bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of annexin A1 peptide in regulating PI3K/Akt signaling pathway to reduce lung injury after cardiopulmonary bypass in rats
Authors: He Yunzi , Zhang Yuanjie , Wu Hanhua , Luo Junli , Cheng Chi , Zhang Hong 
Published: December 2021

Introduction Cardiopulmonary bypass (CPB) –induced lung ischemia-reperfusion (I/R) injury remains a large challenge in cardiac surgery; up to date, no effective treatment has been found. Annexin A1 (AnxA1) has an anti-inflammatory effect, and it has been proven to have a protective effect on CPB-induced lung injury. However, the specific mechanism of AnxA1 in CPB-induced lung injury is not well studied. Therefore, we established a CPB-induced lung injury model to explore the relevant mechanism of AnxA1 and try to find an effective treatment for lung protection. Methods Male rats were randomized into five groups ( n = 6, each): sham (S group), I/R exposure (I/R group), I/R + dimethyl sulfoxide (D group), I/R + Ac2-26 (AnxA1 peptide) (A group), and I/R + LY294002 (a PI3K specific inhibitor) (AL group). Arterial blood gas analysis and calculation of the oxygenation index, and respiratory index were performed. The morphological changes in lung tissues were observed under light and electron microscopes. TNF-α and IL-6 and total protein in lung bronchoalveolar lavage fluid were detected via enzyme-linked immunosorbent assay. The expressions of PI3K, Akt, and NF-κB (p65) as well as p-PI3K, p-Akt, p-NF-κB (p65), and AnxA1 were detected via western blotting. Results Compared with the I/R group, the A group showed the following: lower lung pathological damage score; decreased expression of IL-6 and total protein in the bronchoalveolar lavage fluid, and TNF-α in the lung; increased lung oxygenation index; and improved lung function. These imply the protective role of Ac2-26, and show that LY294002 inhibited the ameliorative preconditioning effect of Ac2-26. Conclusion This finding suggested that the AnxA1 peptide Ac2-26 decreased the inflammation reaction and CPB-induced lung injury in rats, the lung protective effects of AnxA1may be correlated with the activation of PI3K/Akt signaling pathway.
Enoxaparin Use in Hospitalized SARS-CoV-2-Positive Patients with Elevated D-Dimer: A Pilot Study
Authors: Zalivansky Yuliana , Pereira Luis , Budovich Aliaksandr 
Published: December 2021

Introduction: The SARS-CoV-2 is a human pathogenic coronavirus that causes a respiratory tract infection, which may lead to systemic hyper-inflammation that is associated with a hypercoagulable state. Anticoagulation as an adjunct may decrease thrombi formation. Objectives: This study aims to evaluate the efficacy and safety of enoxaparin for the prevention of thrombotic events in hospitalized SARS-CoV-2 patients with elevated D-dimer. Methods: A single-center retrospective cohort study was conducted to evaluate three enoxaparin dosing regimens: full treatment (1 mg/kg SC Q12H or 1.5 mg/kg SC Q24H), intermediate (.5 mg/kg SC Q12H or 1 mg/kg SC Q24H), and prophylaxis (40 mg SC Q24H). The primary endpoint evaluated the percentage of patients who developed a venous thromboembolism (VTE). The secondary endpoints evaluated the development of a major bleed, mechanical ventilation need, and death. Results: Forty-five patients were included with 27, 8, and 10 participants in the full treatment, intermediate, and prophylaxis arms, respectively. Six patients developed a VTE: 3, 1, and 2 in the listed above groups, respectively ( P = .83). Twenty patients died: 11, 3, and 6, respectively ( P = .64). Four patients developed a major bleed: 1, 1, and 2, respectively ( P = .17). Six patients required intubation: 1, 2, and 3 in the arms, respectively ( P = .043). Conclusion: The study did not find a difference in respect to the development of a VTE between the three investigated doses of anticoagulation. However, our findings suggest that treatment dose of enoxaparin might be associated with lower risk for mechanical ventilation in hospitalized COVID-19-positive patients with elevated D-dimer.
Predictive Value of Combination of D-dimer and Fibrinogen in Diagnosing Acute CVST
Authors: Pathak Abhishek , Singh Varun Kumar , Kumar Anand , Mishra Vijaya Nath , Joshi Deepika , Chaurasia Rameshwar Nath 
Published: December 2021

