bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advances in the therapeutic study of oncolytic virus in colorectal cancer
Authors: Chen Junjie , Chen Kailang , Yuan Xianglin 
Published: August 2024

AbstractColorectal cancer (CRC) represents a considerable global health challenge, ranking third in incidence and second in mortality worldwide. However, existing therapies for diseases with advanced stages often fail, thereby necessitating the search for more comprehensive treatments. Oncolytic virus, a novel anticancer approach, exhibits promising capabilities in selectively targeting and destroying tumor cells while augmenting their efficacy through genetic engineering modifications. Anticipated as a new therapeutic paradigm for CRC, this study aimed to assess the performance of oncolytic virus in clinical trials and explore their potential synergies with other therapeutic modalities, offering insights into the future direction of CRC treatment.
Pharmacokinetic Factors Associated With Early Meropenem Target Attainment in Pediatric Severe Sepsis*
Authors: Paice Kelli , Tang Girdwood Sonya , Mizuno Tomoyuki , Pavia Kathryn , Punt Nieko , Tang Peter , Dong Min , Curry Calise , Jones Rhonda , Gibson Abigayle , Vinks Alexander A. , Kaplan Jennifer 
Published: August 2024

OBJECTIVES:
To determine the frequency of early meropenem concentration target attainment (TA) in critically ill children with severe sepsis; to explore clinical, therapeutic, and pharmacokinetic factors associated with TA; and to assess how fluid resuscitation and volume status relate to early TA.

DESIGN:
Retrospective analysis of prospective observational cohort study.

SETTING:
PICU in a single academic quaternary care children’s hospital.

PATIENTS:
Twenty-nine patients starting meropenem for severe sepsis (characterized as need for positive pressure ventilation, vasopressors, or ≥ 40 mL/kg bolused fluid), of which 17 were newly escalated to PICU level care.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Concentration-time profiles were analyzed using modeling software employing opportunistic sampling, Bayesian estimation, and a population pharmacokinetic model. Time above four times minimum inhibitory concentration (T > 4×MIC), using the susceptibility breakpoint of 1 µg/mL, was determined for each patient over the first 24 hours of meropenem therapy, as well as individual clearance and volume of distribution (Vd) estimates. Twenty-one of 29 patients met a target of 40%T > MIC 4 μg/mL. Reaching TA, vs. not, was associated with lower meropenem clearance. We failed to identify a difference in Vd or an association between the TA group and age, weight, creatinine-based estimated glomerular filtration rate (eGFR), or the amount of fluid administered. eGFR was, however, negatively correlated with overall T > MIC.

CONCLUSIONS:
Eight of 29 pediatric patients with early severe sepsis did not meet the selected TA threshold within the first 24 hours of meropenem therapy. Higher clearance was associated with failure to meet targets. Identifying patients likely to have higher meropenem clearance could help with dosing regimens.
Quantification of Coronary Artery Stenosis in Very-High-Risk Patients Using Ultra-High Resolution Spectral Photon-Counting CT
Authors: Fahrni Guillaume , Boccalini Sara , Mahmoudi Allal , Lacombe Hugo , Houmeau Angèle , Elbaz Meyer , Rotzinger David , Villien Marjorie , Bochaton Thomas , Douek Philippe , Si-Mohamed Salim A. 
Published: August 2024

Objective
Development of spectral photon-counting computed tomography (SPCCT) for ultra-high-resolution coronary CT angiography (CCTA) has the potential to accurately evaluate the coronary arteries of very-high-risk patients. The aim of this study was to compare the diagnostic performances of SPCCT against conventional CT for quantifying coronary stenosis in very-high-risk patients, with invasive coronary angiography (ICA) as the reference method.

Materials and Methods
In this prospective institutional review board–approved study, very-high-risk patients addressed for ICA following an acute coronary syndrome were consecutively included. CCTA was performed for each patient with both SPCCT and conventional CT before ICA within 3 days. Stenoses were assessed using the minimal diameter over proximal and distal diameters method for CCTA and the quantitative coronary angiography method for ICA. Intraclass correlation coefficients and mean errors were assessed. Sensitivity and specificity were calculated for a >50% diameter stenosis threshold. Reclassification rates for conventional CT and SPCCT were assessed according to CAD-RADS 2.0, using ICA as the gold standard.

