bluuebunny/crossref_metadata_2025_split huggingface dataset:
External Validation of the Charlson Comorbidity Index-based Model for Survival Prediction in Thai Patients Diagnosed with Dementia
Authors: Buawangpong Nida , Phinyo Phichayut , Angkurawaranon Chaisiri , Soontornpun Atiwat , Jiraporncharoen Wichuda , Sirikul Wachiranun , Pinyopornpanish Kanokporn 
Published: August 2024

Abstract
Background
The Charlson Comorbidity Index (CCI) is commonly employed for predicting mortality. Nonetheless, its performance has rarely been evaluated in patients with dementia. This study aimed to examine the predictive capability of the CCI-based model for survival prediction in Thai patients diagnosed with dementia.

Methods
An external validation study was conducted using retrospective data from adults with dementia who had visited the outpatient departments at Maharaj Nakorn Chiang Mai Hospital between 2006 and 2012. The data obtained from electronic medical records included age, gender, date of dementia diagnosis and death, types of dementia, and comorbidities at the time of dementia diagnosis. The discriminative ability and calibration of the CCI-based model were estimated using Harrell’s C Discrimination Index and visualized with calibration plot. As the initial performance did not meet satisfaction, model updating and recalibration were performed.

Results
Of 702 patients, 56.9% were female. The mean age at dementia diagnosis was 75.22 (SD 9.75) year-old. During external validation, Harrell's C-statistic of the CCI-based model was 0.58 (95% CI, 0.54–0.61). The model showed poor external calibration. Model updating was subsequently performed. All updated models demonstrated a modest increase in Harrell's C-statistic. Temporal recalibration did not significantly improve the calibration of any of the updated models.

Conclusion
The CCI-based model exhibited fair discriminative ability and poor calibration for predicting survival in Thai patients diagnosed with dementia. Despite attempts at model updating, significant improvements were not achieved. Therefore, it is important to consider the incorporation of other influential prognostic factors.
Partial (incomplete) removal of granulation tissue using modified minimally invasive surgical technique in treatment of infrabony defects (randomized control clinical trial)
Authors: Ibrahim Ahmed Adel , Tawfik Omnia Khaled , ElNahass Hani 
Published: August 2024

Abstract
Aim
This study aims to compare the clinical and radiographic outcomes after complete versus incomplete removal of granulation tissue (GT) during modified minimally invasive surgical technique (M-MIST) for management of periodontitis patients with deep pockets associated with infra-bony defects.

Methodology
Ten patients with a total of 14 deep non-resolving pockets (≥ 5 mm) associated with a vertical infra-bony defect were recruited for this study. They were randomized into 2 groups; a test group with incomplete removal of GT and a control group with complete removal of GT. Clinical parameters of clinical attachment level (CAL), residual probing depth (rPD) and buccal recession (Rec.) were recorded every 3 months. Radiographic periapicals were taken at baseline, 6 and 9 months. The significance level was set to 0.05.

Results
None of the results showed statistical significance between the 2 groups (p > 0.05). The test group showed less CAL gain (2 ± 0.87 mm, p = 0.062), more reduction in rPD (3.1 ± 0.96 mm, p = 0.017) and more recession (0.857 ± 0.26 mm, p = 0.017) than control group CAL gain (2.4 ± 0.58 mm, p = 0.009), rPD reduction (2.9 ± 0.3 mm, p = 0.001) and recession (0.5 ± 0.34 mm, p = 0.203) respectively. Control group had linear reduction in depth defect (DD) (0.68 ± 0.287, p = 0.064) compared to an increase in DD in test group (-0.59 ± 0.5, p = 0.914).

Conclusions
No statistical significance were observed in healing parameters between complete removal of GT in M-MIST and incomplete (partial) removal of GT of deep pockets with infra-bony defects both clinically and radiographically. Further studies with larger samples are needed to confirm the results.
Synergistic intravesical instillation for bladder cancer: CRISPR-Cas13a and fenbendazole combination therapy
Authors: Liang Mingkang , Wang Yongqiang , Liu Lisha , Deng Dashi , Yan Zeqin , Feng Lida , Kong Chenfan , Li Chenchen , Li Yuqing , Li Guangzhi 
Published: August 2024

Abstract
Background
CRISPR-Cas13a is renowned for its precise and potent RNA editing capabilities in cancer therapy. While various material systems have demonstrated efficacy in supporting CRISPR-Cas13a to execute cellular functions in vitro efficiently and specifically, the development of CRISPR-Cas13a-based therapeutic agents for intravesical instillation in bladder cancer (BCa) remains unexplored.

