bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antifungal susceptibility pattern of Candida species isolated from pregnant women
Authors: Ali Maqsood , Edrees Wadhah Hassan , Al-Shehari Wadee Abdullah , Xue Gao , Al-Hammadi Safa , Qasem Eglal Ahmed , Chaulagain Ram Prasad , Lal Nand 
Published: August 2024

IntroductionCandida species, opportunistic yeast, are the second most common cause of female vulvovaginal candidiasis. This study aimed to evaluate the antifungal susceptibility profile of the isolated Candida species in pregnant women in Hajjah governorate, Yemen.MethodsA hospital-based cross-sectional study was conducted among 396 pregnant women attending Authority AL-Gumhorri Hospital Hajjah between February and July 2023. Vaginal swabs were collected, and Candida species were isolated and identified based on the standard laboratory method. Furthermore, the antifungal drug susceptibility of Candida species was determined by the Kirby-Bauer technique.Results and discussionThe prevalence of vaginal Candida infection among pregnant women was 61.4%. Candida albicans was the most predominant species (59.26%), followed by Candida krusei(13.58%), Candida Tropicalis (11.12%), Candida Grabata (9.87%), and Candida dubliniensis (6.17%). The highest rate of Candida infections was among women aged 24–30 years (71.9%) who finished primary school (77.8%), with the third trimester (80%), multigravida (66.1%), and recurrent infection (67.7%) showing significant differences (P &lt; 0.05). The Candida albicans isolates were resistant to clotrimazole and itraconazole at 34.7% and 23.6%, respectively.In addition, the resistance of Candida krusei, Candida tropicalis, Candida glabrata, and Candida dublinensis isolates to fluconazole, voriconazole, voriconazole, and nystatin was 57.6%, 63%, 43.8%, and 60%, respectively. Additionally, approximately 46.2% of isolated Candida albicans exhibited one kind of antifungal drug resistance, whereas 38.7% of isolated non-albicans exhibited resistance to three different antifungal agents. According to the above findings, Candida infection is highly prevalent in Yemen and quite widespread. Interventions in health education are advised to increase women’s knowledge of vaginitis and its prevention. The antifungal susceptibility test may also be helpful in determining the best medication for each patient.
Platelet indices and the risk of pulmonary arterial hypertension: a two-sample and multivariable Mendelian randomization study
Authors: Li Yinuo , Liu Xi , Hong Qian , Xu Rui 
Published: August 2024

BackgroundRecent epidemiological studies have indicated a correlation between platelet indices and pulmonary arterial hypertension (PAH), yet the causality between them remains unclear. To explore the causal relationship between four platelet indices and PAH, with the aim of providing a theoretical basis for clinical prevention and treatment.MethodsSingle-nucleotide polymorphisms (SNPs) associated with platelet-related traits were selected as exposure factors from published genome-wide association studies (GWAS), including: platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV), and platelet distribution width (PDW). Summary-level data for PAH were obtained from the FinnGen study (248 cases and 289,117 controls). Two-sample and multivariable Mendelian randomization (MR) analyses were conducted to assess the causal relationship between exposure factors and the risk of outcomes. The inverse variance weighted (IVW) method was utilized as the primary MR analysis approach, supplemented by weighted median, mode-based estimation, MR-Egger regression, and the MR Pleiotropy Residual Sum and Outlier (MR-PRESSO) test to detect and adjust for pleiotropy, ensuring the reliability of the results through sensitivity analysis.Results(1) The IVW results from the two-sample MR analysis showed a positive causal association between PLT and the risk of developing PAH [(OR = 1.649, 95%CI: 1.206–2.256, P = 0.0017)], with the sensitivity analysis confirming the robustness of the causal relationship. The MR-Egger intercept analysis did not detect potential pleiotropy (P = 0.879). (2) The MVMR results showed no statistically significant causal relationship between these four markers and the risk of developing PAH. After adjusting for collinearity, a direct positive causal association was observed between PLT and the risk of developing PAH (OR = 1.525, 95%CI: 1.063–2.189, P = 0.022).ConclusionThe positive correlation between PLT and the risk of PAH suggests that correcting elevated platelet levels may reduce the risk of developing PAH.
Transcatheter dilation and stenting of the modified blalock-taussig shunt in cyanotic heart diseases: points to consider. A single-center experience
Authors: Mini Nathalie , Zartner Peter A. , Schneider Martin B. E. 
Published: August 2024

