bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plasma Proteomic Profile Predicts Survival in Heart Failure With Reduced Ejection Fraction
Authors: Gui Hongsheng , She Ruicong , Luzum Jasmine , Li Jia , Bryson Timothy D. , Pinto Yigal , Sabbah Hani N. , Williams L. Keoki , Lanfear David E. 
Published: May 2021

Background:
It remains unclear whether the plasma proteome adds value to established predictors in heart failure (HF) with reduced ejection fraction (HFrEF). We sought to derive and validate a plasma proteomic risk score (PRS) for survival in patients with HFrEF (HFrEF-PRS).

Methods:
Patients meeting Framingham criteria for HF with EF<50% were enrolled (N=1017) and plasma underwent SOMAscan profiling (4453 targets). Patients were randomly divided 2:1 into derivation and validation cohorts. The HFrEF-PRS was derived using Cox regression of all-cause mortality adjusted for clinical score and NT-proBNP (N-terminal pro-B-type natriuretic peptide), then was tested in the validation cohort. Risk stratification improvement was evaluated by C statistic, integrated discrimination index, continuous net reclassification index, and median improvement in risk score for 1-year and 3-year mortality.

Results:

Participants’ mean age was 68 years, 48% identified as Black, 35% were female, and 296 deaths occurred. In derivation (n=681), 128 proteins associated with mortality, 8 comprising the optimized HFrEF-PRS. In validation (n=336) the HFrEF-PRS associated with mortality (hazard ratio, 2.27 [95% CI, 1.84–2.82],
P
=6.3×10
-14
), Kaplan-Meier curves differed significantly between HFrEF-PRS quartiles (
P
=2.2×10
-6
), and it remained significant after adjustment for clinical score and NT-proBNP (hazard ratio, 1.37 [95% CI, 1.05–1.79],
P
=0.021). The HFrEF-PRS improved metrics of risk stratification (C statistic change, 0.009,
P
=0.612; integrated discrimination index, 0.041,
P
=0.010; net reclassification index=0.391,
P
=0.078; median improvement in risk score=0.039,
P
=0.016) and associated with cardiovascular death and HF phenotypes (eg, 6-minute walk distance, EF change). Most HFrEF-PRS proteins had little known connection to HFrEF.

Conclusions:
A plasma multiprotein score improved risk stratification in patients with HFrEF and identified novel candidates.
Ultra‐Fast‐Track Extubation in Adult Congenital Heart Surgery
Authors: Bianchi Paolo , Constantine Andrew , Costola Giulia , Mele Sara , Shore Darryl , Dimopoulos Konstantinos , Aw Tuan‐Chen 
Published: May 2021

Background
In pediatric cardiac surgery, perioperative management has evolved from slow weaning of mechanical ventilation in the intensive care unit to “ultra‐fast‐track” anesthesia with early extubation (EE) in theater to promote a faster recovery. The strategy of EE has not been assessed in adults with congenital heart disease, a growing population of patients who often require surgery.

Methods And Results

Data were collected retrospectively on all patients >16 years of age who underwent adult congenital heart surgery in our tertiary center between December 2012 and January 2020. Coarsened exact matching was performed for relevant baseline variables. Overall, 711 procedures were performed: 133 (18.7%) patients underwent EE and 578 (81.3%) patients received conventional extubation. After matching, patients who received EE required less inotropic or vasopressor support in the early postoperative period (median Vasoactive‐inotropic score 0.5 [0.0–2.0] versus 2.0 [0.0–3.5];
P
<0.0001) and had a lower total net fluid balance than patients after conventional extubation (1168±723 versus 847±733 mL;
P
=0.0002). The overall reintubation rate was low at 0.3%. EE was associated with a significantly shorter postoperative length of stay in higher dependency care units before a “step‐down” to ward‐based care (48 [45–50] versus 50 [47–69] hours;
P
=0.004). Lower combined intensive care unit and high dependency unit costs were incurred by patients who received EE compared with patients who received conventional extubation (£3949 [3430–4222] versus £4166 [3893–5603];
P
<0.0001).