Methods
In this study, we introduce a CRISPR-Cas13a nanoplatform, which effectively inhibits PDL1 expression following intravesical instillation. This system utilizes a fusion protein CAST, created through the genetic fusion of CRISPR-Cas13 and the transmembrane peptide TAT. CAST acts as a potent transmembrane RNA editor and is assembled with the transepithelial delivery carrier fluorinated chitosan (FCS). Upon intravesical administration into the bladder, the CAST-crRNAa/FCS nanoparticles (NPs) exhibit remarkable transepithelial capabilities, significantly suppressing PDL1 expression in tumor tissues.To augment immune activation within the tumor microenvironment, we integrated a fenbendazole (FBZ) intravesical system (FBZ@BSA/FCS NPs). This system is formulated through BSA encapsulation followed by FCS coating, positioning FBZ as a powerful chemo-immunological agent.

Results
In an orthotropic BCa model, the FBZ@BSA/FCS NPs demonstrated pronounced tumor cell apoptosis, synergistically reduced PDL1 expression, and restructured the immune microenvironment. This culminated in an enhanced synergistic intravesical instillation approach for BCa. Consequently, our study unveils a novel RNA editor nanoagent formulation and proposes a potential synergistic therapeutic strategy. This approach significantly bolsters therapeutic efficacy, holding promise for the clinical translation of CRISPR-Cas13-based cancer perfusion treatments.
Health care utilization of patients with acute abdominal pain before and after emergency department visits
Authors: Verleger Katharina , Fischer-Rosinsky Antje , Möckel Martin , Schneider Anna , Slagman Anna , Keil Thomas , Schenk Liane ,   the INDEED Research Group, Baier Natalie , Busse Reinhard , Brammen Dominik , Drepper Johannes , Dröge Patrik , Greiner Felix , Henschke Cornelia , Kuhlmann Stella , Kreye Björn , Lüpkes Christian , Reinhold Thomas , Riens Burgi , Rosenbusch Marie-Luise , Staeps Felix , Schmieder Kristin , Schreiber Daniel , von Stillfried Dominik , Below Maike , Röhrig Rainer , Roll Stephanie , Ruhnke Thomas , Walcher Felix , Zimmermann Grit , King Ryan 
Published: August 2024

Abstract
Background
Acute abdominal pain (AAP) is a major driver for capacity-use in emergency departments (EDs) worldwide. Yet, the health care utilization of patients with AAP before and after the ED remains unclear. The primary objective of this study was to describe adult patients presenting to the ED with AAP and their outpatient care (OC) use before and after the ED. Secondary objectives included description of hospitalization rates, in-hospital mortality, ED re-visits, and exploration of potential risk factors for hospitalization and ED re-visits.

Methods
For the analysis, we combined routine hospital data from patients who visited 15 EDs in Germany in 2016 with their statutory health insurance OC claims data from 2014 to 2017. Adult patients were included based on a chief complaint or an ED diagnosis indicating unspecific AAP or the Manchester Triage System indicator “Abdominal pain in adults”. Baseline characteristics, ED diagnosis, frequency and reason of hospitalization, frequency and type of prior-OC (prOC) use up to 3 days before and of post-OC use up to 30 days after the ED visit.

Main results
We identified 28,085 adults aged ≥ 20 years with AAP. 39.8% were hospitalized, 33.9% sought prOC before the ED visit (48.6% of them were hospitalized) and 62.7% sought post-OC up to 30 days after the ED visit. Hospitalization was significantly more likely for elderly patients (aged 65 and above vs. younger; adjusted OR 3.05 [95% CI 2.87; 3.25]), prOC users (1.71 [1.61; 1.90]) and men (1.44 [1.37; 1.52]). In-hospital mortality rate was 3.1% overall. Re-visiting the ED within 30 days was more likely for elderly patients (1.32 [1.13; 1.55) and less likely for those with prOC use (0.37 [0.31; 0.44]).

