bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary transcatheter dilation of the pulmonary valve in cyanotic patients with tetralogy of Fallot and dominant pulmonary valve stenosis
Authors: Mini Nathalie , Arenz Claudia , Mikus Marian , Schneider Martin B. E. 
Published: November 2024

ObjectivesThis study reviews the outcome of pulmonary valve dilation (PVB) in patients with tetralogy of Fallot (TOF) and predominantly pulmonary valve stenosis as first palliation and the impact of balloon-related cusp tears (BRCTs) on the surgical strategy.BackgroundThe early management of cyanotic patients TOF is still controversial.MethodsThis was a retrospective study of 19 patients with TOF who underwent PVB over 4 years. Differential growth of the pulmonary valve/annulus (PV) and arteries was documented, as was differential saturation improvement. Surgical findings were analyzed, including BRCT and subsequent surgical methods.ResultsThe median saturation value improved significantly from 70% (45%–98%) to 90% (74%–98%) (p-value = 0.03). Recurrent desaturation 7–45 days after the intervention occurred in 7 patients; 2 needed reinterventions, and 5 needed an early repair. At the time of repair, the median PV z-score improved from −3.7 (−6.12 to −1.3) to −2.1 (−4.2 to −0.19) (p-value = 0.2). The LPA z-score improved from −1.95 (−3.4 to −0.4) to 0.36 (−2.9 to 1.8) (p-value = 0.2), and the RPA z-score improved from −2 (−2.8 to 0.04) to 0.18 (−2.4 to 1.3) (p-value = 0.34). The mean pressure gradient decreased from 50 mmHg (32–72) to 38 mmHg (20–55) (p-value 0.08). The surgical repair was on time in 13 patients; one was still waiting for surgery. BRCTs were found in 8 patients and had no impact on the surgical strategy. Seven patients needed transannular patching, and in 11, the PV could be preserved (including 7 with BRCTs).ConclusionPalliative transcatheter dilation of predominantly pulmonary valve stenosis in patients with TOF and predominantly pulmonary valve stenosis is safe and effective in palliating cyanosis in most patients. It can improve saturation and prompt pulmonary development, delaying the surgical repair to the right time. A subsequent BRCT seems to have no negative impact on the surgical strategy.
Predicting hypoglycemia in elderly inpatients with type 2 diabetes: the ADOCHBIU model
Authors: Zhang Rui-Ting , Liu Yu , Sun Chao , Wu Quan-Ying , Guo Hong , Wang Gong-Ming , Lin Ke-Ke , Wang Jing , Bai Xiao-Yan 
Published: November 2024

BackgroundHypoglycemic episodes cause varying degrees of damage in the functional system of elderly inpatients with type 2 diabetes mellitus (T2DM). The purpose of the study is to construct a nomogram prediction model for the risk of hypoglycemia in elderly inpatients with T2DM and to evaluate the predictive performance of the model.MethodsFrom August 2022 to April 2023, 546 elderly inpatients with T2DM were recruited in seven tertiary-level general hospitals in Beijing and Inner Mongolia province, China. Medical history and clinical data of the inpatients were collected with a self-designed questionnaire, with follow up on the occurrence of hypoglycemia within one week. Factors related to the occurrence of hypoglycemia were screened using regularized logistic analysis(r-LR), and a nomogram prediction visual model of hypoglycemia was constructed. AUROC, Hosmer-Lemeshow, and DCA were used to analyze the prediction performance of the model.ResultsThe incidence of hypoglycemia of elderly inpatients with T2DM was 41.21% (225/546). The risk prediction model included 8 predictors as follows(named ADOCHBIU): duration of diabetes (OR=2.276, 95%CI 2.097˜2.469), urinary microalbumin(OR=0.864, 95%CI 0.798˜0.935), oral hypoglycemic agents (OR=1.345, 95%CI 1.243˜1.452), cognitive impairment (OR=1.226, 95%CI 1.178˜1.276), insulin usage (OR=1.002, 95%CI 0.948˜1.060), hypertension (OR=1.113, 95%CI 1.103˜1.124), blood glucose monitoring (OR=1.909, 95%CI 1.791˜2.036), and abdominal circumference (OR=2.998, 95%CI 2.972˜3.024). The AUROC of the prediction model was 0.871, with sensitivity of 0.889 and specificity of 0.737, which indicated that the nomogram model has good discrimination. The Hosmer-Lemeshow was χ2 = 2.147 (P=0.75), which meant that the prediction model is well calibrated. DCA curve is consistently higher than all the positive line and all the negative line, which indicated that the nomogram prediction model has good clinical utility.ConclusionsThe nomogram hypoglycemia prediction model constructed in this study had good prediction effect. It is used for early detection of high-risk individuals with hypoglycemia in elderly inpatients with T2DM, so as to take targeted measures to prevent hypoglycemia.Trial registrationChiCTR2200062277. Registered on 31 July 2022.
A dose escalation study to evaluate the safety of an aerosol BCG infection in previously BCG-vaccinated healthy human UK adults
Authors: Fredsgaard-Jones Timothy , Harris Stephanie A. , Morrison Hazel , Ateere Alberta , Nassanga Beatrice , Ramon Raquel Lopez , Mitton Celia , Fletcher Eve , Decker Jonathan , Preston-Jones Hannah , Jackson Susan , Mawer Andrew , Satti Iman , Barer Michael , Hinks Timothy , Bettinson Henry , McShane Helen 
Published: November 2024

