bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Life After Endovascular Thrombectomy for Acute Ischemic Stroke in Northern Finland
Authors: Junttola Ulla , Liisanantti Janne , Isokangas Juha-Matti , Kaakinen Timo , Vakkala Merja , Lahtinen Sanna 
Published: July 2024

Objectives: Endovascular thrombectomy has demonstrated a major therapeutic improvement in the treatment of acute ischemic stroke. The benefit of endovascular thrombectomy is commonly reported by determining the functional outcome using the modified Rankin Scale (mRS). There is a lack of knowledge concerning the quality of life (QoL) and factors impacting the QoL after endovascular thrombectomy. The aim of this study was to assess the QoL of stroke survivors who underwent endovascular thrombectomy and to determine the variables associated with QoL.Methods: Prospective single‐center analysis of 98 patients who underwent endovascular thrombectomy between 2015 and 2019. QoL was assessed by using the Rand 36‐Item Health Survey (RAND‐36), Beck’s Depression Inventory (BDI), Stroke Impact Scale‐16 (SIS‐16), and Alcohol Use Disorders Identification Test (AUDIT) questionnaires.Results: Of the 98 patients, 53 (54.1%) reported poor QoL. According to the logistic regression analysis, the National Institutes of Health Stroke Scale (NIHSS) score > 6 on the first postprocedural day, right hemispheric infarction, and depression were independently associated with poor QoL. Depression was reported by 40.8% of all the respondents. QoL scores of the patients treated with endovascular thrombectomy were impaired in physical functioning, physical and emotional role functioning, social functioning, and general health compared to the age‐adjusted values of the Finnish general population.Conclusion: Endovascular thrombectomy (EVT)‐treated stroke survivors experience disability in multiple levels. More than half of the patients report poor QoL. Neurological disability, functional dependence, depression, and comorbidities are associated with poor QoL. Social capability is impaired and the difficulties are more distinct among individuals with age above 65 years.
Surgical Care Through a Community Free Clinic-Ambulatory Surgical Center Partnership
Authors: Park Flora S. , Pang Jonathan C. , Yang Christopher D. , Breziner Dalia , Manzanarez-Felix Karlos O. , Hoyos Juan Pablo , Ruiz Andres M. , Alvarez Claudia A. , Swentek Lourdes Y. , Chin Theresa L. 
Published: July 2024

Background Disparities secondary to underinsurance present throughout the surgical care continuum. Community free clinics are uniquely capable to provide health care services to the medically underserved, but surgery often falls outside their scope of care. Methods Retrospective chart review was conducted on consecutive community free clinic patients receiving free surgical services via referral to a partnering ambulatory surgery center between March 2016 and September 2021. Those with documented contact information were recruited 1-3 years post-procedure for long-term quality-of-life (LTQOL) outcomes assessment via modified Veterans RAND 12-item health survey. Results Of 142 included patients, 95.7% identified as Hispanic/Latino and 75.6% were uninsured. Twelve patients had cancerous or precancerous lesions detected and/or removed through diagnostic or definitive procedures. 3.5% experienced postoperative complication including bacterial (n = 2) or fungal (n = 1) surgical site infection and wound dehiscence (n = 2). With a 48.9% response rate, no significant differences in sociodemographic or clinical characteristics were found between surveyed vs non-surveyed patients. Of surveyed patients, 59.7% and 52.2% reported pre-/post-operative improvement in physical health and emotional health, respectively. Discussion Free diagnostic screening procedures provided timely diagnoses while free definitive surgeries safely and positively impacted long-term patient-reported physical health. Longitudinal, multidisciplinary follow-up and social support may be warranted to concurrently improve emotional and mental health in similarly underinsured populations.
The impact of ankle movements on venous return flow: A comparative study
Authors: Cao Yun , He JinFeng , Chen Xufeng , Jing Lei , Qiu JiaWen , Geng YuJuan , Chen Feng , Sun GuoZhen , Ji XueLi 
Published: July 2024

