bluuebunny/crossref_metadata_2025_split huggingface dataset:
Individualized vs standard control of intraoperative blood pressure on serum creatinine profile and release of microRNA-21-5p after major gastrointestinal surgery in older patients with hypertension: a randomized controlled trial
Authors: Lu Jiangfeng , Jiang Zongming , Song Qiliang , Chen Wendi , Chen Zhonghua , Li jia 
Published: December 2024

Abstract

Background: Intraoperative hypotension is associated with postoperative renal function decline. Whether personalized blood pressure control is favorable for renal function remains unknown. This study investigated the effects of individualized intraoperative blood pressure management on renal function and serum microRNA-21-5p levels in older patients with hypertension after major gastrointestinal surgery.
Methods: A total of 220 patients scheduled for elective major gastrointestinal surgery were randomly divided into two groups: conventional blood pressure management (Group C) and individualized blood pressure management (Group S), with 110 patients in each group. In Group S, blood pressure was controlled within ±10% of baseline systolic blood pressure or ±20% of baseline mean arterial pressure. Moderately open fluid management strategies were adopted in both groups. Blood samples were collected from all patients before and after surgery to measure creatinine and microRNA-21-5p levels.
Results: The creatinine level was significantly lower in Group S than in Group C seven days after surgery (P<0.05), and the reduction in creatinine levels in the week following surgery was also significantly greater in Group S than in Group C (P<0.05).
The relative expression level of microRNA-21-5p was also significantly lower in Group S than in Group C at the end of surgery and 6 h post-surgery (P<0.05 and P<0.01, respectively).
Conclusion: Intraoperative individualized blood pressure management could reduce the release of microRNA-21-5p related to renal injury and attenuates the elevation of postoperative creatinine in older patients with hypertension.
Trial registration number: ChiCTR1900022713 and Date on :2019/04/23
Patients with anti-PM/Scl-positive and idiopathic inflammatory myopathy resemble antisynthetase syndrome
Authors: Barbosa Rafaella do Amaral , Shinjo Samuel Katsuyuki 
Published: December 2024

Abstract

Background. Anti-PM/Scl autoantibody has been associated with an overlap between polymyositis (PM) and systemic sclerosis (SSc). However, owing to few studies, we analyzed the relevance of this autoantibody in patients with idiopathic inflammatory myopathies (IIMs) without SSc.
Methods. This single-center retrospective cohort study was conducted between 2004 and 2024. Of these, 93 adult patients with IIMs (66 with dermatomyositis and 27 with PM - EULAR/ACR 2017) without SSc were included: 16 anti-PM/Scl(+) and 77 anti-PM/Scl(-). We excluded patients with other types of IIMs, cancer-associated myositis, or overlap myositis, including SSc, as well as those with other myositis-specific and/or myositis-associated autoantibodies.
Results. The median age, sex distribution, and white ethnicity, and median follow-up duration were comparable between the anti-PM/Scl(+) and anti-PM/Scl(-) groups. There were no differences in clinical and laboratory characteristics, except for a higher frequency of lung involvement, joint involvement, “mechanics’ hand,” “hiker’s feet,” and Raynaud’s phenomenon, in contrast to a lower frequency of facial rash and “V”-neck sign in patients with anti-PM/Scl(+) than in those with anti-PM/Scl(-) (all p<0.05). Furthermore, patients with anti-PM/Scl(+) presented a higher frequency of disease relapse (68.8% vs. 33.8%), disease activity (50.0% vs. 24.7%), and immunosuppressant use at the last medical evaluation (all p<0.05). Severe infection and death rates were comparable between the groups.
Conclusions. Anti-PM/Scl positivity was observed in 17.2% of IIMs’ patients without SSc. Patients with this autoantibody present clinical manifestations resembling antisynthetase syndrome with increased disease relapse and disease activity.
Zoning of Critical Hubs of Climate Change (Flood-Drought) Using the Hydrologic Engineering Center-Hydrologic Modeling System and Copula Functions Case study: Khorramabad Basin
Authors: Robati Maryam , Najafgholi Pouriya , Nikoomaram Hanieh , Vaziri Baharak Motamed 
Published: December 2024