Conclusions
In adult patients undergoing surgery for congenital heart disease, EE is associated with a reduced need for postoperative hemodynamic support, a shorter intensive care unit stay, and lower health‐care‐related costs.
Gastric cancer detection using the serum pepsinogen test method
Authors: Trivanovic Dragan , Plestina Stjepko , Honovic Lorena , Dobrila-Dintinjana Renata , Vlasic Tanaskovic Jelena , Vrbanec Damir 
Published: May 2021

Background: Gastric cancer (GC) is the eighth most common cause of cancer deaths in Croatia and one of the most common causes of cancer deaths worldwide. A reliable diagnostic tool for the early detection of GC is essential. Objective: We previously suggested a pepsinogen test method to reduce the mortality from GC by allowing early detection. Here, we report an updated analysis from a prospective single-center clinical study to evaluate the sensitivity and specificity of the pepsinogen test method and to determine whether this test can be used as a part of routine laboratory assessment of high-risk patients. Methods: We present mature data of the pepsinogen test method in the Croatian population after a median follow-up of 36 months. Statistical analyses were performed using a Mann-Whitney U test, multiple logistic regression, and receiver operating characteristics (ROC) to evaluate the predictive power of the assayed biomarkers. Results: Of the 116 patients, 25 patients had GC and 91 demonstrated a nonmalignant pathology based on tissue biopsy. Cutoff values were pepsinogen I ⩽70 and pepsinogen I/II ratio ⩽3.0. Using ROC curve analysis, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were determined to be 87.22%, 78.12%, 90.10%, 71.43%, and 92.86%, respectively, for the diagnosis of GC. The area under the curve was 0.700 (95% confidence interval 0.57–0.83). Conclusion: Pepsinogen tests are valuable for screening a population in need of further diagnosis and could help to avoid unnecessary invasive endoscopic procedures.
Esophageal Carcinosarcoma: Analysis of Clinical Features and Prognosis of 24 Cases and a Literature Review
Authors: Chen Shusen , Shi Yu , Lu Zhengjing , Wang Mingwei , Cong Longfei , Yang Baixia , Chen Xudong , Cai Jing , Yang Xi 
Published: May 2021

Objective: Esophageal carcinosarcoma (ECS) is a rare malignant tumor that accounts for only 0.5%-2.8% of all esophageal malignancies. As most current studies are case reports, the relationship between clinical features and prognosis remains controversial. Methods: We investigated the clinical features and prognosis of 24 patients with ECS in a single center from 2006 to 2018. There were 18 male and 6 female patients aged 52-82 years with a median age of 62.5 years. In addition, we included 9 studies on ECS from PubMed and a literature review. Results: The median follow-up time of the 24 patients was 70.5 (range, 10-156)months. The 3-year and 5-year survival rates were 83.3% and 70.8%, respectively. Among the 24 patients, none of the 10 (41.7%) stage T1 cancer patients had lymph node metastasis; however, lymph node metastasis was noted in 8 (57.1%) stage T2-4 cancer patients. The literature review revealed that 211 patients had a 5-year survival rate of 11.8%-68.2%, and 54.5%-95.8% study participants had early stage ECS. Although the information provided in the literature review is limited, it appears to be a characteristic of the early stage of the disease and predicts better prognosis when ECS is diagnosed, which is similar to the result of the current study. Conclusion: Our results indicate that ECS has a favorable prognosis, even among patients with early stage ECS who undergo radical esophagectomy with lymph node dissection. Because of the low incidence of ECS, further studies with more cases need to investigate this rare malignancy.
Shared Predictors of Academic Achievement in Children with ADHD: A Multi-Sample Study
Authors: Carrasco Kelly D. , Chuang Chi-Ching , Tripp Gail 
Published: May 2021

Objective: To identify common and shared predictors of academic achievement across samples of children with ADHD. Method: Two clinically referred samples from New Zealand (1 n = 88, 82% boys; 2 n = 121, 79% boys) and two community samples from the United States (3 n = 111, 65% boys; 4 n = 114, 69% boys), completed similar diagnostic, cognitive and academic assessments. Hierarchical multiple regression analyses identified significant predictors of word reading, spelling, and math computation performance in each sample. Results: Entered after IQ, semantic language, age at testing, and verbal working memory emerged as consistent predictors of achievement across academic subjects and samples. Visual-spatial working memory contributed to variance in math performance only. Symptom severity explained limited variance. Conclusions: We recommend evaluations of children with ADHD incorporate assessments of working memory and language skills. Classroom/academic interventions should accommodate reduced working memory and address any identified language weaknesses.
Incorporation of Celiomesenteric Trunk With Double Kissing Directional Branches During Fenestrated-Branched Endovascular Aortic Repair
Authors: Marcondes Giulianna B. , Tenorio Emanuel R. , Lima Guilherme B. , Mendes Bernardo , Saqib Naveed , Khan Sophia , Macedo Thanila A. , Lee Hansoo , Oderich Gustavo S. 
Published: May 2021