BackgroundOur study focuses on the technique and results of interventional dilation and stenting of the modified Blalock–Taussig shunt (MBTS) performed in our center, providing a comprehensive review of our practice over the past 4 years.Methods42 catheter interventions on MBTS performed on 32 patients between January 2020 and May 2024 included 11 balloon dilatations and 31 stenting procedures. They were analyzed retrospectively. We documented early and late complications, the need for in-shunt reintervention or surgical revision, in-stent thrombotic events, and sudden death.ResultsThe median age, weight, body surface area, and procedural radiation time at the time of the intervention were 100 days (15–870 days), 5 kg (2.6–12 kg), 0.3 m2 (0.19–0.54 m2), and 12 min (7–28 min). Four interventions were performed as an emergency in three patients, of which three were performed with ECMO support. The interventions were semi-emergent for severe hypoxia in 22 patients and elective for mild desaturation in the rest. All interventions were successfully performed without any intervention-related complications or death. Eighty-two percent of the shunt dilations led to saturation improvement. Of the 31 shunt stentings performed in 26 patients, saturation improvement was documented in 97% of the cases. The late complication with stent thrombosis was documented in one patient. In two patients, sudden death and cardiac decompensation with the need for resuscitation were documented.ConclusionMBTS interventions are effective in emergent and semi-emergent situations with severe hypoxia. While serial balloon dilatations improved the luminal diameter in clipped MBTS, most patients needed stenting as a definitive procedure. In some cases, enlargement of the shunt via stenting may be an alternative to the surgical shunt revision to accommodate the shunt size and weight and delay the subsequent operation when there are contraindications. Dual antiplatelet therapy is strongly recommended to reduce thrombotic events, especially in shunts with more than one stent and those that need reinterventions.
Equity-oriented improvement science as organizational resilience: a cross-case comparison of collective thriving
Authors: Anderson Erin , Ringer James 
Published: August 2024

IntroductionThis paper explores organizational resilience by applying the theory of social embeddedness of thriving at work from the positive organizational psychology research through a cross-case comparison of five schools involved in improvement work during the pandemic.MethodsUsing document analysis, observation, and interviews, this study is framed through the literature on workplace stress in schools under pressure and argues that schools with limited resources, such as schools in need of improvement, need to rethink how educators spend time together to improve together if we hope to retain thriving (energetic, motivated, and cognitively engaged) educators.FindingsThe findings focus on collective thriving as demonstrated through the work behaviors embedded in equity-focused improvement in teams (Design Improvement). We explore what collective thriving looks like in two of the five schools, including a discussion of the resources produced from the equity-centered continuous improvement work that supports thriving. Lastly, we provide a comparative analysis of the contextual factors that led to these two schools thriving during this time, as compared to other schools in their cohort.DiscussionThe two schools collectively thrived during the 2020–21 schools year through (a) a systematic approach with common, transparent routines, and (b) inclusive social learning through collective and multiple perspectives.
The association between circulating irisin levels and osteoporosis in women: a systematic review and meta-analysis of observational studies
Authors: Shen Xiaoyang , Chen Yan , Zhang Jing , Yang Meina , Huang Lu , Luo Jiaqi , Xu Liangzhi 
Published: August 2024