IntroductionTuberculosis (TB) is the leading cause of death worldwide from a single infectious agent. Bacillus Calmette-Guérin (BCG), the only licensed vaccine, provides limited protection. Controlled human infection models (CHIMs) are useful in accelerating vaccine development for pathogens with no correlates of protection; however, the need for prolonged treatment makes Mycobacterium tuberculosis an unethical challenge agent. Aerosolised BCG provides a potential safe surrogate of infection. A CHIM in BCG-vaccinated as well as BCG-naïve individuals would allow identification of novel BCG-booster vaccine candidates and facilitate CHIM studies in populations with high TB endemicity. The purpose of this study was to evaluate the safety and utility of an aerosol BCG CHIM in historically BCG-vaccinated volunteers.MethodsThere were 12 healthy, historically BCG-vaccinated UK adults sequentially enrolled into dose-escalating groups. The first three received 1 × 104 CFU aerosol BCG Danish 1331 via a nebuliser. After safety review, subsequent groups received doses of 1 × 105 CFU, 1 × 106 CFU, or 1 × 107 CFU. Safety was monitored through self-reported adverse events (AEs), laboratory tests, and lung function testing. Immunology blood samples were taken pre-infection and at multiple timepoints post-infection. A bronchoalveolar lavage (BAL) taken 14 days post-infection was analysed for presence of live BCG.ResultsNo serious AEs occurred during the study. Solicited systemic and respiratory AEs were frequent in all groups, but generally short-lived and mild in severity. There was a trend for more reported AEs in the highest-dose group. No live BCG was detected in BAL from any volunteers. Aerosol BCG induced potent systemic cellular immune responses in the highest-dose group 7 days post-infection.DiscussionAerosol BCG infection up to a dose of 1 × 107 CFU was well-tolerated in historically BCG-vaccinated healthy, UK adults. No live BCG was detected in the BAL fluid 14 days post-infection despite potent systemic responses, suggesting early clearance. Further work is needed to expand the number of volunteers receiving BCG via the aerosol route to refine and establish utility of this aerosol BCG CHIM.Clinical trial registrationhttps://clinicaltrials.gov/, identifier NCT04777721.
Contribution of pectin-degrading bacteria to the quality of cigar fermentation: an analysis based on microbial communities and physicochemical components
Authors: Su Youbo , Cui Yonghe , Fu Kejian , Bu Lingduo , Sun Yucui , Zhou Qi , Yin Yuming , Sun Yulong , Yang Huating , Wu Lang , Song Xueru 
Published: November 2024