Background: Cerebral venous sinus thrombosis (CVST) is an uncommon subtype of stroke, and the role of D-dimer and fibrinogen in early diagnosis of CVST has been studied with varying results. The present study aims to study the role of the combination of D-dimer and fibrinogen in early diagnosis of acute CVST. Methods: Forty consecutive confirmed acute CVST cases admitted at a tertiary care center were recruited for the study. D-dimer and fibrinogen were assessed by a rapid semiquantitative latex agglutination assay. Results: Out of the 40 CVST patients, 21 (52.50%) were females. The mean age of the patients was 37.58 years ± 19.17 years. Common clinical features were headache ( N = 38 [95%]), papilloedema ( N = 15 [37.5%]), and seizures ( N = 12 [30%]). Although the sensitivity (75%) of the combination of D-dimer and fibrinogen assay was lower than that of D-dimer or fibrinogen alone, the specificity and positive predictive value (75% each) was higher. Conclusion: The combination of D-dimer and fibrinogen testing may aid in an early diagnosis of acute CVST and in better management.
Battling With Books: The Gamification of an EFL Extensive Reading Class
Authors: Freiermuth Mark R. , Ito Michiyo 
Published: December 2021

Background Extensive reading (ER) classes have become a popular way to promote reading in EFL (English as a Foreign Language) classrooms because ER supports the idea of reading for pleasure. However, reading in the classroom can still become stale if students have little chance to reflect on what they have read or if they become burdened by the reading requirements. Aim In an attempt to create a more energetic ER classroom, we converted the classroom into a game-based environment with the aim of promoting L2 reading enjoyment and motivating students to read in a more focused manner . Method As for specifics, 55 female Japanese university students—divided into two groups based upon English proficiency—participated in a social book reading game called Bibliobattle whereby students discussed their favorite books in small groups. Three iterations of the game were incorporated into the ER classroom as a way to enliven reading activities. Results The game proved largely successful. From the data obtained in the debriefing questionnaires, students mentioned that they were motivated by the activities through reflection on their book’s content and through the sharing of specific details about what they had read with their peers. Although both groups of students indicated their motivation to play the game, this was especially true for the lower level readers—a group that had demonstrated more apathy towards ER in the past. Based upon our experiences while running the game, we recommend that Bibliobattles be implemented as specialized events in the ER classroom as a means to help stimulate a love for reading in a second language; however, it should also be noted that student preparation for such battles is time-consuming, so the number of battles per semester should be limited to a maximum of two per semester.
Difficulties in Addressing Artificial Hydration and Nutrition Therapy for Terminal Cancer Patients: What to do if Patients/Families’ Wishes Differ From the Medically Appropriate Treatment Plans?
Authors: Nakajima Nobuhisa 
Published: December 2021

Purpose: Artificial hydration and nutrition therapy (AHNT) initiated by patients/families sometimes differs from medically appropriate treatment plans. We aimed to identify the causes of these differences and examine the ensuing responses and outcomes. Methods: Of 133 adult cancer patients receiving end-of-life care in the last 2 years, these discrepancies occurred in 41 patients. We retrospectively examined the following issues: (1) The reason why these discrepancies occurred. (2) Based on the causes identified in (1), the following actions were taken: 1) If the consent to change to medically appropriate AHNT was obtained, physical findings using Japan Palliative Oncology Study (JPOS) group and Edmonton Symptom Assessment System (ESAS) were compared before and 1 week after the intervention. 2) If consent was not obtained, time-limited trial (TLT) was conducted, and these results were compared. (3) The communication between patients/families and medical professionals was compared using Support Team Assessment Schedule. Results. (1) Causes: a) the lack of understanding of the disease condition in 26 cases and b) faulty expectation of AHNT in 15 cases. (2) In 30 cases of 1) (20 of a) and 10 of b)) and 11 of 2) in which TLT was performed, JPOS and ESAS improved significantly. (3) The communication above was improved significantly in 1) and 2) ( P = .0027 and .0039, respectively). Conclusion. Providing medically appropriate AHNT with the consent of patients/families is expected to not only alleviate distressing symptoms but also improve the communication between patients/families and medical professionals, as well as improve the quality of palliative care.
Career Goal Discrepancy, Career Distress, and Goal Adjustment: Testing a Dual Moderated Process Model in Young Adults
Authors: Praskova Anna , McPeake Lisa 
Published: December 2021