Purpose: Common celiomesenteric trunk (CMT) is a rare anatomical variation that occurs in 0.5% to 3.4% of the general population. Its presence may complicate planning and implantation of fenestrated and branched stent-grafts because the wide diameter and short length of the CMT to its bifurcation does not allow sufficient sealing for placement of bridging stents. Case Report: We report a patient with thoracoabdominal aortic aneurysm (TAAA) and CMT treated by fenestrated-branched endovascular aortic repair (FB-EVAR) using double kissing directional branches to incorporate the celiac axis and superior mesenteric artery. Pitfalls of stent design and implantation are outlined. Conclusion: Double kissing directional branches should be considered as an alternative to incorporate vessels with early bifurcation such as a CMT.
Association of plasma VEGF levels and the antidepressant effects of ketamine in patients with depression
Authors: Zheng Wei , Zhou Yan-Ling , Wang Cheng-Yu , Lan Xiao-Feng , Zhang Bin , Zhou Su-Miao , Yan Su , Yang Ming-Zhe , Nie Sha , Ning Yu-Ping 
Published: May 2021

Aims: Growing evidence suggests that vascular endothelial growth factor (VEGF) may be involved in the neuronal mechanisms underlying both depression aetiology and the response to ketamine treatments. The aim of this study was to examine whether changes in plasma VEGF levels are associated with the antidepressant effects of repeated ketamine infusions in patients with depression. Methods: Ninety-six patients with depression were enrolled and received six ketamine infusions during a 12-day period. Depressive symptom severity and plasma VEGF levels were measured by the Montgomery–Åsberg Depression Rating Scale (MADRS) and an enzyme-linked immunosorbent assay (ELISA) respectively, at baseline, 13 days and 26 days. Results: Despite a significant improvement in MADRS scores after patients received six ketamine infusions ( p < 0.001), no changes in plasma VEGF levels were observed at 13 days when compared with baseline. Moreover, no significant difference in plasma VEGF levels at baseline and 13 days was found between ketamine responders and nonresponders. No association was found between the antidepressant effects of repeated ketamine treatments and plasma VEGF levels. Conclusion: This study indicated that VEGF may not be a potential predictor of antidepressant response to repeated intravenous administration of ketamine in patients with depression.
Posterior Displacement of L1 May be a Risk Factor for Proximal Junctional Kyphosis After Adult Spinal Deformity Correction
Authors: Xi Zhuo , Duan Ping-Guo , Mummaneni Praveen V. , Liu Jinping , Guinn Jeremy M.V. , Wang Minghao , Li Bo , Wu Hao-Hua , Rivera Joshua , Burch Shane , Berven Sigurd H. , Chou Dean 
Published: May 2021

Study Design: Retrospective cohort study. Objective: Overcorrection in adult spinal deformity (ASD) surgery may lead to proximal junctional kyphosis (PJK) because of posterior spinal displacement. The aim of this paper is to determine if the L1 position relative to the gravity line (GL) is associated with PJK. Methods: ASD patients fused from the lower thoracic spine to sacrum by 4 spine surgeons at our hospital were retrospectively studied. Lumbar-only and upper thoracic spine fusions were excluded. Spinopelvic parameters, the L1 plumb line (L1PL), L1 distance to the GL (L1-GL), and Roussouly type were measured. Results: One hundred fourteen patients met inclusion criteria (63 patients with PJK, 51 without). Mean age and follow up was 65.51 and 3.39 years, respectively. There was no difference between the PJK and the non-PJK groups in baseline demographics, pre-operative and immediate post-operative pelvic incidence-lumbar lordosis mismatch, sagittal vertical axis, or coronal Cobb. The immediate postoperative L1-GL was -7.24 cm in PJK and -3.45 cm in non-PJK ( P < 0.001), L1PL was 1.71 cm in PJK and 3.07 cm in non-PJK ( P = 0.004), and PT (23.76° vs 18.90°, P = 0.026) and TK (40.56° vs 31.39°, P < 0.001) were larger in PJK than in non-PJK. After univariate and multivariate analyses, immediate postoperative TK and immediate postoperative L1-GL were independent risk factors for PJK without collinearity. Conclusions: A dorsally displaced L1 relative to the GL was associated with an increased risk of PJK after ASD surgery. The postoperative L1-GL distance may be a factor to consider during ASD surgery.
Rapid screening for COVID-19 by applying artificial intelligence to chest computed tomography images: A feasibility study
Authors: Galván Pedro , Fusillo José , González Felipe , Vukujevic Oraldo , Recalde Luciano , Rivas Ronald , Ortellado José , Portillo Juan , Mazzoleni Julio , Hilario Enrique 
Published: May 2021