Objective To compare the haemodynamic effects of different ankle movements combined ankle and toe movements on the femoral vein of the lower extremity. Methods 28 healthy volunteers participated in the study. Doppler ultrasound was used to measure peak systolic velocity and time-averaged mean velocity of the common femoral vein during ankle dorsiflexion, ankle dorsiflexion with simultaneous toe extension, ankle plantarflexion, and ankle plantarflexion with simultaneous toe flexion. Results In comparison to the resting state, both ankle alone or ankle combined with toe movement showed statistically significant differences ( p < .01). However, there were no significant difference in the velocity of the common femoral vein between ankle alone and ankle combined with toe movement ( p > .05). It is noteworthy that dorsiflexion of the ankle resulted in the highest peak velocity of blood flow. Conclusion The impact of ankle movement, with or without toe movement, the velocity of the common femoral vein is not significantly correlated.
Exploring the potential of CuO nanoneedles and CNT/PVC nanocomposites in medium voltage cable technology
Authors: Elbasiony A. M. , Alkhursani Sheikha A. , Ghobashy Mohamed Mohamady , Madani Mohamed , Al-Gahtany Samera Ali , Sharshir A. I. 
Published: July 2024

This study focuses on the development of CuO nanoneedle and multi wall carbon nanotube (CNT) reinforced poly (vinyl chloride) (PVC) nanocomposites for medium voltage cable applications. CuO nanoneedles were synthesized using a pulsed wire evaporation technique and integrated with CNTs to create CuO/CNT nanocomposites. The nanocomposites were then used to reinforce PVC films through a solution casting method. Microstructural characterization confirmed the uniform dispersion of CuO nanoneedles and CNTs concentrations (0–0.4 wt%) within the PVC matrix. Microstructural characterization by XRD, SEM, and TEM confirmed the formation of CuO nanoneedles (diameter ∼4 nm, length 200–250 nm) and their uniform dispersion within the PVC matrix along with CNTs. Optical studies revealed reduced optical bandgap and Urbach tail width in PVC/CuO/CNT nanocomposites compared to neat PVC/CuO. Electrical characterization showed significantly improved AC conductivity (up to eight orders of magnitude) with increasing CNT loading, attributed to the formation of efficient charge transport networks. Dielectric studies revealed concurrent improvements in dielectric permittivity and losses with CNT addition. Simulations demonstrated a more uniform electric field distribution in PVC/CuO/CNT nanocomposites, mitigating hotspots. The synergetic effects of CuO nanoneedles and CNTs led to excellent improvements in the electric properties of PVC, underscoring their potential in medium voltage cable applications.
Efficacy and safety of atogepant, a small molecule CGRP receptor antagonist, for the preventive treatment of migraine: a systematic review and meta-analysis
Authors: Hou Min , Luo Xiaofeng , He Shuangshuang , Yang Xue , Zhang Qing , Jin Meihua , Zhang Pan , Li Yang , Bi Xiaoting , Li Juan , Cheng Caiyi , Xue Qiang , Xing Haiyan , Liu Yao 
Published: July 2024

Abstract
Background
Migraine is one of the most common diseases worldwide while current treatment options are not ideal. New therapeutic classes of migraine, the calcitonin gene-related peptide (CGRP) antagonists, have been developed and shown considerable effectiveness and safety. The present study aimed to systematically evaluate the efficacy and safety of atogepant, a CGRP antagonist, for migraine prophylaxis from the results of randomized controlled trials (RCTs).

Methods
The Cochrane Library, Embase, PubMed and https://www.clinicaltrials.gov/ were searched for RCTs that compared atogepant with placebo for migraine prophylaxis from inception of the databases to Feb 1, 2024. Outcome data involving efficacy and safety were combined and analyzed using Review Manager Software version 5.3 (RevMan 5.3). For each outcome, risk ratios (RRs) or standardized mean difference (SMD) were calculated.

Results
4 RCTs with a total of 2813 subjects met our inclusion criteria. The overall effect estimate showed that atogepant was significantly superior to placebo in terms of the reduction of monthly migraine (SMD − 0.40, 95% CI -0.46 to -0.34) or headache (SMD − 0.39, 95% CI -0.46 to -0.33) days, the reduction of acute medication use days (SMD − 0.45, 95% CI -0.51 to -0.39) and 50% responder rate (RR 1.66, 95% CI 1.46 to 1.89), while no dose-related improvements were found between different dosage groups. For the safety, significant number of patients experienced treatment-emergent adverse events (TEAEs) with atogepant than with placebo (RR 1.10, 95% CI 1.02–1.21) while there was no obvious difference between the five dosage groups. Most TEAEs involved constipation (RR 2.55, 95% CI 1.91–3.41), nausea (RR 2.19, 95% CI 1.67–2.87) and urinary tract infection (RR 1.49, 95% CI 1.05–2.11). In addition, a high dosage of atogepant may also increase the risk of treatment-related TEAEs (RR 1.64, 95% CI 1.02–2.63) and fatigue (RR 3.07, 95% CI 1.13–8.35).