Abstract

Climate change is currently the major challenge facing mankind, and this crisis has been the topmost global issue due to the increasing role of human activities and the high sensitivity of human societies to the threats caused by these changes. The climate changes created for humans and nature have led to risks and threats that occur on different spatial and temporal scales. Therefore, adopting policies to deal with climate change will be a critical issue in risk management. Nonetheless, identifying critical hubs in the study area helps improve the risk management process in the ​​risk assessment of climate change consequences, such as floods and droughts. Accordingly, this study mainly aimed to identify such points in the study area according to this principle. As with other parts of the world, the Khorramabad Basin (Lorestan province, Iran) is prone to serious risks in terms of climate change. This area is located as a Class III sub-basin in the Class II Karkheh basin and the Class I basin of the Persian Gulf and the Sea of ​​Oman. In this study, the critical hubs of the desired watershed were identified using the HEC-HMS rainfall simulation model to prioritize the flood-prone sub-basins of the Khorramabad Basin. The sub-basins with a high drought risk were prioritized with the detailed function (copula) statistical method. An important point in this evaluation is the use of Global Precipitation Measurement (GPM) precipitation data as common data in the analyses made in the flood and drought sections. The return rate was also calculated in both methods. The model implementation and statistical analysis revealed that the highest probability of flood occurrence belonged to the flooded part of W990, W1140, and W710 sub-basins, with respective flow volumes and maximum flow rates of 5140.8364 mm and 1389.276 m3/s, 539.0018 mm and 383.838 m3/s, and 466.8089 mm and 1561.104 m3/s, based on the flow volume in all the estimated return periods. In the drought section, the sub-basins W1070, W730, and W610 would be the most critical hubs in terms of drought probability, with return periods of 1.1578, 1.1923, and 1.1976 years, respectively.
Surgical Rib Fixation in Patients with Cardiopulmonary Disease Improves Outcomes
Authors: Kim Jennie , Chien Chih Ying , Lewis Meghan , Benjamin elizabeth , Demetriades Demetrios 
Published: December 2024

Abstract

Introduction: The role of rib fixation (RF) in flail chest is debated, and guidelines conditionally recommend RF in highly selected patients. Patients with cardiopulmonary disease (CPD) have traditionally not been deemed surgical candidates. We hypothesize that RF would benefit even high-risk patients with CPD.
Methods: Adult patients with isolated flail chest and CPD were identified from the Trauma Quality Improvement Program database (2016–2018). Hospital transfers, patients dead within 72 hours, penetrating mechanism, concomitant thoracic aortic injury or cancer were excluded. Primary outcome was in-hospital mortality. Secondary outcomes were in-hospital complications, ventilator days, need for tracheostomy, and length of stay. RF patients were propensity score matched (1:1) to non-operative management (NOM) patients. Multivariate regression identified independent risk factors for outcomes.
Results: In this 3-year period, 4,614 patients were admitted with flail chest and history of CPD. After exclusions and propensity matching, 544 (12%) underwent analysis (RF n = 272, NOM n = 272). RF patients had a lower mortality compared to NOM patients (1.8% vs 5.5%, p = 0.023) but more likely to develop venous thromboembolic events (5.1% vs 1.85%, p = 0.036), prolonged ventilation (28.4% vs 15.1%, p < 0.001), and tracheostomy (15.4% vs 6.6%, p = 0.001). Multivariate analysis showed RF was independently associated with decreased mortality (OR 0.165, 95% CI 0.037–0.735, p = 0.018) while age > 85years (OR 145.115, 95% CI 9.721-2166.262) and ventilator-associated pneumonia (OR 8.283, 95% CI 1.375–49.888) were associated with increased mortality.
Conclusions: RF shows a survival benefit even in high-risk patients with CPD. Patient selection should be individualized but RF should not be excluded based solely on pre-existing conditions.
Does automated 3D computed tomography bronchography and angiography improve anatomical teaching in pulmonary segmentectomy?
Authors: Zhao Yuan , Yuan Fei , Liu Wen , Zuo Jianhui , Zhang Renquan , Wang Wei 
Published: December 2024