Aim: The aim of the study was to present the results and impact of the application of artificial intelligence (AI) in the rapid diagnosis of COVID-19 by telemedicine in public health in Paraguay. Methods: This is a descriptive, multi-centered, observational design feasibility study based on an AI tool for the rapid detection of COVID-19 in chest computed tomography (CT) images of patients with respiratory difficulties attending the country’s public hospitals. The patients’ digital CT images were transmitted to the AI diagnostic platform, and after a few minutes, radiologists and pneumologists specialized in COVID-19 downloaded the images for evaluation, confirmation of diagnosis, and comparison with the genetic diagnosis (reverse transcription polymerase chain reaction (RT-PCR)). It was also determined the percentage of agreement between two similar AI systems applied in parallel to study the viability of using it as an alternative method of screening patients with COVID-19 through telemedicine. Results: Between March and August 2020, 911 rapid diagnostic tests were carried out on patients with respiratory disorders to rule out COVID-19 in 14 hospitals nationwide. The average age of patients was 50.7 years, 62.6% were male and 37.4% female. Most of the diagnosed respiratory conditions corresponded to the age group of 27–59 years (252 studies), the second most frequent corresponded to the group over 60 years, and the third to the group of 19–26 years. The most frequent findings of the radiologists/pneumologists were severe pneumonia, bilateral pneumonia with pleural effusion, bilateral pulmonary emphysema, diffuse ground glass opacity, hemidiaphragmatic paresis, calcified granuloma in the lower right lobe, bilateral pleural effusion, sequelae of tuberculosis, bilateral emphysema, and fibrotic changes, among others. Overall, an average of 86% agreement and 14% diagnostic discordance was determined between the two AI systems. The sensitivity of the AI system was 93% and the specificity 80% compared with RT-PCR. Conclusion: Paraguay has an AI-based telemedicine screening system for the rapid stratified detection of COVID-19 from chest CT images of patients with respiratory conditions. This application strengthens the integrated network of health services, rationalizing the use of specialized human resources, equipment, and inputs for laboratory diagnosis.
Subsoils—a sink for excess fertilizer P but a minor contribution to P plant nutrition: evidence from long-term fertilization trials
Authors: Siebers Nina , Wang Liming , Funk Theresa , von Tucher Sabine , Merbach Ines , Schweitzer Kathlin , Kruse Jens 
Published: May 2021

Abstract
Background
The phosphorus (P) stocks of arable subsoils not only influence crop production but also fertilizer P sequestration. However, the extent of this influence is largely unknown. This study aimed to (i) determine the extent of P sequestration with soil depth, (ii) analyze P speciation after long-term P fertilization, and (iii) compare soil P tests in predicting crop yields. We analyzed four long-term fertilizer trials in Germany to a depth of 90 cm. Treatments received either mineral or organic P, or a combination of both, for 16 to 113 years. We determined inorganic and organic P pools using sequential extraction, and P speciation using 31P nuclear magnetic resonance (NMR) and X-ray absorption near edge structure (XANES) spectroscopy. In addition, we applied three P soil tests, double-lactate (DL), calcium acetate lactate (CAL), and diffusive gradients in thin films (DGT).

Results
The results suggested that plants are capable of mobilizing P from deeper soil layers when there is a negative P budget of the topsoil. However, fertilization mostly only showed insignificant effects on P pools, which were most pronounced in the topsoil, with a 1.6- to 4.4-fold increase in labile inorganic P (Pi; resin-P, NaHCO3–Pi) after mineral fertilization and a 0- to 1.9-fold increase of organic P (Po; NaHCO3–Po, NaOH–Po) after organic P fertilization. The differences in Po and Pi speciation were mainly controlled by site-specific factors, e.g., soil properties or soil management practice rather than by fertilization. When modeling crop yield response using the Mitscherlich equation, we obtained the highest R2 (R2 = 0.61, P < 0.001) among the soil P tests when using topsoil PDGT. However, the fit became less pronounced when incorporating the subsoil.