Identifying a large discrepancy in young people’s career goal progress can lead to distress, activating meaning-making, self-regulatory mechanisms aimed at resolving the uncomfortable situation. We assessed these important career-regulatory processes in a theoretical model by testing the indirect effects of career goal discrepancy on goal adjustment (assimilation and accommodation) via career distress, and assessed the conditionality of these effects based on two moderators (career calling and negative career feedback). In a cross-sectional study, we recruited 287 young adults with a mean age of 23.79 years ( SD = 3.35), and tested complex dual moderated process model (OLS regression). Greater career goal discrepancy was associated with more career distress, and, in turn, less assimilative and more accommodative tendencies. These indirect effects depended on the level of career calling and negative career feedback. The findings can be used to tailor interventions to optimise the consequences of identified gaps in young people’s career progress.
Step Number and Aerobic Minute Exercise Prescription and Progression in Stroke: A Roadmap
Authors: Peters Sue , Klassen Tara D. , Schneeberg Amy , Dukelow Sean P. , Bayley Mark T. , Hill Michael D. , Pooyania Sepideh , Yao Jennifer , Eng Janice J. 
Published: December 2021

Background While higher therapeutic intensity improves motor recovery after stroke, translating findings from successful studies is challenging without clear exercise intensity targets. We show in the DOSE trial 1 more than double the steps and aerobic minutes within a session can be achieved compared with usual care and translates to improved long-term walking outcomes. Objective We modeled data from this successful higher intensity multi-site RCT to develop targets for prescribing and progressing exercise for varying levels of walking impairment after stroke. Methods In twenty-five individuals in inpatient rehabilitation, twenty sessions were monitored for a total of 500 one-hour physical therapy sessions. For the 500 sessions, step number and aerobic minute progression were modeled using linear mixed effects regression. Using formulas from the linear mixed effects regression, targets were calculated. Results The model for step number included session number and baseline walking speed, and for aerobic minutes, session number and age. For steps, there was an increase of 73 steps per session. With baseline walking speed, for every 0.1 m/s increase, a corresponding increase of 302 steps was predicted. For aerobic minutes, there was an increase of .56 minutes of aerobic activity (ie, 34 seconds) per session. For every year increase in age, a decrease of .39 minutes (ie, 23 seconds) was predicted. Conclusions Using data associated with better walking outcomes, we provide step number and aerobic minute targets that future studies can cross-validate. As walking speed and age are collected at admission, these models allow for uptake of routine measurement of therapeutic intensity. Registration: www.clinicaltrials.gov ; NCT01915368.
Contrasting approaches for addressing non-adherence in randomized controlled trials: An illustration from the REFLUX trial
Authors: Keele Luke , Grieve Richard 
Published: December 2021

Background: In many randomized controlled trials, a substantial proportion of patients do not comply with the treatment protocol to which they have been randomly assigned. Randomized controlled trials are required to report results according to the intention-to-treat estimand, but recent methodological guidance recognizes the importance of estimating other causal quantities. Methods: This article outlines an analytical framework for randomized controlled trials with non-compliance. We apply the ICH E9 (R1) addendum and combine it with the potential outcomes framework to define key estimands, outline the major assumptions for identification of each estimand, and highlight the assumptions that cannot be verified from the randomized controlled trial data. We contrast the assumptions and estimates in a re-analysis of the REFLUX trial. We report alternative estimates for the effectiveness of receipt of laparoscopic surgery versus medical management for patients with gastro-intestinal reflux disease. Results: The article finds that adjusted as-treated and per-protocol estimates were similar in magnitude to those based intention-to-treat methods. Instrumental variable estimates of the complier average causal effect were larger, with wider confidence intervals. Conclusion: We recommend that in randomized controlled trials with non-compliance, studies should outline which estimand is most relevant to the study context, evaluate key assumptions, and present estimates from a range of methods as a sensitivity analysis.
Understanding CLL biology through mouse models of human genetics
Authors: ten Hacken Elisa , Wu Catherine J. 
Published: December 2021