ObjectiveThis study aims to investigate the effects of pectin-degrading bacteria on the microbial community and physicochemical properties during the fermentation process of cigar tobacco, evaluating its potential in reducing green bitterness and enhancing aroma.MethodsBy isolating and screening pectin-degrading bacteria, high-throughput sequencing and physicochemical analysis were employed to compare the microbial flora and physicochemical component differences in different treatment groups of cigar tobacco. Furthermore, correlation analysis was performed to examine the relationships between these variables.ResultsThe results showed that the strains YX-2 and DM-3, isolated from the cigar tobacco variety “Yunxue No. 1,” exhibited strong pectin-degrading abilities. Phylogenetic analysis revealed that strain YX-2 is highly homologous to Bacillus flexus, while strain DM-3 is highly homologous to Bacillus siamensis. After fermentation, the addition of strains YX-2 and DM-3 significantly reduced the pectin content in the tobacco leaves, increased the total sugar and reducing sugar content, reduced green bitterness, and markedly enhanced the total aroma components. Notably, DM-3 exhibited outstanding performance in the production of Maillard reaction products. Microbial community analysis showed that the addition of pectin-degrading bacteria significantly increased the diversity of both bacteria and fungi, especially in the TDM3 group, where the relative abundance of Pseudomonas was notably elevated. Correlation analysis revealed that Pseudomonas had a significant positive correlation with both reducing sugar and total sugar, and a significant negative correlation with pectin, indicating its important role in sugar metabolism and pectin degradation. Additionally, fungal genera such as Cercospora were significantly negatively correlated with total sugar and total nitrogen, while Eurotium was closely associated with pectin degradation and reducing sugar accumulation.ConclusionThis study found that the addition of Pectin-degrading bacteria YX-2 and DM-3 significantly optimized the microbial community structure during the cigar tobacco fermentation process and improved the physicochemical properties of the tobacco leaves, with notable effects in reducing green bitterness and enhancing aroma.
The characteristics of auditorial event-related potential under propofol sedation associated with preoperative cognitive performance in glioma patients
Authors: Wang Xinxin , Yang Wanning , Jian Minyu , Liang Yi , Yang Zuocheng , Chen Yiwei , Ma Bo , Wang Chengwei , Hou Zonggang , Deng Zhenghai , Liu Haiyang , Xie Jian , Han Ruquan 
Published: November 2024

BackgroundGlioma patients often experience neurocognitive deficits, particularly mild cognitive impairment (MCI), which affects their perioperative safety. The use of auditory event-related potentials (AERPs) might be a promising method for reflecting perioperative cognitive function in patients, even under unresponsive sedation. In this study, we aimed to investigate the relationships between the AERP under sedation and preoperative cognitive performance in glioma patients.MethodsPatients with primary supratentorial gliomas who were scheduled for elective craniotomy under general anesthesia were included in this prospective observational study. The patients were categorized into MCI and non-MCI groups based on their preoperative Montreal Cognitive Assessment (MoCA) scores. AERP characteristics, including mismatch negativity (MMN), P300, and event-related spectral perturbation (ERSP) in the theta bands, were analyzed under different propofol-induced sedation conditions. Differences in these parameters between groups and their relationships with preoperative cognitive performance were subsequently investigated.ResultsTwenty-nine eligible patients were included in the analysis. Compared to that in the non-MCI group, the average amplitude of the MMN component evoked by the novel stimulus significantly decreased during the recovery period in the MCI group (−3.895 ± 1.961 μV vs. -1.617 ± 1.831 μV, p = 0.003). Theta-ERSPs also differed between the two groups under standard (0.021 ± 0.658 μV2/Hz vs. 0.515 ± 0.622 μV2/Hz, p = 0.048) and novel (0.212 ± 0.584 μV2/Hz vs. 0.823 ± 0.931 μV2/Hz, p = 0.041) stimulation conditions under light sedation. After correcting for age, education level, site of lesion, WHO pathological grade and combined symptomatic epilepsy as confounders, the frontal theta-ERSP induced by standard and novel stimuli under light sedation was inversely related to the preoperative MoCA score (standard stimuli: β = −0.491, p = 0.011; novel stimuli: β = −0.594, p = 0.007), as was the average MMN amplitude induced by novel stimuli during the recovery period (β = −0.356, p = 0.035).ConclusionThe AERP neural response characteristics of glioma patients during propofol sedation were associated with preoperative cognitive performance, which might be a potential neurophysiological indicator for monitoring perioperative cognitive function, especially theta-ERSP.
First implementation and results of online adaptive radiotherapy for cervical cancer based on CT-Linac combination
Authors: Jiang Dazhen , Yang Chunxu , Sun Shaoxing , Wang Dajiang , Xiao Zhizhi , Hu Jie , Mei Zijie , Xie Conghua , Liu Hui , Qiu Hui , Wang Xiaoyong 
Published: November 2024