Conclusion
We conclude that if the soil has a good P supply, the majority of P taken up by plants originates from the topsoil and that the DGT method is a mechanistic surrogate of P plant uptake. Thus, DGT is a basis for optimization of P fertilizer recommendation to add as much P fertilizer as required to sustain crop yields but as low as necessary to prevent harmful P leaching of excess fertilizer P.
Learning curves for drug response prediction in cancer cell lines
Authors: Partin Alexander , Brettin Thomas , Evrard Yvonne A. , Zhu Yitan , Yoo Hyunseung , Xia Fangfang , Jiang Songhao , Clyde Austin , Shukla Maulik , Fonstein Michael , Doroshow James H. , Stevens Rick L. 
Published: May 2021

Abstract
Background
Motivated by the size and availability of cell line drug sensitivity data, researchers have been developing machine learning (ML) models for predicting drug response to advance cancer treatment. As drug sensitivity studies continue generating drug response data, a common question is whether the generalization performance of existing prediction models can be further improved with more training data.

Methods
We utilize empirical learning curves for evaluating and comparing the data scaling properties of two neural networks (NNs) and two gradient boosting decision tree (GBDT) models trained on four cell line drug screening datasets. The learning curves are accurately fitted to a power law model, providing a framework for assessing the data scaling behavior of these models.

Results
The curves demonstrate that no single model dominates in terms of prediction performance across all datasets and training sizes, thus suggesting that the actual shape of these curves depends on the unique pair of an ML model and a dataset. The multi-input NN (mNN), in which gene expressions of cancer cells and molecular drug descriptors are input into separate subnetworks, outperforms a single-input NN (sNN), where the cell and drug features are concatenated for the input layer. In contrast, a GBDT with hyperparameter tuning exhibits superior performance as compared with both NNs at the lower range of training set sizes for two of the tested datasets, whereas the mNN consistently performs better at the higher range of training sizes. Moreover, the trajectory of the curves suggests that increasing the sample size is expected to further improve prediction scores of both NNs. These observations demonstrate the benefit of using learning curves to evaluate prediction models, providing a broader perspective on the overall data scaling characteristics.

Conclusions
A fitted power law learning curve provides a forward-looking metric for analyzing prediction performance and can serve as a co-design tool to guide experimental biologists and computational scientists in the design of future experiments in prospective research studies.
Association of meat consumption with NAFLD risk and liver-related biochemical indexes in older Chinese: a cross-sectional study
Authors: Peng Hewei , Xie Xiaoxu , Pan Xinting , Zheng Jing , Zeng Yidan , Cai Xiaoling , Hu Zhijian , Peng Xian-E 
Published: May 2021

Abstract
Background
Non-alcohol fatty liver disease (NAFLD) is the most common liver disease and an unhealthy lifestyle can lead to an increased risk of NAFLD. The present study aims to evaluate the association of meat consumption with NAFLD risk and liver-related biochemical indexes in middle-aged and elderly Chinese.

Methods
A cross-sectional study was conducted in individuals who were 45 years or older and underwent a physical examination from April 2015 to August 2017 in Southeast China. To evaluate associations between meat intake and NAFLD risk, inverse probability of treatment weighting and subgroup analyses were performed with logistic regressions. Spearman’s rank correlation was carried out to examine the relationship between meat consumptions and liver-related biochemical indexes.

Results
High consumptions of red meat (28.44–49.74 and > 71.00 g/day) (ORadjusted = 1.948; P < 0.001; ORadjusted = 1.714; P = 0.002) was positively associated with NAFLD risk on inverse probability of treatment weighting analysis, adjusting for smoking, tea intake, weekly hours of physical activity and presence of hypertension, dyslipidemia and diabetes. Exposure–response relationship analysis presented that red meat intake was positively associated with NAFLD risk. Significant associations of red meat intakes with serum levels of γ-glutamyl transferase, alanine transaminase, aspartate aminotransferase, total triglyceride and high-density lipoprotein cholesterol were found (rs = 0.176; P < 0.001; rs = 0.128; P < 0.001; rs = 0.060; P = 0.016; rs = 0.085; P = 0.001; rs = − 0.074; P = 0.003).

Conclusions
These findings suggest that the reduction of meat consumption may decrease NAFLD risk and should warrant further investigations.