bluuebunny/crossref_metadata_2025_split huggingface dataset:
The detailed transseptal puncture technique for optimal closure in patients with a patent foramen ovale
Authors: Ilkay Erdogan , Sariçam Ersin , Kaçmaz Fehmi , Yakici Aysel , Koca Çiğdem , Özeke Özcan , Polat Melike , Güney Murat Can , Karaduman Bilge Duran , Erdöl Mehmet Akif , Onal Mehmet Zulkuf 
Published: November 2024

BackgroundThe closure of a patent foramen ovale (PFO) using transseptal puncture has particular advantages and disadvantages. Thus, transseptal puncture should be re-evaluated in detail.AimsWe aimed to assess the effectiveness of the detailed transseptal puncture technique in patients who underwent PFO closure due to cryptogenic stroke or transient ischemic attack in terms of residual shunts and atrial fibrillation.MethodsWe prospectively analyzed 144 consecutive patients who underwent PFO closure by the detailed transseptal puncture technique between February 2013 and April 2023 in two centers. All of the patients had a &gt;10 mm long-tunnel PFO.ResultsThe procedural success rate was 100%. However, after the procedure, moderate pericardial effusion developed in one patient (0.7%) and an acute pulmonary embolism related to femoral vein thrombosis was observed in one patient (0.7%) during the first month. Complications related to the procedure were noted in two patients (1.4%) during the first month of follow-up. Residual shunts were observed in 1.4% of cases after PFO closure.ConclusionWe demonstrated that the detailed transseptal technique is safe and effective for PFO closure. The detailed transseptal PFO closure technique significantly reduced the risk of atrial fibrillation, and the occurrence of residual shunts was significantly low following the closure.
Thrombomodulin is a stronger indicator of combined oral contraceptives-induced activated protein C pathway resistance in the thrombin generation test than activated protein C
Authors: Ninivaggi Marisa , Sokolova Lily , Donkervoort Demy , de Laat Bas , de Laat-Kremers Romy 
Published: November 2024

BackgroundThe mechanism by which combined oral contraceptives (COCs) lead to hypercoagulation is not fully understood, although activated protein C (APC) pathway resistance has been implicated. APC and thrombomodulin (TM) tend to be considered as interchangeable reagents, even though their biological action in coagulation is different. However, it remains unclear which reagent is better suited for the detection of APC pathway resistance. We compared the effectiveness of TM and APC in TG to detect COC-induced APC pathway resistance using thrombin generation (TG).MethodsTG was measured on ST Genesia in 48 healthy women, of whom 24 used COCs. TG was triggered with STG-ThromboScreen (with and without TM), spiked with a low and high concentration of TM or APC (2 or 15 nM TM, or 1.5 or 5.5 nM APC), aimed to achieve 50% and 90% ETP inhibition, respectively.ResultsTG was higher in women using COCs. TM and APC inhibit TG in all women, although their inhibitory effect is more pronounced in women without COC compared to women with COC. The addition of 2 nM TM causes an ETP reduction of 40% (1,289 vs. 768 nM•min) in women without COC and an ETP reduction of 24% (1,704 vs. 1,287 nM•min) in women with COC. The addition of 1.5 nM APC causes an ETP reduction of 41% (1,289 vs. 759 nM•min) in women without COC and an ETP reduction of 23% (1,704 vs. 1,316 nM•min) in women with COC. The difference in effect between women with and without COC is largest when 15 nM TM, aimed at 90% ETP inhibition, is used. 15 nM TM leads to the smallest overlap in ETP inhibition between women with and without COC (27% overlap), compared to 2 nM TM (41% overlap), and 1.5 nM APC (38% overlap) and 5.5 nM APC (41% overlap).ConclusionAlthough TM and APC are often used interchangeably to assess the sensitivity of the APC system in TG, our findings suggest that TM is a better discriminator to detect COC-use induced APC pathway resistance. In addition, we found that the ETP is a better TG test readout for APC pathway resistance testing than the peak height.
Navigating pancreas transplant perceptions: assessing public sentiment and strategies using AI-driven analysis
Authors: Garcia Valencia Oscar A. , Thongprayoon Charat , Jadlowiec Caroline C. , Mao Shennen A. , Miao Jing , Leeaphorn Napat , Suppadungsuk Supawadee , Csongradi Eva , Budhiraja Pooja , Khoury Nadeen , Vaitla Pradeep , Cheungpasitporn Wisit 
Published: November 2024