Results
Twenty-six coronary stenoses were identified in 26 patients (4 women [15%]; age 64 ± 8 years) with 19 (73%) above 50% and 9 (35%) equal or above 70%. The median stenosis value was 64% (interquartile range, 48%–73%). SPCCT showed a lower mean error (6% [5%, 8%]) than conventional CT (12% [9%, 16%]). SPCCT demonstrated greater sensitivity (100%) and specificity (90%) than conventional CT (75% and 50%, respectively). Ten (38%) stenoses were reclassified with SPCCT and one (4%) with conventional CT.

Conclusions
In very-high-risk patients, ultra-high-resolution SPCCT coronary angiography showed greater accuracy, sensitivity, and specificity, and led to more stenosis reclassifications than conventional CT.
THE PROTECTIVE EFFECT OF FASCIOTOMY COMBINED WITH HYPERTONIC SALINE FLUSHING FOR CRUSH SYNDROME IN RATS
Authors: Wen Yaqian , Wang Xiaoge , Zhang Jie , Rong Lei , Ren Wenjie , Tian Linqiang , Liu Liangming 
Published: August 2024

ABSTRACT
In natural disasters such as earthquakes and landslides, the main problem that wounded survivors are confronted with is crush syndrome (CS). The aim of this study was to explore more convenient and effective early treatment measures for it. In the present study, we investigated the protective effect of fasciotomy combined with different concentration of hypertonic saline flushing with CS rats. CS model was prepared by compressing the buttocks and both lowering limbs of rats with 7.5 kg dumbbell for 4 h. The rats were divided into 10 groups, which were normal control group, model group, incision without flushing group, 0.45%, 0.9%, 3%, 5%, 7% saline group, 3%–0.45% and 7%–0.45% saline alternating flushing group, respectively. Six hours after the treatment, the blood was sampled for measurement of the potassium, calcium, glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, creatinine, urea, myoglobin, and lactic acid content. The blood flow of the compressed tissue and kidneys, the pathological changes of the kidneys, and the survival rate of 3%–0.45% saline alternating flushing group were also observed. The experimental results showed that fasciotomy alone for treatment cannot improve the presentation of CS of rats. Instead, hypertonic saline flushing significantly improved the glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, creatinine, urea indices, blood flow of muscles, and kidneys. It also enormously decreased the blood K+, myoglobin, lactic acid concentration, and slight increased the blood Ca2+. Among them, alternating flushing with 3%–0.45% saline had the best therapeutic effect on CS. Finally, it can be found that 3%–0.45% saline treatment regimen dramatically raised the survival rate of CS rats. All in all, this study suggests that fasciotomy combined with hypertonic saline flushing is a good therapeutic approach for CS.
ACUTE KIDNEY INJURY FOLLOWING ACUTE CHOLANGITIS: A RISK MULTIPLIER FOR ADVERSE OUTCOMES AND HEALTHCARE UTILIZATION
Authors: Tang Lili , Wan Weiwei , Zhang Jie , Zhang Hongtao , Wang Yuhao , Li Xiaoyue 
Published: August 2024