Conclusions
This meta-analysis suggests that atogepant is effective and tolerable for migraine prophylaxis including episodic or chronic migraine compared with placebo. It is critical to weigh the benefits of different doses against the risk of adverse events in clinical application of atogepant. Longer and multi-dose trials with larger sample sizes are required to verify the current findings.
Traversed dynamics of climate change and One Health
Authors: Shafique Muhammad , Khurshid Mohsin , Muzammil Saima , Arshad Muhammad Imran , Malik Imran Riaz , Rasool Muhammad Hidayat , Khalid Aimen , Khalid Rabia , Asghar Rubab , Baloch Zulqarnain , Aslam Bilal 
Published: July 2024

AbstractClimate change, caused by both natural and human activities, poses significant threats to global health, including rising temperatures, extreme weather events, and environmental disruptions. The One Health concept, emphasizing the interconnectedness of human, animal, and environmental health, is crucial in addressing these challenges. Climate change is linked to the emergence and resurgence of infectious diseases, resulting in substantial economic losses worldwide due to outbreaks, floods, and disrupted trade, among other factors. Therefore, it is crucial to adapt to this changing climate to safeguard One Health. By implementing a One Health approach, we can effectively address the consequences of climate change and make substantial contributions to health and food safety. This approach also holds the potential to mitigate economic losses, particularly in low and middle-income countries. Additionally, in the future, research interventions based on the One Health framework may offer sustainable solutions to combat climate change.
TopoDoE: a design of experiment strategy for selection and refinement in ensembles of executable gene regulatory networks
Authors: Bouvier Matteo , Zreika Souad , Vallin Elodie , Fourneaux Camille , Gonin-Giraud Sandrine , Bonnaffoux Arnaud , Gandrillon Olivier 
Published: July 2024

Abstract
Background
Inference of Gene Regulatory Networks (GRNs) is a difficult and long-standing question in Systems Biology. Numerous approaches have been proposed with the latest methods exploring the richness of single-cell data. One of the current difficulties lies in the fact that many methods of GRN inference do not result in one proposed GRN but in a collection of plausible networks that need to be further refined. In this work, we present a Design of Experiment strategy to use as a second stage after the inference process. It is specifically fitted for identifying the next most informative experiment to perform for deciding between multiple network topologies, in the case where proposed GRNs are executable models. This strategy first performs a topological analysis to reduce the number of perturbations that need to be tested, then predicts the outcome of the retained perturbations by simulation of the GRNs and finally compares predictions with novel experimental data.

Results
We apply this method to the results of our divide-and-conquer algorithm called WASABI, adapt its gene expression model to produce perturbations and compare our predictions with experimental results. We show that our networks were able to produce in silico predictions on the outcome of a gene knock-out, which were qualitatively validated for 48 out of 49 genes. Finally, we eliminate as many as two thirds of the candidate networks for which we could identify an incorrect topology, thus greatly improving the accuracy of our predictions.

Conclusion
These results both confirm the inference accuracy of WASABI and show how executable gene expression models can be leveraged to further refine the topology of inferred GRNs. We hope this strategy will help systems biologists further explore their data and encourage the development of more executable GRN models.
The reverse TRBV30 gene of mammals: a defect or superiority in evolution?
Authors: Wu Fengli , Wu Yingjie , Yao Yuanning , Xu Yuanyuan , Peng Qi , Ma Long , Li Jun , Yao Xinsheng 
Published: July 2024