BackgroundPancreas transplantation, a crucial treatment for diabetes, is underutilized due to its invasiveness, strict criteria, organ scarcity, and limited centers. This highlights the need for enhanced public education and awareness through digital health platforms.MethodsWe utilized Google's AI-driven, consensus-based model and Claude AI 3.0 Opus by Anthropic to analyze public perceptions of pancreas transplantation. The top 10 websites identified by Google as of April-May 2024 were reviewed, focusing on sentiment, consensus, content readability, and complexity to develop strategies for better public engagement and understanding using digital health technologies.ResultsThe top 10 websites, originating from the US and UK, showed a neutral and professional tone, targeting medical professionals and patients. Complex content was updated between 2021 and 2024, with a readability level suitable for high school to early college students. AI-driven analysis revealed strategies to increase public interest and understanding, including incorporating patient stories, simplifying medical jargon, utilizing visual aids, emphasizing quality of life improvements, showcasing research progress, facilitating patient outreach, promoting community engagement, partnering with influencers, and regularly updating content through digital health platforms.ConclusionTo increase interest in pancreas transplantation in the era of connected health, we recommend integrating real patient experiences, simplifying medical content, using visual explanations, emphasizing post-transplant quality-of-life improvements, highlighting recent research, providing outreach opportunities, encouraging community connections, partnering with influencers, and keeping information current through digital health technologies. These methods aim to make pancreas transplantation more accessible and motivating for a diverse audience, supporting informed decision-making.
Teaching online with an artificial pedagogical agent as a teacher and visual avatars for self-other representation of the learners. Effects on the learning performance and the perception and satisfaction of the learners with online learning: previous and new findings
Authors: Herbert Cornelia , Dołżycka Joanna Daria 
Published: November 2024

IntroductionBuilding upon previous research, this study aims to provide answers to the questions of how the presence of a humanoid artificial pedagogical agent as teacher and instructor and visual self-other representation of the learners through avatars influence the immediate cognitive performance and learning experience in online learning among adult learners.MethodsSeveral outcome measures were investigated to evaluate if effects are the same or different for the different experimental conditions and if learning with the pedagogical agent and visual self-other representation is modulated by the learner’s previous experiences with and preferences for online learning. Teacher presence and self-other presence of the learners were experimentally manipulated. A humanoid artificial agent, visible on all of the slides of the online course material and instructing the material represented the teacher. The avatars of the learners (self-avatar and peer avatars) were kept of minimal functionality but self-avatars were preselected or could be self-selected by the learners. The learner’s cognitive learning performance, the learner’s attention to the pedagogical agent, their sense of teacher presence and of self- and other-presence, their satisfaction with the course as well as the learner’s previous learning experiences were measured by cognitive testing, self-report, and linguistic analysis as major performance indicators and a positive learning experience. The analysis comprised 133 university students and results were additionally compared for two subsamples.ResultsLearning performance, learning satisfaction, and the attention paid to the teacher were positively related. In addition, positive evaluations of the cognitive presence elicited by the teacher were found. Self- or other-presence of avatars did not significantly influence the learner’s performance beyond teacher presence but the learner’s perception of it and their motivation to study online.DiscussionThe study and its results extend the previous literature that focused on the effects of pedagogical agents in online teaching or on virtual representations of the learner’s self and classmates in online learning. Despite limitations, the results of this study provide insights into combining teaching with artificial pedagogical agents and visual avatars for self-other representation during online teaching and the observations can serve as catalyst for future research.
Thyroid FT4-to-TSH ratio in the first trimester is associated with gestational diabetes mellitus in women carrying male fetus: a prospective bi-center cohort study
Authors: Song Shuoning , Zhang Yuemei , Qiao Xiaolin , Duo Yanbei , Xu Jiyu , Zhang Jing , Chen Yan , Nie Xiaorui , Sun Qiujin , Yang Xianchun , Wang Ailing , Lu Zechun , Sun Wei , Fu Yong , Dong Yingyue , Yuan Tao , Zhao Weigang 
Published: November 2024

