus casei CCFM1074 Alleviates Collagen-Induced Arthritis in Rats via Balancing Treg/Th17 and Modulating the Metabolites and Gut Microbiota
Authors: Fan Zhexin , Ross R. Paul , Stanton Catherine , Hou Bao , Zhao Jianxin , Zhang Hao , Yang Bo , Chen Wei 
Published: May 2021

Gut microbiota and their influence on metabolites are receiving increasing attentions in autoimmune diseases including rheumatoid arthritis (RA). Probiotics become a promising manipulator to prevent or attenuate the progression of arthritis, some evidences suggesting that lactobacilli treatment influence the responses to RA therapy but the underlying mechanisms are limited. By using a collagen-induced arthritis (CIA) rats, the study assessed the effects of two L. casei strains (CCFM1074, CCFM1075) on the immune responses, gut microbiota and plasma metabolites via an integrated cross-omics approach including fecal 16S rRNA high-throughput sequencing and plasma metabolomics. The genome of the two strains was analyzed and compared using whole-genome sequencing approach to further confirm biology functions. CCFM1074 reduced arthritic symptoms while CCFM1075 did not, though both strains down-regulated the plasma IL-6 and Th17 cells proportion. CCFM1074 enhanced the proportion of Treg cells in mesenteric lymph nodes which was significantly associated with SCFAs upregulation, as well as with genomic evidence that CCFM1074 possesses more functional genes involved in carbohydrate metabolism. Moreover, CCFM1074 regulated the gut microbiota, including modulating community structure, decreasing the abundance of Alistipes and Parabacteroides and increasing the abundance of Oscillibacter. The differential metabolites modulated by CCFM1074 including eicosapentaenoic acid and docosapentaenoic acid which involved in unsaturated fatty acids metabolism. Furthermore, alterations of gut microbial community were correlated with the plasma metabolome. In summary, L. casei CCFM1074 alleviated arthritis via rebalancing gut microbiota, immune responses and plasma metabolites.
Effectiveness of Thermal Properties in Thermal Energy Storage Modeling
Authors: Torres Sevilla Law , Radulovic Jovana 
Published: May 2021

This paper studies the influence of material thermal properties on the charging dynamics in a low temperature Thermal Energy Storage, which combines sensible and latent heat. The analysis is based on a small scale packed bed with encapsulated PCMs, numerically solved using COMSOL Multiphysics. The PCMs studied are materials constructed based on typical thermal properties (melting temperature, density, specific heat capacity (solid and liquid), thermal conductivity (solid and liquid) and the latent heat) of storage mediums in literature. The range of values are: 25–65°C for the melting temperature, 10–500 kJ/kg for the latent heat, 600–1,000 kg/m3 for the density, 0.1–0.4 W/mK (solid and liquid) for the thermal conductivity and 1,000–2,200 J/kgK (solid and liquid) for the specific heat capacity. The temperature change is monitored at three different positions along the tank. The system consists of a 2D tank with L/D ratio of 1 at a starting temperature of 20°C. Water, as the heat transfer fluid, enters the tank at 90°C. Results indicate that latent heat is a leading parameter in the performance of the system, and that the thermal properties of the PCM in liquid phase influence the overall heat absorption more than its solid counterpart.
A Decreased Level of Soluble Klotho Can Predict Cardiovascular Death in No or Mild Abdominal Aortic Calcification Hemodialysis Patients
Authors: Cai Hong , Zhu Xuying , Lu Jiayue , Zhu Minxia , Liu Shang , Zhan Yaping , Ni Zhaohui , Gu Leyi , Zhang Weiming , Mou Shan 
Published: May 2021

