bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term Survival in Ischemic Stroke Patients: A Comprehensive Analysis of the TyG-AIP-BMI Composite Index (TabCI) from MIMIC-IV ICU Data
Authors: Hu Yinqin , Li Junxiong , Wang Chenghao , Cheng Jiwei 
Published: October 2024

Abstract

Background Insulin resistance-induced metabolic disorders play a crucial role in exacerbating ischemic stroke. This study aims to explore the association between TabCI and long-term mortality risk in severe ischemic stroke patients.
Methods Data from the Medical Information Mart for Intensive Care IV (MIMIC-IV 2.2) database were accessed to retrieve data of ischemic stroke patients. Patients were stratified into four groups based on TabCI quartiles. The study assessed the primary outcome of 180-day all-cause mortality and secondary outcomes including 90-day and 1-year ACM. Kaplan-Meier curves were used to compare outcomes across groups, and lasso regression analysis was employed to select covariates. Multivariable Cox proportional hazards regression models and restricted cubic splines (RCS) were used to explore the association between TabCI and these outcomes. Lastly, interaction and subgroup analyses were conducted to validate the stability of results.
Results A total of 1,141 severe ischemic stroke patients were included, with a mean age of 69 years (interquartile range [IQR]: 59-79), and 565 participants (49.5%) were male. Kaplan-Meier analysis indicated significantly lower long-term survival rates in patients in Q1 and Q3 compared to those in Q2 and Q4. Cox proportional hazards regression analysis adjusted for covariates showed a statistically significant increase in 180-day mortality risk in TabCI quartiles, with Q2 and Q4 groups also exhibiting increased risks at 90 days and 1 year. Additionally, RCS analysis revealed a gradual L-shaped correlation between TabCI and 90-day and 180-day all-cause mortality, with a smooth U-shaped trend observed for 1-year mortality, demonstrating significant non-linearity. Subgroup analysis further indicated an inverse correlation between TabCI and long-term mortality risk in non-Caucasian patients and those using aspirin, as well as negative correlations in TabCI among patients not receiving CRRT for 90-day and 180-day mortality.
Conclusion TabCI could serve as a marker for stratifying long-term risk among severe ischemic stroke patients, although its clinical predictive efficacy for long-term mortality in these patients is limited.
Assessment of Encroachment along the Urban River using Unmanned Ariel Vehicle
Authors: Mishra Anurag , Ohri Anurag , Singh Prabhat Kumar , Gaur Shishir , Singh Nikhilesh , Calay Rajnish Kaur 
Published: October 2024

Abstract

Streams and rivulets have a significant contribution to maintain river networks and their hydrology. It plays a crucial role in shaping downstream ecosystems and connecting watersheds. Despite their importance, these smaller rivers often lack the legal protections afforded to larger river segments, leaving them vulnerable to encroachment and changes in land use. The Assi River, a minor tributary of the river Ganga, once a historical lifeline and cultural symbol, is currently facing a severe threat to its existence. Due to illegal construction and encroachments, a substantial part of the river Assi has been transformed into a narrow channel carrying the municipal load of the city. The study, embraced encroachment and land use analysis in different buffer widths in high resolution scale. A UAV (DJI Phantom 4) was used to collect the aerial imagery and data was processed using Pix4D Mapper 4.1.2 to produce ortho-photo and DSM having horizontal accuracy of 5 cm. The land use and encroachment have been analysed using processed UAV images on QGIS.
Color Differences of Skin Paddles Using the Free Flap for Autologous Breast Reconstruction in Asian Patients
Authors: Nakatsuka Kengo , Karakawa Ryo , Yano Tomoyuki 
Published: October 2024