AbstractAt the 3’ end of the C2 gene in the mammalian TRB locus, a distinct reverse TRBV30 gene (named TRBV31 in mice) has been conserved throughout evolution. In the fully annotated TRB locus of 14 mammals (including six orders), we observed noteworthy variations in the localization and quality of the reverse V30 genes and Recombination Signal Sequences (RSSs) in the gene trees of 13 mammals. Conversely, the forward V29 genes and RSSs were generally consistent with the species tree of their corresponding species. This finding suggested that the evolution of the reverse V30 gene was not synchronous and likely played a crucial role in regulating adaptive immune responses. To further investigate this possibility, we utilized single-cell TCR sequencing (scTCR-seq) and high-throughput sequencing (HTS) to analyze TCRβ CDR3 repertoires from both central and peripheral tissues of Primates (Homo sapiens and Macaca mulatta), Rodentia (Mus musculus: BALB/c, C57BL/6, and Kunming mice), Artiodactyla (Bos taurus and Bubalus bubalis), and Chiroptera (Rhinolophus affinis and Hipposideros armige). Our investigation revealed several novel observations: (1) The reverse V30 gene exhibits classical rearrangement patterns adhering to the ‘12/23 rule’ and the ‘D-J rearrangement preceding the V-(D-J) rearrangement’. This results in the formation of rearranged V30-D2J2, V30-D1J1, and V30-D1J2. However, we also identified ‘special rearrangement patterns’ wherein V30-D rearrangement preceding D-J rearrangement, giving rise to rearranged V30-D2-J1 and forward Vx-D2-J. (2) Compared to the ‘deletional rearrangement’ (looping out) of forward V1-V29 genes, the reverse V30 gene exhibits preferential utilization with ‘inversional rearrangement’. This may be attributed to the shorter distance between the V30 gene and D gene and the ‘inversional rearrangement’ modes. In summary, in the mammalian TRB locus, the reverse V30 gene has been uniquely preserved throughout evolution and preferentially utilized in V(D)J recombination, potentially serving a significant role in adaptive immunity. These results will pave the way for novel and specialized research into the mechanisms, efficiency, and function of V(D)J recombination in mammals.
Legionella pneumophila cell surface RtxA release by LapD/LapG and its role in virulence
Authors: Kanaan Hussein , Chapalain Annelise , Chokr Ali , Doublet Patricia , Gilbert Christophe 
Published: July 2024

Abstract
Background
Legionella pneumophila is a Gram-negative intracellular bacillus and is the causative agent of a severe form of pneumonia called Legionnaires’ disease which accounts for 2-9% of cases of community acquired pneumonia. It produces an extremely large protein belonging to the RTX (Repeats in ToXin) family, called RtxA, and we previously reported that RtxA is transported by a dedicated type 1 secretion system (T1SS) to the cell surface. RTX proteins have been shown to participate in the virulence or biofilm formation of various bacteria, the most studied models being the pore forming hemolysin A (HlyA) of Escherichia coli and the biofilm associated protein LapA of P. fluorescens. LapA localization depends on the enzymatic release by LapD/LapG complex activity. This study aimed to elucidate the dual localization (cell surface associated or released state) of L. pneumophila RTX protein (RtxA) and whether this released versus sequestered state of RtxA plays a role in L. pneumophila virulence.

Results
The hereby work reveals that, in vitro, LapG periplasmic protease cleaves RtxA N-terminus in the middle of a di-alanine motif (position 108–109). Consistently, a strain lacking LapG protease maintains RtxA on the cell surface, whereas a strain lacking the c-di-GMP receptor LapD does not exhibit cell surface RtxA because of its continuous cleavage and release, as in the LapA-D-G model of Pseudomonas fluorescens. Interestingly, our data point out a key role of RtxA in enhancing the infection process of amoeba cells, regardless of its location (embedded or released); therefore, this may be the result of a secondary role of this surface protein.

Conclusions
This is the first experimental identification of the cleavage site within the RTX protein family. The primary role of RtxA in Legionella is still questionable as in many other bacterial species, hence it sounds reasonable to propose a major function in biofilm formation, promoting cell aggregation when RtxA is embedded in the outer membrane and facilitating biofilm dispersion in case of RtxA release. The role of RtxA in enhancing the infection process may be a result of its action on host cells (i.e., PDI interaction or pore-formation), and independently of its status (embedded or released).
Awake fiberoptic intubation of a patient with severe multiple trauma in prone position: a case report
Authors: Yang Jingli , Zou Feng , Ma Guoping 
Published: July 2024

Abstract
Background
Fiberoptic-guided intubation is considered as “gold standard” of difficult airway management. Management of the airway in prone position in patients with severe trauma presenting with penetrating waist and hip injury poses a major challenge to the anesthesiologist.