Background: Soluble Klotho plays an important role in cardiovascular disease and death in chronic kidney disease (CKD). We assessed the relationship between serum soluble Klotho (sKL) level and outcome in MHD patients.Methods: Soluble Klotho was detected by ELISA. Cox regression analysis and Kaplan-Meier analysis showed the relationship between sKL and cardiovascular disease (CVD) mortality in maintenance hemodialysis (MHD) patients.Results: There were 45 cases (35.2%) of all-cause death and 36 cases (28.1%) of CVD mortality. Multivariate linear regression analysis showed that Log[iPTH] (γ = −0.224, P = 0.015) was an independent predictor of sKL level. Cox regression showed that lower sKL was associated with higher CVD mortality rate [OR = 0.401, 95% CI (0.183–0.867), P = 0.022]. Kaplan-Meier analysis showed that the CVD mortality rate increased significantly in patients with low sKL (P = 0.006). Compared with high sKL patients, low sKL patients with no or mild vascular calcification [aortic calcification score (AACs) ≤ 4] had no significant difference in all-cause mortality rate. The CVD mortality rate was significantly lower in high sKL patients (P = 0.004) than in those with low sKL. In the severe calcification group (AACs ≥ 5), all-cause and CVD mortality rates were similar between different sKL groups (P = 0.706 and 0.488, respectively). The area under the receiver-operating characteristic curve (AUC) of soluble Klotho for predicting the CVD in MHD patients with AACs ≤ 4 was 0.796 (0.647–0.946, P = 0.017), sensitivity was 0.921, and specificity was 0.50 for a cutoff value of 307.69 pg/ml.Conclusions: Lower sKL was associated with higher CVD mortality rate. Lower sKL concentration in MHD patients with no or mild calcification can predict CVD mortality.
Development and Validation of a Machine-Learning Model for Prediction of Extubation Failure in Intensive Care Units
Authors: Zhao Qin-Yu , Wang Huan , Luo Jing-Chao , Luo Ming-Hao , Liu Le-Ping , Yu Shen-Ji , Liu Kai , Zhang Yi-Jie , Sun Peng , Tu Guo-Wei , Luo Zhe 
Published: May 2021

Background: Extubation failure (EF) can lead to an increased chance of ventilator-associated pneumonia, longer hospital stays, and a higher mortality rate. This study aimed to develop and validate an accurate machine-learning model to predict EF in intensive care units (ICUs).Methods: Patients who underwent extubation in the Medical Information Mart for Intensive Care (MIMIC)-IV database were included. EF was defined as the need for ventilatory support (non-invasive ventilation or reintubation) or death within 48 h following extubation. A machine-learning model called Categorical Boosting (CatBoost) was developed based on 89 clinical and laboratory variables. SHapley Additive exPlanations (SHAP) values were calculated to evaluate feature importance and the recursive feature elimination (RFE) algorithm was used to select key features. Hyperparameter optimization was conducted using an automated machine-learning toolkit (Neural Network Intelligence). The final model was trained based on key features and compared with 10 other models. The model was then prospectively validated in patients enrolled in the Cardiac Surgical ICU of Zhongshan Hospital, Fudan University. In addition, a web-based tool was developed to help clinicians use our model.Results: Of 16,189 patients included in the MIMIC-IV cohort, 2,756 (17.0%) had EF. Nineteen key features were selected using the RFE algorithm, including age, body mass index, stroke, heart rate, respiratory rate, mean arterial pressure, peripheral oxygen saturation, temperature, pH, central venous pressure, tidal volume, positive end-expiratory pressure, mean airway pressure, pressure support ventilation (PSV) level, mechanical ventilation (MV) durations, spontaneous breathing trial success times, urine output, crystalloid amount, and antibiotic types. After hyperparameter optimization, our model had the greatest area under the receiver operating characteristic (AUROC: 0.835) in internal validation. Significant differences in mortality, reintubation rates, and NIV rates were shown between patients with a high predicted risk and those with a low predicted risk. In the prospective validation, the superiority of our model was also observed (AUROC: 0.803). According to the SHAP values, MV duration and PSV level were the most important features for prediction.Conclusions: In conclusion, this study developed and prospectively validated a CatBoost model, which better predicted EF in ICUs than other models.
Clinical Significance of Ultrasound-Based Hemodynamic Assessment of Extracranial Internal Carotid Artery and Posterior Cerebral Artery in Symptomatic and Angiographic Evolution of Moyamoya Disease: A Preliminary Study
Authors: Zheng Shuai , Ge Peicong , Shi Zhiyong , Wang Jingzhe , Li Yi , Yu Tengfei , Zhang Jinghan , Zhang Hongxia , Zhang Dong , He Wen 
Published: May 2021