ObjectiveThis systematic review and meta-analysis aimed to investigate the association between circulating irisin levels and osteoporosis in women, exploring irisin’s potential role in the pathophysiology and management of osteoporosis.MethodWe searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, WanFang, and VIP databases up to January 2023. The inclusion criteria were observational studies reporting on circulating irisin levels in women. The standardized mean difference (SMD) and correlation coefficients with a 95% confidence interval (CI) were used as the main effect measures under a random-effects model. Heterogeneity was evaluated using the Cochrane Q statistic and the I2 statistics. Subgroup analysis and univariate meta-regression analysis were performed to identify the sources of heterogeneity. The quality of the included study was assessed by the Newcastle-Ottawa Score. The quality of evidence was evaluated using the GRADE system. Publication bias was assessed using Begg’s and Egger’s test, and the trim-and-fill method. Sensitivity analysis was performed to assess the stability of the results.ResultsFifteen studies with a total of 2856 participants met the criteria. The analysis showed significantly lower irisin levels in postmenopausal osteoporotic women compared to non-osteoporotic controls (SMD = -1.66, 95% CI: -2.43 to -0.89, P &lt; 0.0001; I2 = 98%, P &lt; 0.00001) and in postmenopausal individuals with osteoporotic fractures than in non-fractures controls (SMD = -1.25, 95% CI: -2.15 to -0.34, P = 0.007; I2 = 97%, P &lt; 0.00001). Correlation analysis revealed that irisin levels positively correlated with lumbar spine BMD (r = 0.37, 95% CI: 0.18 to 0.54), femoral BMD (r = 0.30, 95% CI: 0.18 to 0.42), and femoral neck BMD (r = 0.31, 95% CI: 0.14 to 0.47) in women. Despite significant heterogeneity, the robustness of the results was supported by using the random effects model and sensitivity analysis.ConclusionThe current evidence suggests that lower irisin levels are significantly associated with osteoporosis and fracture in postmenopausal women, suggesting its utility as a potential biomarker for early detection of osteoporosis and therapeutic target. However, further high-quality prospective research controlling for confounding factors is needed to clarify the relationship between irisin levels and osteoporotic outcomes.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO, identifier CRD42023410264.
Elevated triglyceride-glucose index associated with increased risk of diabetes in non-obese young adults: a longitudinal retrospective cohort study from multiple Asian countries
Authors: Han Jian , Dai Weifeng , Chen Lixia , Huang Zhenhua , Li Chengzhi , Wang Keke 
Published: August 2024

ObjectivePrevious studies have confirmed a positive correlation between the Triglyceride-Glucose (TyG) index and future risk of diabetes. However, evidence of this association in non-obese young populations remains limited. This study aims to investigate the relationship between the TyG index and the future risk of diabetes among non-obese young adults.MethodsThis retrospective cohort study included 113,509 non-obese young adults from China and 9,549 from Japan. The mean age was 35.73 ± 6.38 years, and 56,469 participants (45.89%) were male. The median follow-up duration was 3.38 years. The association between baseline TyG index and risk of diabetes was examined using Cox proportional hazards regression models. Non-linear relationships between the TyG index and risk of diabetes were identified using cubic splines and smoothed curve fitting in the Cox models. Sensitivity and subgroup analyses were also conducted.ResultsAfter adjusting for covariates, the results indicated a positive correlation between the TyG index and risk of diabetes in non-obese young adults (HR=3.57, 95% CI: 2.92-4.36, P&lt;0.0001). A non-linear relationship was observed with an inflection point at 7.3. The HR to the right of this inflection point was 3.70 (95% CI: 3.02-4.52, P&lt;0.0001), while to the left, it was 0.34 (95% CI: 0.06-1.88, P=0.2161). The robustness of our findings was confirmed through a series of sensitivity analyses and subgroup analyses.ConclusionThis study reveals a positive and non-linear association between the TyG index and risk of diabetes among non-obese young adults. Interventions aimed at reducing the TyG index by lowering triglycerides or fasting glucose levels could substantially decrease the future likelihood of developing diabetes in this population.
Predicting intraoperative major blood loss in microsurgery for brain arteriovenous malformations
Authors: Shi Jichun , Xu Shuangxiang , Feng Yu , Wei Wei , Zou Yichun , Xiong Wenping , Zhao Wenyuan , Zhang Tingbao , Peng Hao , Chen Jincao 
Published: August 2024