PurposeTo assess the dosimetric effectiveness of image-guided radiation treatment (IGRT) and online adaptive radiation therapy (oART) for cervical cancer. As well as survival follow-up was conducted to validated the safety and efficacy of oART.MethodsA total of 15 cervical cancer patients were enrolled. oART was performed on a CT-integrated linear accelerator. The initial plan was revised to include the distribution of IGRT dose using daily fan-beam CT (FBCT) images, after which the distinctions between ART and IGRT in terms of target coverage and organs at risk (OARs) sparing were analyzed. Survival follow-up was conducted to validated the safety and efficacy of oART in this group.ResultsPTV Dmax value decreased by 1.23 Gy in the ART plan when compared to that in the IGRT plan; PTV D95 increased by 1.34 Gy; PTV V50 coverage increased by 4.86%; CTV coverage increased by 3.02%; PTV D2cc of the colon, rectum, and small intestine decreased by 1.24 Gy, 1.29 Gy, and 1.12 Gy, respectively. The V10 and V30 of the pelvis increased by 1.27% and 0.56%, respectively, while the V30 of the left and right femoral heads dropped by 2.82% and 3.41%, respectively. Except for the pelvic changes, all other differences were statistically significant (p &lt; 0.01). The average time for the ART procedure was 21.22 min (range: 18.72–24.90 min). The median follow-up time is 28.0 months. Median event-free survival and overall survival were not reached. EFS rate and OS rate at 3 years were 79.4% and 92.9%.ConclusionOnline ART for cervical cancer can minimize the dose of OARs and enhance the target volume coverage significantly when compared to IGRT with satisfied survival time.
Hemangiopericytoma following allogeneic hematopoietic stem cell transplantation in a patient with primary plasma cell leukemia: the first case report and literature review
Authors: Shi Yajun , Liang Guohao , Zhang Haiying , Wang Yaqing , Han Ying , Tong Shenglian , Liang Shunyu , Wang Ying , Bai Hai , Xi Rui 
Published: November 2024

BackgroundHemangiopericytoma (HPC) is a rare secondary tumor after allogeneic hematopoietic stem cell transplantation (allo-HSCT), which has not been reported in the literature. Herein, we reported a case of HPC after allo-HSCT.Case descriptionWe reported a case of a middle-aged female patient with primary plasma cell leukemia who presented lumbosacral pain and right lower limb pain and numbness on1684 days post-transplant. She underwent an MRI of the lumbar spine, which showed abnormal signal intensity in the spinal canal at the second through fifth lumbar spine vertebral levels. The patient was diagnosed with HPC based on a pathological biopsy of the diseased tissue in the spinal canal. Radiotherapy was administered to the lesion in the second through fifth lumbar vertebrae. The patient experienced less numbness and pain.ConclusionAccording to the literature, this is the first reported case of post-transplant HPC. Therefore, attention should be paid to secondary tumors after transplantation, especially rare tumors.
Guiding adjuvant radiotherapy in stage III endometrial cancer: a prognostic model based on SEER
Authors: Li Chunmei , Han Zheshen , Chen Linlin , Du Gajincuo , Cai Rong 
Published: November 2024

BackgroundThe effect of overall survival (OS) with adjuvant radiotherapy in stage III endometrial cancer (EC) remains controversial, and the adverse invents were unignorable.MethodsA total of 4,064 stage III EC patients who underwent adjuvant chemotherapy post-operatively were selected from Surveillance, Epidemiology, and End Results (SEER) Program. Independent risk factors were identified through Cox regression models. A nomogram was developed accordingly to predict OS. The concordance index (C-index), calibration, and Receiver Operating Characteristic (ROC) curves were applied to assess the model. Patients were divided into the low- and high-risk groups based on the optimal risk cutoff. Stratified analysis was conducted by radiation in both groups, and interactions between radiation and the risk groups were conducted to explore if any benefit less from adjuvant radiotherapy.ResultsA total of five candidate factors were identified from the model showing good calibration and consistency discriminative power in the training (C-index: 0.73; 95% CI: 0.70–0.75), testing (C-index: 0.73; 95% CI: 0.69–0.77), and external validation cohorts (C-index: 0.88, 95% CI, 0.78–0.97). Patients were categorized into the low- and high-risk groups based on the optimal risk cutoff of 2.1048630. The women in the high-risk group experience significantly less (42% vs. 63% reduction) or none (0 vs. 63%) benefit (p-interaction = 0.049 vs. 0.016 in training and testing cohorts, respectively).ConclusionA nomogram incorporating five variables was established to predict OS in stage III EC patients with adjuvant chemotherapy. The high-risk groups benefit less or none from adjuvant radiotherapy, which may serve as a useful reference for better guidance of radiotherapy in stage III EC patients.
Effectiveness analysis of a pharmacist-led intervention for orthopedic perioperative use of antibiotics: a retrospective cohort study
Authors: Wu Danwei , Li Yingxu , Zhen Jiancun , Wu Yong , Ren Shuang , Zhao Yuan , Sun Ning , Lin Xuanzi , Lai Liangpeng , Zhang Wei 
Published: November 2024