Conclusions
prOC use was associated with more frequent hospitalizations but fewer ED re-visits. ED visits by prOC patients without subsequent hospitalization may indicate difficulties of OC resources to meet the complex diagnostic requirements and expectations of this patient population. Fewer ED re-visits in prOC users indicate effective care in this subgroup.
Civilians under missile attack: post-traumatic stress disorder among the Jewish and Bedouin population of Southern Israel
Authors: Shvartsur Rachel , Savitsky Bella 
Published: August 2024

Abstract
Background
Over the past 20 years, Jewish and Bedouin civilians in southern Israel have faced the ongoing threat of missile attacks from Gaza, with possible mental health consequences. This study aimed to assess the prevalence of post-traumatic stress disorder (PTSD) among Jewish and Bedouin adult civilians in southern Israel in a period with few missile attacks from Gaza, and no military operations.

Methods
The study population included 389 participants (246 Jews, 143 Bedouins) living within 40 km/25 mi from Gaza for at least 2 years and interviewed between January and March 2023 (before the ongoing war that started on October 7th, 2023). The PTSD Checklist (PCL-5) was used, with a score of 33 as a cutoff point for the presence of PTSD.

Results
Compared to Jews, a significantly lower proportion of Bedouins reported accessibility to bomb shelters and siren warning systems. Overall, 20.3% of the respondents exhibited PTSD. Multivariate analysis revealed that after adjustment for demographic and household characteristics, Bedouins had a six-fold significantly higher probability of PTSD in comparison to Jews (OR 5.6, 95%CI 2.8–10.8). Compared to participants with high socioeconomic status (SES), participants with low SES had a six-fold significantly higher probability of PTSD (OR 6.0, 95%CI 2.2–16.5). Participants who did not have an alarm system had more than two-fold odds for PTSD (OR 2.3, 95%CI 1.1–5.5). Being single, living in urban areas, or having a disability significantly increased the probability of PTSD.

Conclusions
The findings of this study demonstrate a significantly higher prevalence of PTSD among the Bedouin population of Southern Israel. Several sociodemographic characteristics were associated with the increased prevalence of PTSD, the most prominent of which was low SES. Healthcare professionals and authorities should be proactive in screening for PTSD, and provide tailored treatment and support, taking into account ethnical and cultural background. Authorities should address the disparity in bomb shelter access and siren warning coverage between Bedouin and Jewish communities.
Heart–Lungs interactions: the basics and clinical implications
Authors: Jozwiak Mathieu , Teboul Jean-Louis 
Published: August 2024

AbstractHeart–lungs interactions are related to the interplay between the cardiovascular and the respiratory system. They result from the respiratory-induced changes in intrathoracic pressure, which are transmitted to the cardiac cavities and to the changes in alveolar pressure, which may impact the lung microvessels. In spontaneously breathing patients, consequences of heart–lungs interactions are during inspiration an increase in right ventricular preload and afterload, a decrease in left ventricular preload and an increase in left ventricular afterload. In mechanically ventilated patients, consequences of heart–lungs interactions are during mechanical insufflation a decrease in right ventricular preload, an increase in right ventricular afterload, an increase in left ventricular preload and a decrease in left ventricular afterload. Physiologically and during normal breathing, heart–lungs interactions do not lead to significant hemodynamic consequences. Nevertheless, in some clinical settings such as acute exacerbation of chronic obstructive pulmonary disease, acute left heart failure or acute respiratory distress syndrome, heart–lungs interactions may lead to significant hemodynamic consequences. These are linked to complex pathophysiological mechanisms, including a marked inspiratory negativity of intrathoracic pressure, a marked inspiratory increase in transpulmonary pressure and an increase in intra-abdominal pressure. The most recent application of heart–lungs interactions is the prediction of fluid responsiveness in mechanically ventilated patients. The first test to be developed using heart–lungs interactions was the respiratory variation of pulse pressure. Subsequently, many other dynamic fluid responsiveness tests using heart–lungs interactions have been developed, such as the respiratory variations of pulse contour-based stroke volume or the respiratory variations of the inferior or superior vena cava diameters. All these tests share the same limitations, the most frequent being low tidal volume ventilation, persistent spontaneous breathing activity and cardiac arrhythmia. Nevertheless, when their main limitations are properly addressed, all these tests can help intensivists in the decision-making process regarding fluid administration and fluid removal in critically ill patients.
Scientific analysis of folk contract documents from Tianshui region: insights of fiber use and preservation state
Authors: Ge Mengfan , Gu Zhou , Tian Feifei , Shi Jiatong , Yang Yiming , Shi Jilong , Han Bin 
Published: August 2024