ABSTRACT

Background: Acute kidney injury (AKI) is a common, fatal complication of acute cholangitis (AC). The link between AC and AKI is poorly understood. Aims: To delineate the incidence trends, clinical outcomes and healthcare utilization of inpatients with AKI following AC and to explore the risk factors for AKI following AC. Methods: This population-based retrospective study used the National Inpatient Sample database from 2010 to 2018 to compare the demographics, complications, in-hospital mortality and healthcare utilization between AC patients with and without AKI. Predictors of AKI and the prognostic impact of AKI on in-hospital outcomes were defined using multivariate logistic regression. Results: The overall incidence of AKI was 24.06% among AC patients. Its trend generally increased annually. AKI was associated with more complications, greater invasive therapy requirements, longer hospital stays, costlier total hospital charges, and higher in-hospital mortality. The risk factors for AKI following AC were advanced age, Black race, multiple comorbidities, large hospitals, teaching hospitals, urban hospitals, hospitals in the southern and western United States, choledocholithiasis/cholelithiasis, surgery, percutaneous transhepatic biliary drainage, deficiency anemia, congestive heart failure, coagulopathy, diabetes, hypertension, chronic liver disease, obesity, chronic kidney disease excluding end-stage renal disease, weight loss, acute pancreatitis, and severe sepsis. Female sex, private insurance, elective admission, and endoscopic retrograde cholangiopancreatography were protective factors against AKI in AC patients. Conclusion: AKI often follows AC and is strongly associated with poor prognosis and increased healthcare utilization. Healthcare professionals should make more efforts to identify patients with AC at risk of AKI and start management promptly to limit adverse outcomes.
Modeling the genomic architecture of adiposity and anthropometrics across the lifespan
Authors: Arehart Christopher H. , Lin Meng , Gibson Raine A. , Raghavan Sridharan , Gignoux Christopher R. , Stanislawski Maggie A. , Grotzinger Andrew D. , Evans Luke M. 
Published: August 2024

AbstractObesity-related conditions are among the leading causes of preventable death and are increasing in prevalence worldwide. Body size and composition are complex traits that are challenging to characterize due to environmental and genetic influences, longitudinal variation, heterogeneity between sexes, and differing health risks based on adipose distribution. We constructed a 4-factor genomic structural equation model using 18 measures and unveiled shared and distinct genetic architectures underlying birth size, abdominal size, adipose distribution, and adiposity. Multivariate genome-wide associations revealed the adiposity factor was enriched specifically in neural tissues and pathways, while adipose distribution was enriched across widespread physiological systems. In addition, polygenic scores for the adiposity factor predicted many adverse health outcomes, while body size and composition predicted a more limited subset. Finally, we characterized the factors’ genetic correlations with obesity-related traits and examined the druggable genome through constructing a bipartite drug-gene network to identify viable therapeutic targets.
Lipoprotein(a) and large artery atherosclerosis: Results from the BIOSIGNAL Study
Authors: Gross Felix , Schütz Valerie , Westphal Laura , Inauen Corinne , Pokorny Thomas , Wegener Susanne , Luft Andreas R. , Spanaus Katharina , von Eckardstein Arnold , Touboul Pierre-Jean , Arnold Markus , Katan Mira 
Published: August 2024

AbstractBackgroundLipoprotein(a) (Lp(a)) is a causal risk-factor for atherosclerotic cardiovascular disease including acute ischemic stroke (AIS). The underlying pathomechanisms mediating this risk are less well understood, especially in AIS caused by large artery atherosclerosis (LAA). In this observational cohort study we evaluated the association of Lp(a) with markers of LAA, namely carotid intima media thickness (cIMT) and the presence of extra- or intracranial vessel narrowing plaques.MethodsAmong participants of the BIOSIGNAL cohort study we determined Lp(a) levels within 24h after symptom onset in 1161 AIS patients from the single center of Zurich. cIMT was determined using a semi-automated computerized edge tracking software, internal carotid artery (ICA) stenosis was graded according to the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria, intracranial ultrasound was performed by transcranial color-coded duplex (TCCD).ResultsIn 1161 participants higher Lp(a) levels were not associated with an increased cIMT in univariable or multivariable regression models containing known cardiovascular risk-factors. Higher Lp(a) levels were not associated with the presence of neither extracranial high-grade ICA-stenosis nor significant intracranial stenosis assessed by neurovascular ultrasound.ConclusionIn AIS patients higher Lp(a) levels were not associated with clinical markers of arteriosclerotic burden despite its association with LAA-stroke etiology and an increased risk for stroke recurrence.RegistrationRegistration-URL:http://www.clinicaltrials.gov; Unique identifier: NCT-02274727
Cortical scaling of the neonatal brain in typical and altered development
Authors: Bonthrone Alexandra F. , Cromb Daniel , Chew Andrew , Gal-Er Barat , Kelly Christopher , Falconer Shona , Arichi Tomoki , Pushparajah Kuberan , Simpson John , Rutherford Mary A. , Hajnal Joseph V. , Nosarti Chiara , Edwards A. David , O’Muircheartaigh Jonathan , Counsell Serena J. 
Published: August 2024