BackgroundFollowing the Chinese guidelines’ recommendation to completely cancel routine cephalosporin skin tests, the choice of cephalosporin as surgical prophylactic medication was affected. This was due to the limited cognition of the predictive value of cephalosporin skin test or the desire to avoid medical disputes. The aim of this retrospective study was to evaluate whether the pharmacist-led perioperative antibiotic prophylaxis model could improve clinicians’ medical behavior in choosing cephalosporin antibiotics for surgical prophylaxis.MethodsFrom July 2021 to May 2022, a retrospective analysis was conducted on the selection of surgical preventive medication, skin test, postoperative infection and adverse drug reactions in foot and ankle surgery. The study was divided into three period: the rountine cephalosporin skin test period (Period I: Skin Test), the period when the routine cephalosporin skin test was cancelled but the pharmacist did not intervene (Period II: Cancel Skin Test), and the period when the pharmacist-led perioperative antibiotic prophylaxis was implemented after the cancellation of the cephalosporin skin test (Period III: Pharmacist Intervention).ResultsA total of 1,583 patients were enrolled in this study. There was no significant difference in the utilization rate of cefuroxime between the routine skin test stage and the skin test cancelled stage [74.92% (Period I) vs. 74.54% (Period II), P &gt; 0.05]. However, in the pharmacist intervention stage, the usage rate of cefuroxime significantly increased compared to the initial stage when the skin test was cancelled [87.07% (Period III) vs. 74.54% (Period II), P &lt; 0.05]. The use of cephalosporins also increased in patients with self-reported beta-lactam allergies between these stages [41.94% (Period III) vs. 3.22% (Period II), P &lt; 0.05)]. There was no significant difference in the incidence of postoperative infection and adverse drug reactions among the three periods.ConclusionThe pharmacist-led perioperative antibiotic prophylaxis model can significantly improve the medical behavior of clinicians in choosing cephalosporin antibiotics as surgical prophylactic medication and optimize the perioperative medication plan.
Animal study on factors influencing anterograde renal pelvis perfusion manometry
Authors: Liu Xin , Li Xing , Liao Limin 
Published: November 2024

ObjectsAnterograde renal pelvis perfusion manometry is an effective method to assist in the diagnosis of upper urinary tract obstruction.MethodsTo established a rat model of partial ureteral obstruction to explore the perfusion rate, renal pelvis volume, obstruction sites, contralateral upper urinary tract, and lower urinary tract functions, which may affect anterograde renal pelvis perfusion manometry. To measure the renal pelvis volume using ultrasound. Depending on whether clamped the contralateral ureter and it continuously emptied the bladder, perfused the renal pelvis at rate of 15, 30, 60, 90, or 120 mL/h to measure the pressure synchronously.ResultsThe research showed the renal pelvis volume of UPJ and UVJ at 1, 2, 3, and 4 weeks respectively, significantly increased compared with the control group. Comparison of the renal pelvis volume between the UPJ and UVJ groups was not statistically significant. The renal pelvis pressure of UPJ and UVJ was significantly increased compared with the control group, and the UVJ group was greater than the UPJ group. The renal pelvic pressure increased as the perfusion rate increased. Comparing the renal pelvis pressure measured using synchronous bladder emptying with the renal pelvis pressure measured singly, the difference was statistically significant. Comparing the renal pelvis pressure measured using synchronous bladder emptying with measured with a clamped contralateral ureter, the difference was not statistically significant; however, in some groups, the difference was statistically significant. Measuring the renal pelvis pressure singly and clamping the contralateral ureter, the difference was not statistically significant, except in some groups, the difference was significant.ConclusionThe study suggested that ureter obstruction sites, perfusion rates, renal pelvis volumes, and synchronous bladder emptying affects the renal pelvis pressure. The function of the contralateral upper urinary tract did not affect renal pelvis pressure in the short term.