Case presentation
A man presented with severe multiple trauma and hemorrhagic shock as a result of an industrial accident with several deformed steel bars penetrating the left lower waist and hip. It was decided to schedule an exploratory laparotomy following extracting the deformed steel bars. Successful administration of awake fiberoptic nasotracheal intubation, performed in a prone position under airway blocks and appropriate sedation, allowed for the procedure. The exploratory laparotomy revealed damage to multiple organs, which were repaired sequentially during a 7-hour surgical operation. The patient’s recovery was uneventful, and he was discharged from the hospital one month after the surgery.

Conclusions
Awake fiberoptic nasotracheal intubation, along with airway blocks and appropriate sedation, can be a viable option in patients with severe multiple trauma in the prone position.
Targeted nanopore sequencing using clinical specimens for the rapid diagnosis of extrapulmonary tuberculosis
Authors: Yu Guocan , Fang Likui , Shen Yanqin , Zhong Fangming , Xu Xudong 
Published: July 2024

Abstract
Background
The clinical presentation of extrapulmonary tuberculosis (EPTB) is atypical and it is easily confused with other diseases such as common infections, making prompt diagnosis a great challenge. This study aimed to evaluate the accuracy of targeted nanopore sequencing (TNS) in the diagnosis of EPTB. The diagnostic accuracy of TNS using different types of extrapulmonary specimens was also evaluated.

Methods
We reviewed the clinical data of patients with suspected EPTB for whom TNS was conducted and who were hospitalized at our center. The true positive, false positive, false negative, and true negative values were determined. Indices of diagnostic accuracy were computed, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the curve (AUC) for TNS and acid-fast bacilli (AFB) culture, and compared with those from clinical diagnosis.

Results
149 patients were included in the analysis. The overall sensitivity, specificity, PPV, NPV, and AUC of TNS for the diagnosis of EPTB were 86.4%, 87.5%, 97.3%, 55.3%, and 0.87, respectively. For diagnosis by AFB culture, these values were 25.6%, 100.0%, 100.0%, 20.5%, and 0.63, respectively. The most common specimens used were lymph node tissue, cerebrospinal fluid, pleural effusion, and pleural tissue. The diagnostic accuracy of TNS using all types of extrapulmonary specimens was good.

Conclusions
TNS demonstrates good diagnostic accuracy in the rapid diagnosis of EPTB and this was true across different types of extrapulmonary specimens.
Salvage radiotherapy for locally recurrent cervical and endometrial carcinoma: clinical outcomes and toxicities
Authors: Cong Hui , Yang Xiaojing , Li Zhaobin , Li Zhen , Lin Shuchen , Jiang Wei , Fu Jie 
Published: July 2024

Abstract
Background
The management of locally recurrent gynecological carcinoma remains a challenge due to the limited availability of data. This study aims to share our institutional experience in using definitive radiotherapy (RT) for the treatment of locally recurrent cervical and endometrial carcinoma.

Methods
The study retrospectively reviewed 20 patients in our hospital completing salvage 3D image-based HDR brachytherapy, with or without EBRT, for locally recurrent cervical and endometrial carcinoma after surgery. The Kaplan–Meier method was applied to estimate the disease-free survival (DFS) and overall survival (OS). The toxicities were assessed by CTCAEv5.

Results
During a median observation period of 21 months, the study reported a tumor objective response rate of 95%. The 3-year DFS and OS rates were 89.4% and 90.9%, respectively. The EBRT combined with brachytherapy achieved a median cumulative dose of 88 Gy to CTV D90. 14 patients received concurrent and/or systemic chemotherapy. Two patients suffered locoregional recurrence after salvage treatment, one of whom only received salvage brachytherapy for prior RT history. The analysis identified significant predictors for DFS, including tumor histology and FIGO stage. 5 patients observed acute grade 1–2 rectal (15%) or genitourinary (10%) toxicities. Late toxicities including grade 1–2 rectal bleeding (10%) and grade 2 pelvic fracture (5%) were seen in 3 patients.

Conclusions
3D image-guided brachytherapy combined with EBRT shows effective tumor control and acceptable toxicity profile for women with locally recurrent gynecologic cancer. The success in managing vaginal recurrence is notably influenced by histologic subtype and FIGO staging.