AbstractTheoretically derived scaling laws capture the non-linear relationships between rapidly expanding brain volume and cortical gyrification across mammalian species and in adult humans. However, the preservation of these laws has not been comprehensively assessed in typical or pathological brain development. Here we assessed the scaling laws governing cortical thickness, surface area and cortical folding in the neonatal brain. We also assessed multivariate morphological terms that capture brain size, shape and folding processes. The sample consisted of 375 typically developing infants, 73 preterm infants and 107 infants with congenital heart disease (CHD) who underwent brain magnetic resonance imaging (MRI). Our results show that typically developing neonates and those with CHD follow the cortical folding scaling law obtained from mammalian brains, children and adults which captures the relationship between exposed surface area, total surface area and cortical thickness. Cortical folding scaling was not affected by gestational age at birth, postmenstrual age at scan, sex or multiple birth in these populations. CHD was characterized by a unique reduction in the multivariate morphological term capturing size, suggesting CHD affects cortical growth overall but not cortical folding processes. In contrast, preterm birth was characterized by altered cortical folding scaling and altered shape, suggesting the developmentally programmed processes of cortical folding are disrupted in this population. The degree of altered shape was associated with cognitive abilities in early childhood in preterm infants.
Trajectories of disability and influence of contextual factors among adults aging with HIV: insights from a community-based longitudinal study in Toronto, Canada
Authors: Su Tai-Te , Bayoumi Ahmed M. , Avery Lisa , Chan Carusone Soo , Tang Ada , Solomon Patricia , Davis Aileen M. , O’Brien Kelly K. 
Published: August 2024

AbstractBackgroundIndividuals aging with HIV may experience disability that is multidimensional and evolving over time. Our aims were to characterize the longitudinal trajectories of disability and to investigate how intrinsic and extrinsic contextual factors influence dimensions of disability over an 8-month period among adults aging with HIV.MethodsWe analyzed longitudinal observational data from a community-based study in Toronto, Canada, where adults aging with HIV completed self-reported questionnaires over 8 months (5 time points). We measured disability using the Short-Form HIV Disability Questionnaire (SF-HDQ), which included six dimensions: physical, cognitive, mental-emotional health challenges, uncertainty, difficulties with day-to-day activities, and challenges to social inclusion. Higher SF-HDQ scores (range: 0-100) indicate greater severity of disability. We assessed intrinsic (age, gender, education, living status, number of comorbidities, mastery) and extrinsic (stigma, social support) contextual factors using baseline self-reported questionnaires. Latent class growth analysis was performed to identify distinct disability trajectories within each of the six dimensions. Multinomial logistic regression models were used to assess the influence of contextual factors on the disability trajectories.ResultsOf 108 participants, 89% identified as men with a mean age of 50.6 years (standard deviation ±10.9). We identified three disability trajectories: low, medium, and high disability severity in the physical, mental-emotional, and day-to-day activities dimensions. Four trajectories: low, medium-low, medium-high, and high (or high-declining) disability severity were in the cognitive, uncertainty, and social inclusion dimensions. Factors such as higher self-mastery and social support were associated with lower disability trajectories, whereas greater number of comorbidities and stigma were associated with more severe disability trajectories over time.ConclusionDisability experiences among adults aging with HIV included three or four distinct trajectories with considerable heterogeneity over time. Information on contextual factors may be helpful for informing interventions and supports that mitigate disability among adults aging with HIV.
Phytochemical Analysis and Cytotoxic Effects of Phyllanthus polygonoides Leaf Extracts on Hepatocellular Carcinoma: A Combined In-Vitro and In-Silico Approach
Authors: Ali Hasnain , Khalid Ammara , Akram Aqsa , Afzal Amina , Khalid Muhammad Noman , Masroor Ashir , Hameed Awais 
Published: August 2024

AbstractThe authors have withdrawn their manuscript owing to the Paper was mistakenly uploaded by the students and the paper was having a lots of mistake and fake data. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.
Evaluation of automated pediatric sleep stage classification using U-Sleep - a convolutional neural network
Authors: Kevat Ajay , Steinkey Rylan , Suresh Sadasivam , Ruehland Warren R , Chawla Jasneek , Terrill Philip I , Collaro Andrew , Iyer Kartik 
Published: August 2024