Objective: To investigate the hemodynamic changes using ultrasound according to digital subtraction angiography (DSA) findings and explore the association between ultrasound parameters and clinical symptoms of moyamoya disease (MMD).Methods: Hemodynamic parameters of extracranial internal carotid artery (EICA) and posterior cerebral artery (PCA) were evaluated by ultrasound. According to DSA findings, EICA parameters among Suzuki stages (stage I-II, III-IV, and V-VI), and PCA parameters among leptomeningeal system scores (score 0–2, 3–4, and 5–6) were compared, respectively. ROC analysis was performed based on the ultrasound parameters to distinguish stroke from non-stroke patients.Results: Forty patients with MMD were included in our study (16 men; median age, 37 years). The diameter (D), peak systolic velocity (PSV), end diastolic velocity (EDV) and flow volume (FV) of EICA decreased as the Suzuki stage advanced (D: P &lt; 0.001; PSV: P &lt; 0.001; EDV: P &lt; 0.001; FV: P &lt; 0.001). The PSV and EDV of PCA increased as the leptomeningeal system scores advanced (PSV: P &lt; 0.001; EDV: P &lt; 0.001). ROC analysis showed that the area under the curves (AUCs) based on the D and FV of EICA, the PSV and EDV of PCA and their combination were 0.688, 0.670, 0.727, 0.684, and 0.772, respectively, to distinguish stroke from non-stroke patients.Conclusions: Ultrasound parameters were related to Suzuki stages and leptomeningeal system scores. Ultrasound may be useful in predicting the occurrence of stroke in patients with MMD. Future prospective studies with large sample sizes and long-term follow-up are needed to confirm our preliminary findings.
Case Report: An MRI Traumatic Brain Injury Longitudinal Case Study at 7 Tesla: Pre- and Post-injury Structural Network and Volumetric Reorganization and Recovery
Authors: Brown Stephanie S. G. , Dams-O'Connor Kristen , Watson Eric , Balchandani Priti , Feldman Rebecca E. 
Published: May 2021

Importance: A significant limitation of many neuroimaging studies examining mild traumatic brain injury (mTBI) is the unavailability of pre-injury data.Objective: We therefore aimed to utilize pre-injury ultra-high field brain MRI and compare a collection of neuroimaging metrics pre- and post-injury to determine mTBI related changes and evaluate the enhanced sensitivity of high-resolution MRI.Design: In the present case study, we leveraged multi-modal 7 Tesla MRI data acquired at two timepoints prior to mTBI (23 and 12 months prior to injury), and at two timepoints post-injury (2 weeks and 8 months after injury) to examine how a right parietal bone impact affects gross brain structure, subcortical volumetrics, microstructural order, and connectivity.Setting: This research was carried out as a case investigation at a single primary care site.Participants: The case participant was a 38-year-old female selected for inclusion based on a mTBI where a right parietal impact was sustained.Main outcomes: The main outcome measurements of this investigation were high spatial resolution structural brain metrics including volumetric assessment and connection density of the white matter connectome.Results: At the first scan timepoint post-injury, the cortical gray matter and cerebral white matter in both hemispheres appeared to be volumetrically reduced compared to the pre-injury and subsequent post-injury scans. Connectomes produced from whole-brain diffusion-weighted probabilistic tractography showed a widespread decrease in connectivity after trauma when comparing mean post-injury and mean pre-injury connection densities. Findings of reduced fractional anisotropy in the cerebral white matter of both hemispheres at post-injury time point 1 supports reduced connection density at a microstructural level. Trauma-related alterations to whole-brain connection density were markedly reduced at the final scan timepoint, consistent with symptom resolution.Conclusions and Relevance: This case study investigates the structural effects of traumatic brain injury for the first time using pre-injury and post-injury 7 Tesla MRI longitudinal data. We report findings of initial volumetric changes, decreased structural connectivity and reduced microstructural order that appear to return to baseline 8 months post-injury, demonstrating in-depth metrics of physiological recovery. Default mode, salience, occipital, and executive function network alterations reflect patient-reported hypersomnolence, reduced cognitive processing speed and dizziness.