Abstract

Background
In this study, we aimed to evaluate color differences of the skin paddle in autologous breast reconstruction performed using the deep inferior epigastric artery perforator (DIEP) flap and the profunda artery perforator (PAP) flap. The primary focus was to compare the color match between the reconstructed breast skin and the donor-site skin, to achieve optimal esthetic results.
Methods
A retrospective analysis was performed on patients who had undergone unilateral breast reconstruction with a DIEP flap or a PAP flap between January 2020 and December 2022. Colors were captured using a digital camera and analyzed using Adobe Photoshop 2024 software. The L*, a*, and b* coordinates were used. The International Commission on Illumination Delta E 2000 (CIEDE2000) score was used to quantify color differences, comparing skin tones of the unaffected breast, DIEP flap, PAP flap, abdomen, and medial thigh.
Results
A total of 125 patients were analyzed. The DIEP flap demonstrated a closer color match to the native breast skin compared with the PAP flap (CIEDE2000 scores, 5.29 vs. 8.69, p < 0.01). No significant difference in color deformity with time was found between the DIEP flap and the PAP flap (CIEDE2000 scores, 5.61 vs. 8.25, p = 0.17).
Conclusion
Our findings suggest that the DIEP flap results in a more favorable color match for breast reconstruction than the PAP flap, enhancing esthetic outcomes. These results underscore the importance of considering skin color matching in flap selection for breast reconstruction surgery.
Opinions of healthcare professionals and patients on Internet of Things +pulmonary rehabilitation in chemotherapy patients with advanced lung cancer: A qualitative study
Authors: Tian Jun , Zhu Zhenggang , Peng Xiaoyu , Chen Yuyao , Liu Xiang , Zhong Wen 
Published: October 2024

Abstract

Objective
To explore opinions of healthcare professionals and patients on "Internet of Things (IoT)" + pulmonary rehabilitation(PR) in chemotherapy patients with advanced lung cancer. and to provide reference for the construction of "IoT+" PR program for advanced lung cancer chemotherapy patients.
Methods
A semi-structured interviews with healthcare workers and patients with advanced lung cancer receiving chemotherapy was conducted to investigated opinions on "IoT+" PR in advanced lung cancer. The framework of semi-structure interview focusing on the current situation, needs and vision, and implementation of "IoT+" PR was established by team discussion. And data were collected and analyzed.
Results
18 healthcare worker and 15 patients were recruited in our study. After interviews finished, we found that "IoT+" PR in advanced lung cancer were overlooked both in patients and health workers, and there were lack of knowledge, misconception, and absence of standard process. And we found that personalized "IoT+" PR plan and social supports were crucial in the ideas of participants. Moreover, participants showed interests in PR based on "IoT " due to its convenience and multi-facets helps.
Conclusion
PR in advanced lung cancer were overlooked both in patients and health workers, The construction of a large-scale tertiary hospital-primary hospital-family pulmonary rehabilitation consortium based on "IoT+" PR provides a new dimension to the traditional rehabilitation approach, efforts in improvement of "IoT+" PR knowledge and perception, establishment of standard and individualized PR plan, and utilization of "IoT " may help the practice of PR in advanced lung cancer.
Rare Synchronous Multiple Primary Lung Cancers with Staged Resection
Authors: Shoukry Sameh , Mateja Heather L , Bowers William , Vitvitsky Eugene 
Published: October 2024

Abstract

Background
Synchronous multiple primary lung cancer (sMPLC) remains a relatively rare and difficult pathology. Owing to ambiguous guidelines, there are few papers with a limited population that discuss outcomes for patients undergoing treatment for sMPLC. Differentiating sMPLC from metastatic lung lesions is crucial, as it directly influences management strategies, with surgical intervention often preferred.
Case Presentation
: We report the case of a 58-year-old male with a significant smoking history who was diagnosed with two histologically distinct adenocarcinomas located in the right and left upper lobes of the lungs. A comprehensive preoperative evaluation, including PET‒CT scans, brain magnetic resonance imaging (MRI), and fine needle aspiration biopsies, was conducted. The patient was treated with staged bilateral upper lobectomies, during which intraoperative complications necessitated conversion to open thoracotomy. Pathological analysis confirmed the diagnosis of sMPLC with negative lymph nodes and clear margins, and the tumors were staged as pT1b pN0 M0 and pT1a pN0 M0, respectively. The patient recovered well and remains cancer-free one year postdiagnosis.
Conclusions
This case underscores the importance of an extensive diagnostic workup and a staged surgical approach in the successful management of sMPLC. The patient's favorable outcome highlights the potential effectiveness of this treatment strategy, although close follow-up is essential to monitor for recurrence, particularly within the first two years following surgery. Ongoing collaboration with databases collecting information on sMPLC is necessary to gain a better understanding of diagnostic and management techniques for this unique class of patients.
Isolation of Bacillus zhangzhouensis OBB from local Polyphylla fullo (L.) larvae and PCR-based detection of cry1 gene
Authors: Boga Ozlem Bakir , Kurbanoglu Esabi Basaran 
Published: October 2024