AbstractStudy ObjectivesU-Sleep is a publicly-available automated sleep stager, but has not been independently validated using pediatric data. We aimed to a) test the hypothesis that U-Sleep performance is equivalent to trained humans, using a concordance dataset of 50 pediatric polysomnogram excerpts scored by multiple trained scorers, and b) identify clinical and demographic characteristics that impact U-Sleep accuracy, using a clinical dataset of 3114 polysomnograms from a tertiary center.MethodsAgreement between U-Sleep and ‘gold’ 30-second epoch sleep staging was determined across both datasets. Utilizing the concordance dataset, the hypothesis of equivalence between human scorers and U-Sleep was tested using a Wilcoxon two one-sided test (TOST). Multivariable regression and generalized additive modelling were used on the clinical dataset to estimate the effects of age, comorbidities and polysomnographic findings on U-Sleep performance.ResultsThe median (interquartile range) Cohen’s kappa agreement of U-Sleep and individual trained humans relative to “gold” scoring for 5-stage sleep staging in the concordance dataset were similar, kappa=0.79(0.19) vs 0.78(0.13) respectively, and satisfied statistical equivalence (TOST p<0.01). Median (interquartile range) kappa agreement between U-Sleep 2.0 and clinical sleep-staging was kappa=0.69(0.22). Modelling indicated lower performance for children <2 years, those with medical comorbidities possibly altering sleep electroencephalography (kappa reduction=0.07-0.15) and those with decreased sleep efficiency or sleep-disordered breathing (kappa reduction=0.1).ConclusionWhile U-Sleep algorithms showed statistically equivalent performance to trained scorers, accuracy was lower in children <2 years and those with sleep-disordered breathing or comorbidities affecting electroencephalography. U-Sleep is suitable for pediatric clinical utilization provided automated staging is followed by expert clinician review.
Primary care clinicians working in or near hospital emergency departments in the UK: A mixed methods systematic review
Authors: Wilsher Stephanie Howard , Brainard Julii , Hanson Sarah , Peacock Duncan , Everden Paul 
Published: August 2024

AbstractObjectivesTo synthesise evidence about primary care clinicians treating patients in or adjacent to hospital emergency departments in the UK.Study designMixed methods narrative systematic review.MethodsEligible studies were in English and described primary care services (general practitioners, GPs, or nurse practitioners) that treat patients within or adjacent to hospital Emergency Departments (ED). Searches were conducted on Medline, EMBASE, Cochrane Library and CINAHL databases. The search included extraction from an international review updated from 2020 to October 2022, and grey literature from inception to October 2022. The methods were informed by consultation with members of the public.ResultsFrom 4189 studies screened, 20 met inclusion criteria. Four studies assessed typology and streaming of services. Seven studies reported patient and public involvement. Ten studies reported differences in clinical outcomes between primary care and emergency services, but not definitive benefit for either. Likewise, results were equivocal for economic evaluations. Diverse delivery formats complicate evaluation and may explain why clinicians had mixed opinions about the utility of such services. Patients were generally satisfied with the service they received, in either primary care or emergency services.ConclusionDiversity of implementation complicate conclusions that can be drawn. Existing evaluations provide little evidence that primary care services in or near emergency departments offers any system advantages for clinical outcomes, or cost savings. Process evaluation in future evaluations is essential to understand what aspects of primary care at emergency departments are likely to improve system and patient care.Implications for the profession and/or patient careThe systematic review assessed outcomes arising due to primary care clinicians providing treatment in or near Emergency Departments (ED) in the UK. There were no consistent benefits for having primary care clinicians in or near EDs. This research highlights the need for healthcare leaders and policy makers to provide more clarity in developing primary care services in or near EDs. It will have impact for leaders in healthcare to consider whether primary care clinicians in or near EDs are providing ‘best value’ healthcare, or whether other models could provide patients appropriate NHS resources according to their health need.Patient and public involvementThree focus groups (with 13 public advisors) were conducted to understand patients’ priorities and perspectives for attending EDs with relatively minor health conditions. This helped to guide study design, data extraction and analysis of this review.