AbstractRapid advances in large-scale next-generation sequencing studies of human samples have progressively defined the highly heterogeneous genetic landscape of chronic lymphocytic leukemia (CLL). At the same time, the numerous challenges posed by the difficulties in rapid manipulation of primary B cells and the paucity of CLL cell lines have limited the ability to interrogate the function of the discovered putative disease “drivers,” defined in human sequencing studies through statistical inference. Mouse models represent a powerful tool to study mechanisms of normal and malignant B-cell biology and for preclinical testing of novel therapeutics. Advances in genetic engineering technologies, including the introduction of conditional knockin/knockout strategies, have opened new opportunities to model genetic lesions in a B-cell–restricted context. These new studies build on the experience of generating the MDR mice, the first example of a genetically faithful CLL model, which recapitulates the most common genomic aberration of human CLL: del(13q). In this review, we describe the application of mouse models to the studies of CLL pathogenesis and disease transformation from an indolent to a high-grade malignancy (ie, Richter syndrome [RS]) and treatment, with a focus on newly developed genetically inspired mouse lines modeling recurrent CLL genetic events. We discuss how these novel mouse models, analyzed using new genomic technologies, allow the dissection of mechanisms of disease evolution and response to therapy with greater depth than previously possible and provide important insight into human CLL and RS pathogenesis and therapeutic vulnerabilities. These models thereby provide valuable platforms for functional genomic analyses and treatment studies.
The efficacy of fosfomycin trometamol in prevention of postoperative urinary tract infection in pregnant women after endoscopic procedures: open clinical trial
Authors: Radwan Mohamed , Hagras Ayman , Nagla Salah , Elhamamy Nareman , Abou Farha Mohammed 
Published: December 2021

Abstract
Background
Fosfomycin tromethamine is recommended (category B) for the treatment of urinary tract infections in pregnant women. We aimed to evaluate the efficacy of single-dose preoperative fosfomycin tromethamine in the prevention of urinary tract infection in pregnant women who underwent lower urinary tract endoscopic surgeries.

Methodology
The subjects of this study were pregnant women who underwent lower urinary tract endoscopic procedures. All patients received Fosfomycin tromethamine1 packet (3 g) dissolved in water the day before surgery. Routine pre- and postoperative urine analysis and urine cultures were performed when needed. Patients were monitored for urinary tract infections and the side effects of the drug. Moreover, maternal and fetal complications were monitored.

Results
The study was conducted on 31 pregnant women with a mean age of 24.48 ± 5.35 years. The endoscopic procedures were as follows: 28 (90.3%) DJ ureteric insertions for hydronephrosis, 2 (6.5%) urinary bladder stones, and cystoscopy (3.2%) for gross hematuria. Two (6.5%) patients had postoperative asymptomatic bacteriuria that resolved with oral antibiotic therapy.

Conclusion
Fosfomycin tromethamine is safe in preventing urinary tract infection and decreases the need for postoperative parenteral antibiotics in pregnant women who require lower urinary tract endoscopic procedures.
Scrotal reconstruction with pedicled gracilis muscle flap following Fournier’s gangrene: a case report and literature review
Authors: Ilori Oluwatosin Stephen , Onilede David. A. , Popoola Ademola. A. , Olatide Olorunnisola O. , Ugwuoke Chidi O. 
Published: December 2021

Abstract
Background
Fournier’s gangrene is an acute soft tissue necrotizing infection involving the perineum and the external genitalia which can result in a major loss of the scrotal wall with exposure of the testicles. Reconstruction of such major defect is quite challenging; the use of pedicled gracilis muscle flap helps to create an aesthetically acceptable scrotum with minimal donor site morbidity.