Abstract

Purpose
As pulmonary segmentectomy becomes increasingly common in the treatment of early-stage lung cancer, it is essential to provide relevant clinical training for residents. Three-dimensional CT bronchography and angiography (3D-CTBA) effectively illustrate the spatial relationships among the bronchi, arteries, and veins of pulmonary segments. This study aimed to evaluate the efficacy of automated 3D-CTBA technology in enhancing anatomical education for pulmonary segmentectomy training.
Methods
Fifty-two surgical residents were randomized into two groups: the 3D-CTBA group and the control group. The 3D-CTBA group utilized automated 3D-CTBA technology alongside specific case for segmentectomy training, while the control group relied on traditional teaching methods. After the training sessions, all participants completed a post-training assessment and questionnaires. Additionally, we collected feedback from instructors regarding the residents' performance through a separate questionnaire.
Results
Residents in the 3D-CTBA group achieved significantly higher scores on the post-training assessments compared to those in the control group (83.46 ± 6.75 vs. 68.27 ± 8.12, p < 0.001). Subjective survey results indicated that automated 3D-CTBA technology greatly benefited residents in preoperatively identifying tumor locations, recognizing anatomical variations during surgery, and mastering relevant surgical techniques. Feedback from instructors indicated that residents in the 3D-CTBA group performed better intraoperatively than those in the control group. Furthermore, residents in the 3D-CTBA group expressed greater interest in learning and higher satisfaction with the course.
Conclusion
Automated 3D-CTBA technology significantly enhanced residents' comprehension of the complex and variable anatomy of pulmonary segments, thereby improving their related surgical skills.
Higher interfragmentary compression force improves lateral tibial plateau fracture stability using locking plate fixation: Experimental and simulation verification
Authors: Xu Daqiang , Jiang Jiang , Ji Zhenhua , Wang Fei , Jia Rui , Hong Hong , Zhang Hongtao , Li Jianyi , Wang Jun 
Published: December 2024

Abstract

Purpose
This study investigated the impact of higher interfragmentary compression force (IFCF) on the stability of locking plate fixation in lateral tibial plateau fractures.
Methods
Biomechanical experiments and finite element analysis (FEA) were employed to compare the performance of the AO cancellous lag screw (AOCLS) and a newly developed combined cancellous lag screw (CCLS).
Results
The results demonstrated that the CCLS provided a higher IFCF without the risk of over-screwing, significantly improving fixation stability. High IFCF markedly increased the initial axial stiffness, allowing for earlier weight-bearing in patients. Additionally, the FEA showed that increased IFCF reduced the peak von Mises stress on implants and the peak equivalent elastic strain on the lateral fragment, thereby enhancing overall structural stability.
Conclusions
These findings suggested that the CCLS, with its superior IFCF and reduced risk of over-screwing, was a promising option for improving fixation stability in lateral tibial plateau fractures. This improvement could facilitate early rehabilitation, minimise complications, and provide better clinical outcomes. These results provide strong scientific evidence for the clinical use of CCLS.
Successful Combined Preimplantation Genetic Testing for Aneuploidy (PGT-A) and for Monogenic Disorders (PGT-M) for Autosomal Dominant Polycystic Kidney Disease Following Kidney Transplant: A Case Report
Authors: Elbanna Wael Saad , Azmy Osama , Elhinnawi Manal Ahmed 
Published: December 2024

Abstract

Background:
Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent genetic kidney disease characterized by the development of cysts in the kidney. It is caused mainly by mutations in the PKD1 or PKD2 genes. Therefore, preimplantation genetic testing for monogenic kidney disease (PGT-M) is a promising strategy for preventing the transmission of the disease to the offspring.
Case Presentation:
Here, we present a case of ADPKD who underwent combined PGT-M and PGT-aneuploidy (PGT-A) and conceived a healthy fetus via intracytoplasmic sperm injection (ICSI). Ultimately, a healthy girl was born.
Conclusion:
PGT-M offers a way for ADPKD couples to have a successful pregnancy and reduce the risk of passing on the disease. Genetic counseling and a team approach are essential for the effective use of PGT-M in these cases.
Deep Learning HRNet-FCN for Blood Vessel Identification in Laparoscopic Pancreatic Surgery
Authors: Shi Jile , Cui Ruohan , Wang Zhihong , Yan Qi , Ping Lu , Zhou Hu , Gao Junyi , Fang Chihua , Han Xianlin , Hua Surong , Wu Wenming 
Published: December 2024