Abstract

The most commonly used bacteria in biopesticide production is Bacillus thuringiensis due to cry proteins. Since continuous and repeated use of biopesticides may cause resistance development in pests, it is necessary to investigate isolates containing new cry genes. Bacillus zhangzhouensis OBB was isolated from Polyphylla fullo larvae. The presence of the cry gene was detected in this isolate. The conclusion that the strain carries the cry gene was made by PCR and SEM analysis. In addition, the central location of the Bacillus zhangzhouensis OBB spore structure, SDS-PAGE analysis and DNA sequence analysis showed phylogenetic differences between B. thuringiensis. B. zhangzhouensis showed bands between ̴ 250 kDa and ̴ 80 kDa. As a result, Bacillus zhangzhouensis OBB can be used as an alternative biopesticide in case of insect resistance to B. thuringiensis biopesticides. Indicating that this isolate has the potential to be effective against Coleoptera insect pests.
Trends in macular and optic nerve head vessel density following myopic photorefractive keratectomy
Authors: bamdad shahram , attar alireza , nejabat Mahmood , nejabat alireza , fallahzadeh milad , ebrahimi Fatemeh , faizabadi Sanam , azimi ali 
Published: October 2024

Abstract

Purpose
We aimed to apply Optical Coherence Tomography Angiography (OCTA) to comprehensively assess changes in the optic nerve head (ONH) and macular perfusion before and after the myopic photorefractive keratectomy (PRK).
Methods
A total of 26 myopic patients eligible for PRK were included based on specific criteria, with meticulous exclusion criteria in place to minimize potential confounders. Participants underwent OCTA assessments of the ONH and macula using the Spectralis OCT (Heidelberg) before, as well as at 1 and 3months after PRK. MATLAB software was utilized for image analysis.
Results
The average age at the time of surgery was 31.3 ± 5.82years with 26.9% of participants being male. The mean intraocular pressure before the surgery was 15.84 ± 2.46 mmHg. Significant alterations were observed in macular vessel density, emphasizing regional variations in vascular response. Regarding Large vessel density (LVD), there was a significant decrease in Superficial Vascular Complex (SVC) (from 24.21–18.67%, P = 0.011) and deep vascular complex (DVC) (from 26.93% to 21.81, P = 0.003) between before surgery and 3 months later. Similarly, in Capillary Vessel Density (CVD (, significant changes were observed between before surgery and 3 months later in SVC (from 18.22–21.16%, P = 0.004) and DVC (from16.89–21.44%, P = 0.002). In comparison to the macula, vascular densities were more stable overtime in optic nerve head. In both LVD and CVD, only DVC had significant decrease between before surgery and 3 months after (P = 0.008, and 0.038 respectively).
Conclusions
While PRK appears to maintain the integrity of certain ocular structures, alterations in macular and optic nerve head perfusion post-PRK suggest potential effects on retinal blood supply.
Long-term monitoring is crucial to understand the implications of these changes, particularly in the context of conditions such as diabetes.
Non-Oliguric Acute Renal Failure Secondary to a Potentially Lethal Dose of Caffeine With Acute Intoxication: A Case Report
Authors: Mitomo Ayaka , Ishioka Kunihiro , Yanai Mitsuru , Ohtake Takayasu , Hidaka Sumi , Kobayashi Shuzo 
Published: October 2024

Abstract

Background Recently, the incidence of caffeine intoxication has been on an upward trend, with severe outcomes. However, acute kidney injury (AKI) resulting from renal pathologies secondary to caffeine intoxication is rare, and the pathophysiological mechanisms underlying AKI are unclear.
Case presentation
A female patient in her 20s ingested an over-the-counter drug containing caffeine. The patient was diagnosed with secondary non oliguric AKI caused by acute intoxication due to ingestion of a lethal dose of caffeine. On day 19 of hospitalization, a renal biopsy was performed to determine the etiology of her prolonged renal dysfunction. Light microscopy revealed normal glomeruli, mild inflammatory cell infiltration, and acute tubular damage. Myoglobin staining was positive within the tubules, with scattered myoglobin columns. Electron microscopy revealed loss of glomerular epithelial foot processes and inflated tubular mitochondria. After undergoing hemodialysis and continuous hemodiafiltration, the patient's overall condition stabilized. After a consultation with a psychiatrist, on her 34th day of hospitalization, she was discharged home.
Conclusions Caffeine antagonizes adenosine receptors, stimulates ryanodine receptors, and elevates catecholamines. The onset of AKI is hypothesized to result from a combination of these mechanisms, resulting in tubular ischemia and injury, as well as renal artery constriction. The development of AKI was thought to be caused by the following factors: (1) disruption of the tubular oxygen supply-demand ratio and consequent ischemia due to adenosine receptor antagonism by caffeine, (2) tubular damage due to rhabdomyolysis and consequent ryanodine receptor stimulation, and (3) increased catecholamine levels and consequent renal artery constriction.
Development and validation of a nomogram to assess the occurrence of liver dysfunction in patients with COVID-19 pneumonia in the ICU
Authors: Wang Zhiwei , Zhao Lina , Xie Keliang 
Published: October 2024