BackgroundGestational diabetes mellitus (GDM) is one of the most common medical complications of pregnancy, which increases the risk of other pregnant complications and adverse perinatal outcomes. Thyroid dysfunction is closely with the risk of diabetes mellitus. However, the relationship between euthyroid function in early pregnancy and GDM is still controversial.AimsThis study was to find the relationship between thyroid function within normal range during early pregnancy as well as glucose and lipids metabolisms as well as the risk of subsequent GDM.MethodsA total of 1486 pregnant women were included in this prospective double-center cohort study. Free thyroxine (FT4), thyroid stimulating hormone (TSH) and antithyroid peroxidase antibodies (TPOAb) were tested during 6-12 weeks of gestation and oral glucose tolerance test (OGTT) was conducted during 24-28 weeks to screen GDM. Relative risks (RR) with 95% confidence intervals (CI) for subsequent risk of GDM by thyroid function quartiles were assessed adjusting for major risk factors.ResultsThe incidence of GDM was 23.0% (342/1486). TSH, FT4 and the percentage of positive TPOAb were no significant difference between women with and without GDM, but FT4/TSH ratio was significantly higher in GDM group compared with NGT group [6.97(0.84,10.61) vs. 4.88(0.66,12.44), P=0.025)]. The linear trends of TC, TG, HDL-C, LDL-C, fasting glucose in the first trimester, insulin, C-peptide, HOMA-IR, fasting glucose during OGTT and incidence of GDM according to FT4/TSH ratio were all statistically significant. Further analysis based on fetal sex presented only the third quartile of FT4/TSH ratio in women carrying male fetus was associated with higher incidence of GDM statistically significant [RR (95% CI), 1.917 (1.143,3.216)], rather than in women carrying female fetus.ConclusionsThyroid function even in normal range is closely related to glucose and lipids metabolisms during the first trimester. Unappropriated FT4/TSH ratio in the first trimester is an independent risk factor of GDM in women carrying male fetus.
Association of hemoglobin glycation index with all-cause and cardio-cerebrovascular mortality among people with metabolic syndrome
Authors: Zhao Leiyong , Li Chengjun , Lv Hequn , Zeng Chunli , Peng Yongjun 
Published: November 2024

BackgroundResearch on the association between blood glucose-related biomarkers and mortality has gained increasing attention. However, the association of hemoglobin glycation index (HGI) with all-cause and cardio-cerebrovascular mortality among people with metabolic syndrome has never been investigated. The objective of this study was to examine the association through a cohort study of the American population.MethodsIn this study, 8,267 participants were included. We utilized multivariable Cox regression analyses to explore the relationship between HGI and outcomes. The dose-response relationship between HGI and mortality was explored with restricted cubic splines. Recursive algorithms and segmented linear regression models were used to calculate the inflection points and assess the effect relationships before and after the inflection points.ResultsIn the model adjusting for all covariates, our analysis did not reveal a statistically significant association between HGI and mortality. Intriguingly, subsequent explorations of non-linear relationships unearthed a U-shaped correlation between HGI and both all-cause mortality and cardio-cerebrovascular mortality among American adults with metabolic syndrome. Before and after the inflection point, the HRs (95%CIs) for the association between HGI and all-cause mortality were 0.72 (0.63, 0.82) and 1.30 (1.17, 1.44), respectively. For cardio-cerebrovascular mortality, similar opposite relationships were found. The metabolic syndrome population with HGI levels at T2 had a lower rate of mortality.ConclusionThis cohort study of the American metabolic syndrome population highlighted a U-shaped association of HGI with all-cause and cardio-cerebrovascular mortality.
Characteristics of soil aggregate distribution and organic carbon mineralization in quinoa fields with different soil textures in the northern of the Yinshan Mountains in inner Mongolia
Authors: Lv Shuning , Liu Ruixiang , Guo Zhanbin , Wang Shuyan 
Published: November 2024