Abstract

Laparoscopic pancreatic surgery remains highly challenging due to the complexity of the pancreas and surrounding vascular structures, with risk of injuring critical blood vessels such as the Superior Mesenteric Vein (SMV)-Portal Vein (PV) axis and splenic vein. Here, we evaluated the High Resolution Network (HRNet)-Full Convolutional Network (FCN) model for its ability to accurately identify vascular contours and improve surgical safety. Using 12,694 images from 126 laparoscopic distal pancreatectomy (LDP) videos and 35,986 images from 138 Whipple procedure videos, the model demonstrated robust performance, achieving a mean Dice coefficient of 0.754, a recall of 85.00%, and a precision of 91.10%. By combining datasets from LDP and Whipple procedures, the model showed strong generalization across different surgical contexts and achieved real-time processing speeds of 11 frames per second. These findings highlight the potential of HRNet-FCN to recognize anatomical landmarks, enhance surgical precision, reduce complications, and improve outcomes in laparoscopic pancreatic procedures.
Tetrazine-Enhanced Donor-Acceptor-Donor Photosensitive Metal-Organic Frameworks for Combating Drug-Resistant Bacteria and Accelerating Diabetic Wound Healing
Authors: Guo Weiwei , Chen Yanzhao , Xue Yangyin , Xu Xiaowei , Su Yu , Zhu Long , Zuo Yifei , Ban Chao , Que Wancai , Zheng Yueqin 
Published: December 2024

Abstract

Multidrug-resistant (MDR) bacterial infections and chronic wounds pose significant challenges in modern healthcare, de-manding innovative treatment approaches. In this study, we introduce two new donor-acceptor-donor (D-A-D) photosensi-tive metal-organic frameworks (MOFs) featuring tetrazine as a potent electron acceptor. By incorporating tetrazine, we en-hance reactive oxygen species (ROS) generation while simplifying synthesis, resulting in efficient charge separation and boosted ROS production. Functionalized with L-arginine, the resulting composites, A@Zn-TDP and A@Ni-TDP, release both ROS and nitric oxide (NO) upon visible light activation, creating a dual-action mechanism that efficiently combats bacteria and accelerates wound healing. In vitro tests against MRSA, E. coli, and S. aureus demonstrate robust antibacterial activity, while in vivo studies reveal significantly accelerated wound closure, reduced bacterial load, and enhanced collagen deposi-tion and vascularization. This dual-action platform offers a powerful tool for tackling drug-resistant infections and promot-ing tissue regeneration in complex wounds, opening new avenues for advanced therapeutic solutions in challenging clinical settings.
Buffering of nuclear membrane tension and mechanotransduction by the endoplasmic reticulum revealed by quantitative ALPIN imaging
Authors: Niethammer Philipp , Shen Zhouyang , Gelashvili Zaza 
Published: December 2024

Abstract

Nuclear deformation by osmotic shock or necrosis activates the cytosolic phospholipase A2 (cPla2) nuclear shape sensing pathway, a key regulator of tissue inflammation and repair. Ca²⁺ and inner nuclear membrane (INM) tension (TINM) are believed to mediate nucleoplasmic cPla2 activation. The concept implies that TINM persists long enough to stimulate cPla2-INM adsorption. However, TINM may instead be rapidly dissipated by the contiguous endoplasmic reticulum (ER), with cPla2-INM adsorption reporting rather on changes in Ca²⁺ than TINM. The impact of TINM and ER contiguity on nuclear shape sensing and mechanotransduction remains unknown.
To address this gap, we developed the Ca2+ insensitive, TINM-only biosensor ALPIN (Amphipathic Lipid Packing sensor domain Inside the Nucleus). By quantitative ALPIN imaging, we found that stress-induced ER fragmentation increases TINM and nuclear membrane mechanotransduction in osmotically shocked or ferroptotic cells, permeabilized cell corpses, and at zebrafish wounds in vivo. Our findings reveal critical roles for the ER and TINM in nuclear shape sensing and introduce ALPIN as promising tool for studying organelle membrane mechanotransduction in health and disease.
Effect of Caloric Restriction Combined with Probiotic Supplementation on Parameters Related to Weight Loss, Homeostatic, and Hedonic Systems of Food Intake in Adult Men Living with Obesity: Secondary Data from a Randomized, Parallel, Double-Blind, Placebo-Controlled Clinical Trial
Authors: Quaresma Marcus dos Santos , Lucin Glaice , Marques Camila , Magalhães Ana Carolina , Ferracini Catarina França , Carrilho Filipa Alves , Nakamoto Fernanda , Mendes Gabriela , Alvares Leonardo Mobília , Santos Ronaldo 
Published: December 2024