Abstract

The global pandemic of novel coronavirus pneumonia (COVID-19) has resulted in millions of deaths over the past three years. As one of the most commonly affected extra-pulmonary organs, numerous studies have reported varying degrees of liver injury in a significant proportion of patients with COVID-19, particularly in severe and critically ill patients. Early prediction of liver dysfunction in hospitalized patients would facilitate the clinical management of COVID-19 and improve clinical prognosis, but reliable and valid predictive models are still lacking. Methods We collected 286 cases of COVID-19 with positive RT-PCR confirmation of SARS-CoV-2 admitted to various ICUs from the case system. These patients were randomly divided into a training cohort (50%) and a validation cohort (50%). In the training cohort, we first used ROC curves to measure the predictive efficiency of each of the variables for the development of liver damage during hospitalization in patients with COVID-19, followed by LASSO regression analysis to screen the variables for predictive models and logistic regression analysis to identify relevant risk factors. A nomogram based on these variables was created following the above model. Finally, the efficiency of the prediction models in the training and validation cohorts was assessed using AUC, consistency index (C index), and calibration curves. Results Out of a total of 79 parameters for COVID-19 patients admitted to the ICUs, 8 were determined to be significantly associated with the occurrence of liver dysfunction during hospitalization. Based on these predictors, further prediction models were used to construct and develop a nomogram that was offered for practical clinical application. The C-index of the column line graphs for the training and validation cohorts was 0.901 and 0.892 respectively. in addition, the calibration curves for the model showed a high degree of agreement between the predicted and actual incidence of liver dysfunction in patients with COVID-19. Conclusion By developing a predictive model and associated nomogram, we predicted the incidence of liver dysfunction during hospitalization in patients with COVID-19 in the ICU. The model’s predictive performance was determined in both the training and validation cohorts, contributing to the clinical management of COVID-19.
β-caryophyllene to relieve inflammation by inhibiting HMGB1 signaling in ischemic stroke mice
Authors: Wang Yuchun , Yang Yang , Meng Tuo , Liu Shengwei , Liu Jingdong , Liu Daohang , Laxman Bharati , Chen Sha , Dong Zhi 
Published: October 2024

Abstract

Background: Characterized by high mortality and high disability rate, ischemic stroke accounts for the vast majority of current stroke patients. Reperfusion after surgical treatment will cause serious secondary damage to the ischemic stroke patient, but there is still no specific drug for the clinical treatment of ischemic stroke. Anti-inflammatory disease is an important part of ischemia and reperfusion injury, and it is urgent to find new anti-inflammatory targets and drugs. High-mobility group box-1(HMGB1) is abundant in both neuronal cell bodies and axons, and has been found to have late pro-inflammatory effects, becoming one of the hot research topics in critical care medicine recently. The increase of HMGB1 expression leads to the aggravation of inflammatory reaction after ischemia stroke. B-caryophyllene (BCP) is a natural drug with anti-inflammatory effects. Whether the anti-inflammatory mechanism of BCP is related to HMGB1 is still unknown. We aimed to investigate the relationship and potential signaling mechanisms between HMGB1 and BCP in ischemia stroke model in vivo and in vitro.
Methods: Establishment of middle cerebral artery embolism model in mice by thread thrombus and primary neurons were exposed to oxygen-glucose deprivation and re-oxygenation (OGD/R) in vitro. In vitro, transfection of HMGB1 DNA overexpression virus（GV-HMGB1）the same time, transfectionHMGB1 DNA silencing virus（RNAi-HMGB1）the same, in vivo , injection of GV-HMGB1 into the lateral ventricle of mice , injection of RNAi-HMGB1 into another group of mice.
Results: It was found that HMGB1 increased after ischemic stroke, and further affected the expression of TLR4, RAGE and other related inflammatory factors, thus reducing the inflammatory response and finally protecting the injury. The results confirmed the effect of HMGB1 in effecting TLR4/RAGE signaling and subsequently regulating inflammation, oxidative stress and apoptosis. Furthermore, BCP alleviates ischemic brain damage potentially by suppressing HMGB1/ TLR4/RAGE signaling, reducing expression of IL-1β/IL-6/TNF-α，inhibiting neuronal death and inflammatory response.
Conclusion: These data indicated that BCP exerted a protective effect against ischemia stroke inflammatory injury by adjusting the HMGB1/TLR4/RAGE signaling pathway, which provided new insights into the mechanisms of this therapeutic candidate for the treatment of ischemia stroke.
Translation, Cross-Cultural Adaptation, and Validation of Self-Care Measurement of Diabetes Scale in Urdu
Authors: Wahid Muhammad Hassan , Sethi Mifrah Rauf , Shehzad Shahid , Uzair Muhammad , Qazi Saad Hussain , Harris Muhammad 
Published: October 2024