Case presentation
We described the case of a 60-year-old man with a large scrotal loss from Fournier’s gangrene following bladder outlet obstruction and perineal abscess. He had multiple debridement and reconstruction with pedicled left gracilis muscle flap with a good aesthetic and functional post-operative outcome. The major challenge encountered was the loss of the skin graft as a result of the retraction of the muscle flap due to too early ambulation; this can thus be avoided by adequate pre-operative counseling and enforcing bed rest.

Conclusions
The use of gracilis muscle flap in the reconstruction of large scrotal defect described in this report has the additional advantage of creating a pliable and soft feel like that of the original scrotum with minimal donor site morbidity.
A review on deep learning MRI reconstruction without fully sampled k-space
Authors: Zeng Gushan , Guo Yi , Zhan Jiaying , Wang Zi , Lai Zongying , Du Xiaofeng , Qu Xiaobo , Guo Di 
Published: December 2021

AbstractBackgroundMagnetic resonance imaging (MRI) is an effective auxiliary diagnostic method in clinical medicine, but it has always suffered from the problem of long acquisition time. Compressed sensing and parallel imaging are two common techniques to accelerate MRI reconstruction. Recently, deep learning provides a new direction for MRI, while most of them require a large number of data pairs for training. However, there are many scenarios where fully sampled k-space data cannot be obtained, which will seriously hinder the application of supervised learning. Therefore, deep learning without fully sampled data is indispensable.Main textIn this review, we first introduce the forward model of MRI as a classic inverse problem, and briefly discuss the connection of traditional iterative methods to deep learning. Next, we will explain how to train reconstruction network without fully sampled data from the perspective of obtaining prior information.ConclusionAlthough the reviewed methods are used for MRI reconstruction, they can also be extended to other areas where ground-truth is not available. Furthermore, we may anticipate that the combination of traditional methods and deep learning will produce better reconstruction results.
Cerebral small vessel disease, cardiovascular risk factors, and future walking speed in old age: a population-based cohort study
Authors: Heiland Emerald G. , Welmer Anna-Karin , Kalpouzos Grégoria , Laveskog Anna , Wang Rui , Qiu Chengxuan 
Published: December 2021

Abstract
Background
The purpose of this study was to examine the associations between combined and individual cerebral small vessel disease (cSVD) markers on future walking speed over 9 years; and to explore whether these associations varied by the presence of cardiovascular risk factors (CRFs).

Methods
This population-based cohort study included 331 adults, aged ≥60 years, without limitation in walking speed (≥0.8 m/s). At baseline, cSVD markers, including white matter hyperintensities (WMH), lacunes, and perivascular spaces (PVS), were assessed on magnetic resonance imaging. The modifiable CRFs (physical inactivity, heavy alcohol consumption, smoking, hypertension, high total cholesterol, diabetes, and overweight/obese) were combined into a score. The association between baseline cSVD markers and the decline in walking speed was examined using linear mixed-effects models, whereas Cox proportional hazards models were used to estimate the association with walking speed limitation (defined as < 0.8 m/s) over the follow-up.

Results
Over the follow-up period, 76 (23.0%) persons developed walking speed limitation. Participants in the highest tertile of the combined cSVD marker score had a hazard ratio (HR) of 3.78 (95% confidence interval [CI] 1.70-8.45) for walking speed limitation compared with people in the lowest score tertile, even after adjusting for socio-demographics, CRFs, cognitive function, and chronic conditions. When investigating the cSVD markers individually, having the highest burden of WMH was associated with a significantly faster decline in walking speed (β coefficient − 0.020; 95% CI -0.035-0.004) and a greater HR of walking speed limitation (HR 2.78; 95% CI 1.31-5.89) compared with having the lowest WMH burden. Similar results were obtained for the highest tertile of PVS (HR 2.13; 95% CI 1.04-4.36). Lacunes were associated with walking speed limitation, but only in men. Having ≥4 CRFs and high WMH volume simultaneously, showed a greater risk of walking speed limitation compared with having ≥4 CRFs and low WMH burden. CRFs did not modify the associations between lacunes or PVS and walking speed.

Conclusions
Combined cSVD markers strongly predict walking speed limitation in healthy older adults, independent of cognitive function, with WMH and PVS being the strongest contributors. Improving cardiovascular health may help to mitigate the negative effects of WMH on future walking speed.