The sub-mountain plains area at the northern foothills of the Yinshan Mountains in Inner Mongolia is an important grain producing area in the cold and arid regions of China, but due to climatic and environmental factors, it has resulted in a fragile ecological environment, degradation of arable land, and serious soil erosion. Quinoa (Chenopodium quinoa Willd.) is a hardy, cold and saline tolerant crop with much higher protein content than other crops. Therefore, it has begun to be grown on a large scale in the region in recent years. In order to investigate the distribution characteristics of soil aggregates and organic carbon (SOC) in quinoa fields in ecologically fragile areas, four quinoa fields with different soil textures, namely, sandy soil, sandy loam, loamy soil and clay loam, were selected for this experiment, and the mass percentages of different soil aggregate particle sizes and the organic carbon content of each particle size were determined before and after quinoa planting, and the organic carbon mineralisation in soil aggregates of quinoa fields with different textures was analysed through indoor organic carbon mineralisation cultures. The dynamic characteristics were analysed. The results showed that the stability of soil aggregates was enhanced after planting quinoa, and the highest mass percentage of aggregates with &gt;2 mm particle size was 27.95% in clay loam soil. Planting quinoa in loamy soil had the most obvious effect on promoting the formation of soil macroaggregates, while the organic carbon content increased the most. The organic carbon (SOC) content of soil aggregates of all grain sizes increased by 0.45–3.09 g kg-1 compared to the pre-sowing period, with the fastest rate and greatest intensity of organic carbon mineralisation in aggregates of 2–0.25 mm grain size. The study showed that growing quinoa in loamy soils improves soil structure, slows down the rate of soil organic carbon mineralization, and increases soil carbon sequestration capacity.
Assessment of corticospinal tract damage and cytokines response in early and late stages of acute unilateral brainstem infarction patients
Authors: Shi Mengye , Chen Huiyou , Ci Xiaojiao , Geng Wen , Qi Xinyang , Chen Yuchen , Yin Xindao 
Published: November 2024

BackgroundAcute brainstem infarction is associated with high morbidity and mortality, the integrity of corticospinal tract (CST) detected via diffusion tensor imaging (DTI) can assist in predicting the motor recovery of the patients. In addition to the damage caused by ischemia and reperfusion, sterile inflammation also contributes to the brain injury after stroke. However, the changes in CST integrity detected by DTI in acute brainstem infarction have yet to be fully elucidated, and it is still unclear whether sterile inflammation can cause damage to the CST.MethodsIn this study, the acute brainstem infarction patients in the early (EABI patients, n = 19) and late (LABI patients, n = 21) stages and healthy controls (HCs, n = 22) are employed. The probabilistic tractography technique was used and the fractional anisotropy (FA) value was chosen to evaluated the integrity of the CST, the IL-6, IL-10, IL-17, IL-1β, and tumor necrosis factor (TNF)-α levels in the plasma are measured to evaluate the level of inflammation.ResultsCompared to the HCs (F = 13.634, p ANOVA &lt; 0.001), the CST FA values on the infarcted side were abnormally elevated in EABI patients (p LSD = 0.003), and decreased in LABI patients (p LSD = 0.034). The levels of IL-6 (F = 12.311, p ANOVA &lt; 0.001, EABI vs HCs: p LSD &lt; 0.001, LABI vs HCs: p LSD &lt; 0.001), IL-10 (F = 11.329, p ANOVA &lt; 0.001, EABI vs HCs: p LSD &lt; 0.001, LABI vs HCs: p LSD = 0.017) and IL-1β (F = 15.986, p ANOVA &lt; 0.001, EABI vs HCs: p LSD &lt; 0.001, LABI vs HCs: p LSD &lt; 0.001) were increased in both EABI and LABI patients, while the IL-17 levels were elevated only in LABI patients (F = 4.258, p ANOVA = 0.019, LABI vs HCs: p LSD = 0.027). Among these cytokines, the increased IL-6 (r = 0.663, p = 0.002) and IL-1β (r = 0.615, p = 0.005) levels of EABI patients might be related to the elevated CST FA values, while the increased IL-17 (r = -0.599, p = 0.004) levels of LABI patients might contribute to the decrease of the CST FA values.ConclusionOur study reveals that the increased CST FA values in EABI patients may include signals generated by the immune cells which move along the CST. The sterile inflammation may contribute to the impairment of CST integrity in LABI patients.
Global lncRNA expression signature in pre-metastatic lung and their regulatory effects in pulmonary metastasis
Authors: Shi Huifang , Wang Peng , Wang Jiaan , Chen Lei , Qin Yan , Lv Jie 
Published: November 2024