Abstract
Folk contract documents (FCD) are valuable materials for studying social history, and the paper they use reflects the social realities of different eras and social classes. Research and scientific analysis of numerous FCD samples after the fourteenth century are rare. We conducted a study on 96 Tianshui folk contract documents (TFCD, 107 paper samples) from the Tianshui area of Gansu Province, Northwest China, taking into account both the textual content and the materiality of paper carriers, and interpreted the results from multiple lines of evidence and discussion. Physical performance analysis revealed that the paper used by the northern folk exhibits a lower apparent density, which is not conducive to the long-term preservation of paper. The preservation status investigation, curtain pattern analysis, and fiber analysis show that the paper used in the TFCD differs from traditional cultural paper regarding disease types, production precision, and fiber materials, providing a basis for its protection and restoration. The analysis of chemical components indicated that the aging and yellowing of paper can be correlated with the content of sulfur and carbonyl groups. The feasibility of using pyrolysis gas chromatography-mass spectrometry (Py-GC/MS) analysis to quickly identify papermaking fibers in a large number of paper samples was proposed. By utilizing various techniques to inspect the paper of documents, this study helps to enhance the academic understanding of FCD materials. In addition, it expands the knowledge base of Northwest handmade paper.
Correlation and concordance of carotid Doppler ultrasound and echocardiography with invasive cardiac output measurement in critically ill patients
Authors: Arango-Granados María Camila , Quintero-Ramírez Jaime Andrés , Mejía-Herrera Felipe , Henao-Cardona Lina Mayerly , Muñoz-Patiño Valentina , Bustamante-Cristancho Luis Alfonso 
Published: August 2024

Abstract
Background
Critical care management heavily relies on accurate cardiac output (CO) measurement. Echocardiography has been a mainstay in non-invasive cardiac monitoring; however, its comparability to invasive methods warrants further exploration. Recent studies have suggested the potential of carotid Doppler measurements as a promising approach to estimate CO. Despite this potential, the literature presents mixed outcomes regarding its reliability and accuracy. This study aims to evaluate the correlation and concordance between carotid Doppler ultrasonography and invasive hemodynamic monitoring in estimating CO in critically ill patients. Furthermore, it assesses the concordance and correlation between echocardiography CO and the standard invasive CO measurements.

Methods
This concordance study involved critically ill adults requiring invasive CO measurement. Patients with arrhythmias, severe valvulopathy, pregnancy, and poor acoustic window were excluded. Statistical analyses comprised univariate analysis, Wilcoxon signed-rank test, Spearman correlation, and intraclass correlation coefficient. Ethical approval was granted by the institution’s ethics committee.

Results
A total of 49 critically ill patients were included, predominantly male (63.27%), with a median age of 57 years. Diagnoses included subarachnoid hemorrhage (53.06%) and heart failure (8.16%). Mean cardiac index was 3.36 ± 0.81 L/min/m2 and mean cardiac output was 5.98 ± 1.47 L/min. Spearman correlation coefficient between echocardiography and invasive CO measurements was 0.58 (p-value = p < 0.001), with an ICC of 0.59 for CO and 0.52 for cardiac index. Carotid measurements displayed no significant correlation with invasive CO.

Conclusion
There is a moderate correlation and concordance between echocardiography and invasive CO measurements. There is no significant correlation between carotid variables and invasive CO, underscoring the necessity for cautious interpretation and application, particularly in patients with distinctive cerebral blood flow dynamics.
Study of Avicennan unani drug saad kufi (Cyperus scariosus R.Br) for cardiac activity on isolated Langendorff rat heart
Authors: Nafees Sana , Nafees Huda , Amin Kunwar Mohammad Yousuf , Rahman Syed Ziaur 
Published: August 2024