ObjectiveIntraoperative blood loss poses a great challenge for brain arteriovenous malformation (AVM) microsurgery, although systematic researches are still lacking. This study aimed to identify factors predicting intraoperative major blood loss in brain AVM microsurgery and to investigate its impact on patient outcome. To deal with the fierce bleeding, we introduced a modified hemostatic method, bone-wax (BW) coated bipolar electrocoagulation.MethodsThe authors retrospectively analyzed the clinical data of 131 patients (50/81 in intraoperative major/non-major blood loss cohort) with brain AVMs who underwent microsurgery in our center during the period between January 2018 and April 2023. According to previous studies, major blood loss was defined as blood loss of at least 1,000 mL. The accuracy and objectivity of our grouping methodology were validated by comparing the hemoglobin mass loss, hematocrit loss and factors associated with intraoperative bleeding. Potential clinical and radiological predictors for intraoperative major blood loss were evaluated using a multivariate stepwise logistic regression. And outcomes of patients in the two cohorts were also compared. At last, the performance of BW coated bipolar electrocoagulation in brain AVM microsurgery was illustrated by the case presentation, histological staining and transmission electron microscopy of the coagulated nidus vessels.ResultsHemoglobin mass loss, hematocrit loss and factors associated with intraoperative bleeding were significant different between the two cohorts. five independent factors predicting intraoperative major blood loss were identified: (1) clinical manifestations; (2,3) location and size of the nidus; (4) deep venous drainage; and (5) the number of draining veins. And the intraoperative major blood loss can not only adversely affect the surgical progression, but also predict poor perioperative outcomes for patients. Regarding the application of BW coated bipolar electrocoagulation, we found the novel hemostatic method exerted efficient hemostatic effect and reduced the damage to the vascular structure in brain AVM microsurgery.ConclusionThis study proposed a nomogram for neurosurgeons to predict intraoperative major blood loss in brain AVM microsurgery preoperatively. And intraoperative major blood loss is associated with poor patient outcomes. In addition, BW coated bipolar electrocoagulation, can be applied to control ferocious bleeding during brain AVM microsurgery, which still remains further researches.
Innovative optimization for enhancing Pb2+ biosorption from aqueous solutions using Bacillus subtilis
Authors: El-Sharkawy Reyad M. , Khairy Mohamed , Abbas Mohamed H. H. , Zaki Magdi E. A. , El-Hadary Abdalla E. 
Published: August 2024

IntroductionToxic heavy metal pollution has been considered a major ecosystem pollution source. Unceasing or rare performance of Pb2+ to the surrounding environment causes damage to the kidney, nervous, and liver systems. Microbial remediation has acquired prominence in recent decades due to its high efficiency, environment-friendliness, and cost-effectiveness.MethodsThe lead biosorption by Bacillus subtilis was optimized by two successive paradigms, namely, a definitive screening design (DSD) and an artificial neural network (ANN), to maximize the sorption process.ResultsFive physicochemical variables showed a significant influence (p &lt; 0.05) on the Pb2+ biosorption with optimal levels of pH 6.1, temperature 30°C, glucose 1.5%, yeast extract 1.7%, and MgSO4.7H2O 0.2, resulting in a 96.12% removal rate. The Pb2+ biosorption mechanism using B. subtilis biomass was investigated by performing several analyses before and after Pb2+ biosorption. The maximum Pb2+ biosorption capacity of B. subtilis was 61.8 mg/g at a 0.3 g biosorbent dose, pH 6.0, temperature 30°C, and contact time 60 min. Langmuir’s isotherm and pseudo-second-order model with R2 of 0.991 and 0.999 were suitable for the biosorption data, predicting a monolayer adsorption and chemisorption mechanism, respectively.DiscussionThe outcome of the present research seems to be a first attempt to apply intelligence paradigms in the optimization of low-cost Pb2+ biosorption using B. subtilis biomass, justifying their promising application for enhancing the removal efficiency of heavy metal ions using biosorbents from contaminated aqueous systems.
Association of peak expiratory flow with motoric cognitive risk syndrome among older adults
Authors: Xu Hui , Gong Xiangwen , Cui Kaiwang , Li Xuerui , Chen Long , Lu Yiyi , Liao Yangfang , Liu Jianping 
Published: August 2024