Abstract

We aimed to investigate the effect of CR with probiotic supplementation on weight loss and parameters related to the homeostatic and hedonic systems. It is a randomized, double-blind, parallel, placebo-controlled clinical trial (UTN: U1111-1247-9906). We include obese adult males, aged 25 to 44 years. The established CR was 30% of the daily energy expenditure. Probiotic supplementation was: two sachets of 1 g each of 1×10⁹ CFU of Lactobacillus acidophilus NCFM, Lactobacillus rhamnosus HN001, Lactobacillus paracasei Lpc-37, and Bifidobacterium lactis HN019. The primary outcomes: body composition. Secondary outcomes: leptin, ghrelin, GLP-1, glucose-dependent insulinotropic polypeptide (GIP), insulin, peptide YY (PYY), and adiponectin. Additionally, binge eating, emotional eating, and cognitive restraint were assessed by the Three-Factor Eating Questionnaire. The study includes per protocol analyses (CR + placebo [CRPLA] n = 12 vs. CR + probiotic [CRPRO] n = 13). Body mass (F = 65.9; p < 0.001) decreased after 4 and 12 weeks (p < 0.001). A similar result was found for absolute fat mass (F = 71.0; p < 0.001) after 4 and 12 weeks (p < 0.001). Leptin levels decreased (F = 13.2; p < 0.001) after 4 (p = 0.002) and 12 weeks (p < 0.001), without group or interaction effect. Moreover, GLP-1 levels did not change after intervention (F = 2.29; p = 0.114). Likewise, GIP (F = 2.0; p = 0.148) and adiponectin (F = 3.14; p = 0.053) levels did not change. Binge eating reduced (F = 16.5; p < 0.001) only in the CRPRO group (p = 0.018). Emotional eating decreased (F = 9.44; p = 0.005), but only in the CRPRO group (p = 0.047). Finally, cognitive restraint increased (F = 43.2; p < 0.001) in the CRPLA (p = 0.003) and CRPRO (p < 0.001) groups. In summary, CR reduced body mass and body fat, as well as decreased leptin levels and increased cognitive restraint. Additionally, reductions in binge eating and emotional eating scores were seen only in the CRPRO group.
Does myopic foresight modeling better capture real-world electricity system transition? Hindcasting in 31 European countries
Authors: Shen Hui , Wen Xin , Trutnevyte Evelina 
Published: December 2024

Abstract

Cost-optimization models typically use perfect foresight to generate scenarios of long-term energy transitions. Instead, real-world energy decisions tend to be made with shorter time horizons and limited knowledge about the future, suggesting the need for myopic foresight. No empirical evidence exists though if implementing myopic foresight in models leads to scenarios that better approximate potential real-world transitions. We use hindcasting to evaluate to what extent cost optimization can capture real-world national electricity system transitions in 31 European countries in 1990 to 2019, comparing perfect and myopic foresights. We find that myopic foresight leads to better hindcasting accuracy in projecting total system cost because the estimated costs are higher than in the case of perfect foresight. But technology-specific installed capacities which drive the costs are not necessarily captured better with myopic foresight. Incorporating historical policies in the models does not consistently result in improved hindcasting accuracy, calling for future research on how to better model policy effects, whether with perfect or myopic foresight. Finally, country-specific model set-ups, informed through hindcasting, become key for ensuring reliable long-term energy scenarios and policy assessments.
Interference Timing of GenAI Sales Agents in Virtual Reality
Authors: Weiss Tobias , Eilks Asmus Eike , Pfeiffer Jella 
Published: December 2024

Abstract

This study investigates how interference timing of artificial sales agents influences user experience in embodied virtual commerce environments. Specifically, we examine how different timing strategies affect consumer perceptions for generative artificial intelligence (GenAI)-driven agent interference in a virtual reality (VR) shopping scenario. Using a controlled experiment with 100 participants in a VR showroom for 3D printers, we compared two interference conditions: the agent either enters the room and offers assistance immediately or delayed after the consumer has examined all products once. The sales agent, implemented through an integrated artificial intelligence (AI) pipeline combining speech-to-text, a large language model, and text-to-speech capabilities, assisted participants in their decision-making process. Employing a Bayesian research methodology, our findings reveal that the timing of initial agent interference credibly influences user experience, primarily mediated through the consumer’s first impression of the agent’s warmth. The immediate interference approach demonstrated superior outcomes. These results provide valuable insights for the design of AI-driven sales environments, demonstrating both the technical feasibility of implementing multistage AI pipelines in virtual commerce and the importance of carefully considered interaction timing. Our findings contribute to the body of knowledge on digital service system transformation in commercial settings and offer practical guidelines for developing more effective virtual shopping experiences.