AbstractCardioprotective Unani drug, Saad Kufi (Cyperus scariosus R.Br.), mentioned by the intellectual colossus Ibn Sina (Avicenna) a thousand years back in his book, “Kitab al-Adviya al-Qalbia” and still widely used by Unani physicians, was selected for experimental study. The main objective of the study was to explore the trial drug ex vivo for validation, hemodynamic elucidation, and molecular mechanism identification for the improvement of Unani therapeutics and to identify a safe and effective novel cardiovascular drug for mainstream medicine. Five doses of 50% ethanolic extract of the physiochemically standardized root were studied in a normal rat heart, on a semi-automated Langendorff apparatus supported with an advanced data acquisition system, perfused with carbogenated non-recirculating Kreb’s-Hensleit solution, at constant flow mode, by continuous recording. The effect of 6 repetitions (n = 6) of each dose was studied with the following parameters on the Lab chart pro version: heart rate, left ventricular developed pressure, cardiac work, and coronary pressure. The significance of the difference was determined by the student’s “t” test. Results of all doses of Saad Kufi showed a significant increase in the above parameters. The maximum increase was observed by Dose III. It could be concluded that Unani’s clinical use of Saad Kufi (C. scariosus R.Br) as cardioprotective was validated and higher doses were indicated to be clinically optimal. Hemodynamically and molecular mechanism-wise, it is indicated to be a sympathomimetic or inotropic-like agent and possibly a direct vasodilator. Since existing long-term treatment of heart failure is not done by cardiac stimulants or positive inotropic and chronotropic agents, the possible future clinical demonstration of therapeutic improvement in heart failure will bring Saad Kufi as a novel drug in mainstream medicine.
Biological aspects of the lingual papillae of the Arab Zebu cattle: a new perspicuity of its chad ecological adaptations
Authors: Abumandour Mohamed , Haddad Seham , Farrag Foad , Kandyel Ramadan , Roshdy Karam , Massoud Diaa , Khalil Eman Kamal 
Published: August 2024

Abstract
Background
Our research is the first to explore the ultrastructural features of the lingual papillary system of Arab Zebu cattle, highlighting their Chadian environmental adaptations.

Results
There were two types of papillary systems: gustatory (fungiform and circumvallate) and mechanical (filiform, conical, and lentiform). The dorsal surface of the apex and rostral parts of the body had well-developed filiform papillae, whereas the tip’s surface had mucosal folds, tubercles, and few filiform papillae. The torus lingua’s dorsal surface displayed few lentiform papillae, while two conical papillae subtypes and numerous circumvallate papillae were present on its lateral surfaces. A slight median ridge on the dorsal surface of the body had not been described previously. Six filiform papillae subtypes were identified: long and rod-like on the tip; tongue-like and elongated on the lateral area of the apex and body; transient conical and leaf-like on the median line. The accessory processes were: one pair (on long, tongue-like, and transient conical), two pairs (on leaf-like and elongated), and four pairs on the large conical papillae. The two fungiform papillae subtypes were surrounded by a groove and had taste pores (3–5 on the oval and 5–9 on the round papillae). The U-shaped annular bad were observed around the ovoid circumvallate papillae, and the circular bad were observed around the round ones. The circumvallate had taste pores (8–14 on the round’s dorsal and lateral surfaces and 6–10 on the ovoid’s lateral surface).

Conclusion
The papillary system’s regional divergence was specialized for its harsh and semi-harsh diet.
Evaluating crown scorch predictions from a computational fluid dynamics wildland fire simulator
Authors: Atchley Adam L. , Hoffman Chad M. , Bonner Sophie R. , Ritter Scott M. , O’Brien Joseph , Linn Rodman R. 
Published: August 2024

Abstract
Background
Crown scorch—the heating of live leaves, needles, and buds in the vegetative canopy to lethal temperatures without widespread combustion—is one of the most common fire effects shaping post-fire canopies. Despite the ability of computational fluid dynamic models to finely resolve fire activity and buoyant plume dynamics including heterogenous 3D distributions of forest canopy heating, these models have had only limited use in simulating fire effects and have not been used to evaluate crown scorch. Here, we demonstrate a method of evaluating crown scorch using a computational fluid dynamics model, FIRETEC, and validate this approach by simulating the experiments that were used to develop Van Wagner’s 1973 crown scorch model.

Results
The average scorch height prediction from FIRETEC compares well with the empirical model derived by Van Wagner, which is the most widely used empirical model for crown scorch. We further find that the 3D buoyant plume dynamics from a steady and homogeneous idealized heat source on the ground results in a spatially heterogenous crown scorch pattern reflecting complex heating dynamics that are best represented by percent scorch rather than height of scorch.

Conclusions
The ability of the computational fluid dynamics model to capture variation in crown scorch due to 3D buoyant plume dynamics provides direct links between forest structure, fire behavior, and fire effects that can be used by forest managers and researchers to better understand how fires result in crown damage under various environmental and management scenarios.