BackgroundThe association between lung function and motoric cognitive risk syndrome (MCR) is unclear. We aimed to explore the association of peak expiratory flow (PEF) with MCR using cross-sectional and longitudinal analyses.MethodsWithin the CHARLS, 5095 participants were included in the cross-sectional analysis, and 4340 MCR-free participants were included in the longitudinal analysis. The PEF was assessed with a lung peak flow meter. MCR was characterized by cognitive complaints and a slow walking speed with normal mobility and without dementia. Logistic regression, Cox regression, and Laplace regression models were employed for data analysis.ResultsIn this cross-sectional study, logistic regression analyses revealed that continuous PEF was associated with MCR (odds ratio [OR], 0.998; 95% confidence interval [CI], 0.998, 0.999), and the ORs (95% CIs) of MCR prevalence were 0.857 (0.693, 1.061) for the middle tertile and 0.665 (0.524, 0.845) for the highest tertile compared to the lowest tertile. In a longitudinal cohort study, continuous PEF was dose-dependently associated with the risk of MCR. Compared with those in the lowest tertile of PEF, the hazard ratios (95% CIs) of incident MCR were 0.827 (0.661, 1,036) for the middle tertile and 0.576 (0.432, 0.767) for the highest tertile. Furthermore, compared with the lowest tertile, the highest tertile was associated with a delayed onset time of MCR of 0.484 (95% CI: 0.151, 0.817) years.ConclusionA higher PEF was related to a lower prevalence of MCR and a lower risk for MCR, and a higher PEF also prolonged the onset time of MCR.
Donepezil as a new therapeutic potential in KCNQ2- and KCNQ3-related autism
Authors: Nissenkorn Andreea , Bar Lior , Ben-Bassat Ariel , Rothstein Lynn , Abdelrahim Hoda , Sokol Riki , Gabis Lidia V. , Attali Bernard 
Published: August 2024

IntroductionThe KCNQ2/KCNQ3 genes encode the voltage-gated K channel underlying the neuronal M-current, regulating neuronal excitability. Loss-of-function (LoF) variants cause neonatal epilepsy, treatable with the M-current-opener retigabine, which is no longer marketed due to side effects. Gain-of-function (GoF) variants cause developmental encephalopathy and autism that could be amenable to M-current, but such therapies are not clinically available. In this translational project, we investigated whether donepezil, a cholinergic drug used in Alzheimer’s, suppresses M currents in vitro and improves cognitive symptoms in patients with GoF variants.Methods(1) The effect of 1 μM donepezil on the amplitude of the M-current was measured in excitatory and inhibitory neurons of mouse primary cultured hippocampal cells. M-current was measured using the standard deactivation protocol (holding at 0 mV and deactivation at −60 mV) in the voltage-clamp configuration of the whole-cell patch clamp technique. The impact of donepezil was also examined on the spontaneous firing activity of hippocampal neurons in the current-clamp configuration. (2) Four children with autism, aged 2.5–8 years, with the following GoF variants were enrolled: KCNQ2 (p. Arg144Gln) and KCNQ 3 (p.Arg227Gln, p.Arg230Cys). Patients were treated off-label with donepezil 2.5–5 mg/d for 12 months and assessed with: clinical Global Impression of Change (CGI-c), Childhood Autism Rating Scale 2 (CARS-2), Adaptive Behavior Assessment System-II (ABAS-II), and Child Development Inventory (CDI).Results(1) Application of donepezil for at least 6 min produced a significant inhibition of the M-current with an IC50 of 0.4 μM. At 1 μM, donepezil reduced by 67% the M-current density of excitatory neurons (2.4 ± 0.46 vs. 0.89 ± 0.15 pA/pF, p &lt; 0.05*). In inhibitory neurons, application of 1 μM donepezil produced a lesser inhibition of 59% of the M-current density (1.39 ± 0.43 vs. 0.57 ± 0.21, p &gt; 0.05). Donepezil (1 μM) potently increased by 2.6-fold the spontaneous firing frequency, which was prevented by the muscarinic receptor antagonist atropine (10 μM). (2) The CARS-2 decreased by 3.8 ± 4.9 points (p &gt; 0.05), but in two patients with KCNQ3 variants, the improvement was over the 4.5 clinically relevant threshold. The global clinical change was also clinically significant in these patients (CGI-c = 1). The CDI increased by 65% (p &lt; 0.05*), while the ABAS-II remained unchanged.DiscussionDonepezil should be repurposed as a novel alternative treatment for GoF variants in KCNQ2/KCNQ3 encephalopathy.