Abstract

Objective: The Cross-sectional study was conducted to validate the Urdu version of the self-care measurement of diabetes scale at Mercy Teaching Hospital, Peshawar from January to March 2024 on 506 diabetic patients.
Methods: The average age of the participants was 48.37 + 12.96 years. The majority were females (n=283, 55.9%), married (n=475, 93.9%) uneducated (n=362, 71.5%) unemployed (n=381, 75.3%), and lived in joint family systems (n=241, 47.6%) respectively.
Results: The study found that 96.6% of patients were diabetic, with 58.5% managing the disease for under 10 years; 38.9% used both insulin and oral medications, while 38.1% used only tablets. Additionally, 71.7% of patients had no other medical comorbidities. The three bilingual experts used forward-backward translation methods to translate the Self-Care Measurement of Diabetes Scale from English to Urdu. The Urdu translation was administered to the patients to evaluate their confirmatory and exploratory factor analysis, construct validity, and Cronbach’s alpha reliability. Factorial validity indicated that the scale conforms to a five-factor model, with items showing significant inter-correlation (p < .01). Item-total correlation showed a significant correlation coefficient (p < .001) to find the construct validity. The Cronbach’s alpha reliability of the Urdu version was 0.704. Confirmatory factor analysis (CFA) demonstrated a goodness of fit model with a Comparative Fit Index (0.970) and a Root Mean Square Error of Approximation (RMSEA) of 0.088.
Conclusion: These findings suggest that the Self-Care Measurement of Diabetes Scale, Urdu translation is a reliable scale with robust validity, suitable for assessing self-care in clinical settings.
A Multi-Institutional Radiographic Evaluation of Pediatric Scapholunate Distance
Authors: Mujadzic M. Mirza , Firouzbakht Peter K. , Mujadzic Tarik , Schlubb Riley A. , Lin Jason , Le Paulina B. , Martinez Carlos R. , Atwez Abdelaziz , Qureshi Hassan , Bassuner Juri , Plikaitis Christina M. , Mujadzic Mirsad 
Published: October 2024

Abstract

Background
Scapholunate (SL) dissociation is the most frequent form of carpal instability. X-ray is the first diagnostic tool for an SL injury. The adult scapholunate distance is well established, however there remains a paucity of literature on the pediatric scapholunate distance. The purpose of this study is to define a standard range of pediatric SL distances.
Objective
We hypothesize that there will be an inverse relationship of SL distance with age.
Materials and Methods
A retrospective review was conducted evaluating patients that underwent bone age hand X-rays between 2005 and 2020. Variables collected included chronologic age, bone age, gender, and scapholunate distance.
Results
4038 total X-rays were included for analysis. Scapholunate distance was inversely proportional to chronological age between the ages of 4 to 17 years. The scapholunate distances were shorter for females compared to males of the same age. The average SL distance for males started at 9.49 mm at 4 years of age and decreased to 1.93 mm by age 17. The average SL distance for females started at 7.82 mm and decreased to 1.72 mm for the same age range. SL distance decreased to the normal adult distance at ages 16 and 17 for females and males, respectively.
Conclusion
Pediatric scapholunate distance is inversely proportional to chronological age. Female patients have a significantly shorter distance at each age compared to males. This study may serve as a reference for pediatric scapholunate distances when evaluating a wrist X-ray for potential scapholunate ligament injuries.