BackgroundLung metastasis has garnered significant attention due to its prevalent occurrence. Pre-metastatic niche (PMN) establishment is a critical prerequisite for the onset of lung metastasis. Emerging evidence indicates that long noncoding RNAs (lncRNAs) play pivotal roles in the metastatic cascade to the lungs. However, the relationship between lncRNA expression profiles and the formation of PMN remains uncharacterized. This study aims to explore the expression profiles and potential roles of lncRNAs in the context of pre-metastatic lung microenvironment.MethodsRNA sequencing was utilized to elucidate the lncRNA landscape in pre-metastatic lung of murine models. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to infer the prospective functions of the differentially expressed lncRNAs. Among these, lncRNA Gm5144-202 in alveolar macrophages (AMs) was further scrutinized for its role in driving M2 macrophage polarization, facilitating the formation of PMN, and orchestrating the apoptosis, proliferation, and migration of tumor cells in vitro.ResultsA total of 232 lncRNAs exhibited differential expression in pre-metastatic murine lungs compared to normal controls, predominantly enriching pathways such as PI3K-Akt signaling, calcium signaling, neuroactive ligand-receptor interaction, and NF-κB signaling. Notably, lncRNA Gm5144-202 exhibited the most pronounced difference, with elevated level in alveolar macrophages (AMs) during the pre-metastatic phase. Silencing of lncRNA Gm5144-202 impeded the polarization of M2-like macrophages, suppressed the expression of factors critical for the formation of the PMN, and inhibited tumor cell invasion.ConclusionsOur research delineated the lncRNA expression profiles in pre-metastatic pulmonary tissues and identified, for the first time, the pivotal role of lncRNA Gm5144-202 in modulating M2 macrophage polarization and tumor cell invasiveness. Consequently, targeting lncRNA Gm5144-202 holds substantial promise for translational applications aimed at mitigating pulmonary metastasis.
Combination of gallium citrate and levofloxacin induces a distinct metabolome profile and enhances growth inhibition of multidrug-resistant Mycobacterium tuberculosis compared to linezolid
Authors: Ilchenko Oleksandr , Nikolaevskaya Elena , Zinchenko Oksana , Ivanytsia Volodymyr , Prat-Aymerich Cristina , Ramstedt Madeleine , Rzhepishevska Olena 
Published: November 2024

IntroductionTuberculosis (TB) treatment typically involves a tailored combination of four antibiotics based on the drug resistance profile of the infecting strain. The increasing drug resistance of Mycobacterium tuberculosis (Mtb) requires the development of novel antibiotics to ensure effective treatment regimens. Gallium (Ga) is being explored as a repurposed drug against TB due to its ability to inhibit Mtb growth and disrupt iron metabolism. Given the potential interactions between Ga and established antibiotics, we investigated how a combination of Ga with levofloxacin (Lfx) or linezolid (Lzd) affects the growth and metabolome of a multidrug-resistant (MDR) Mtb clinical strain.MethodsMtb was cultured using a BACTEC 960 system with concentrations of Ga ranging from 125 to 1,000 μM and with 250 to 500 μM of Ga combined with 0.125 mg/L of Lfx or Lzd. For metabolome analysis, the antibacterials were used at concentrations that inhibited the growth of bacteria without causing cell death. Metabolites were extracted from Mtb cells and analyzed using chromatography-mass spectrometry.ResultsThe MDR Mtb strain exhibited a dose-dependent response to Ga. Notably, the enhancement in growth inhibition was statistically significant for the Ga/Lfx combination compared to Ga alone, while no such significance was observed for Ga/Lzd. Moreover, exposure to Ga/Lfx or Ga/Lzd resulted in distinct metabolite profiles. Ga treatment increased the level of aconitate, fumarate, and glucose in the cells, suggesting the inhibition of iron-dependent aconitase and fumarate hydratase, as well as disruption of the pentose phosphate pathway. The levels of glucose, succinic acid, citric acid, and hexadecanoic acid followed a similar pattern in cells exposed to Ga and Ga/Lfx at 500 μM Ga but exhibited different trends at 250 μM Ga.DiscussionIn the presence of Lfx, the Mtb metabolome changes induced by Ga are more pronounced compared to those observed with Lzd. Lfx affects nucleic acids and transcription, which may enhance Ga-dependent growth inhibition by preventing the metabolic redirection that bacteria typically use to bypass iron-dependent enzymes.