bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Models for End-stage Liver Disease as prognostic assessment and risk stratification tools in sepsis: a study based on MIMIC-IV database
Authors: Shen Tuo , Lv Xingping , Shen Yezhou , Zhou Wei , Liu Xiaobin , Ma Qimin , Ma Shaolin , Sheng Shuyue , Zhu Feng 
Published: July 2024

Abstract

Background
The Model for End-stage Liver Disease (MELD) and its modifications have been used to predict mortality and stratify risk for a variety of non-hepatic diseases with good stability. The purpose of this study was to evaluate the value of the MELD and its modifications in evaluating the prognosis of patients with sepsis.
Methods
This study is based on the MIMIC-IV database. A total of 15,882 patients were included. The correlation between the three models and the mortality rate of patients with sepsis was evaluated, and the optimal cut-off values were calculated. Then, further subgroup analysis was performed to seek better stratification criteria. Finally, stratification was performed according to comorbidities to observe the predictive value of the MELDs in patients with different comorbidities.
Results
MELD, MELD including Na (MELD-Na) and MELD excluding INR (MELD-XI) were all independent predictors of in-hospital mortality, and the optimal cut-off values were 22.5, 22.5 and 19.5, respectively. When grouped by cut-off values, high score groups were significantly associated with increased in-hospital mortality. Further subgroup analysis based on lactate revealed that patients with high MELD score and lactate level (> 4 mmol/L) had higher in-hospital mortality.
Conclusions
The MELDs can effectively predict the in-hospital mortality of sepsis patients and stratify their risk. The MELDs combined with lactate can provide convenient risk stratification for sepsis patients, thus guiding clinicians to better intervene in sepsis patients at an early stage.
Novel mutation in Patients with Microcephalic Osteodysplastic Primordial Dwarfism Type II (MOPD II)
Authors: Gharehdaghi Elika Esmaeilzadeh , Zakeri Sina , Tale Ali , Klashami Zeynab Nickhah , Sedghi Maryam , Amoli Mahsa M. 
Published: July 2024

Abstract

Background
A rare type of autosomal recessive skeletal disorder known as microcephalic osteodysplastic primordial dwarfism (MOPD) type II causes a wide range of clinical abnormalities, including skeletal dysplasia, microcephaly, abnormal skin pigmentation, Insulin resistance, typical facial features and severe tooth deformities. Owing to the diverse nature of MOPD disorders and common clinical characteristics of the Primordial dwarfism (PD) subtypes, mutation analysis is deemed essential for the precise diagnosis and validation of MOPD II. Here, Solo whole-exome sequencing (WES) and GAP-PCR were utilized to find relevant genetic variant(s) in three suspected MOPD patients.
Method
We assessed clinical characteristics of three Iranian patients with hallmarks of MOPD. There were two girls, ages 3 and 4, and a 2-year-old boy. All patients were the results of consanguineous marriages and referred to us from different provinces of Iran. WES was performed and the resulted variants were prioritized according to the standard filtration. In the next step, Sanger sequencing confirmation was conducted for validation of the derived variants by WES in the patients and their parents. Finally, we set up a GAP-PCR, based on conflicting results between WES and Sanger sequencing in one of the patients.
Results
Our results revealed a novel homozygous deletion (384bp) harboring exon 19 of PCNT in a 2-year-old boy. Additionally, we found a nonsense homozygous variant in PCNT gene (c.2812 C > T, p.Gln 938*) in two other patients. This pathogenic variant was clinically reported previously.
Conclusion
Reporting a novel deletion in PCNT gene leads to improvement in genetic testing services, including PND and pre-implantation genetic diagnosis (PGD) for MOPDII.
Oncometabolic Surgery: The Metabolic Effects and Effectiveness of the Different Reconstruction Methods used in Gastric Cancer Surgery. A Systematic Review and Meta-Analysis
Authors: Costa Maria Pinho , Santos-Sousa Hugo , Oliveira Carolina Rodrigues , Amorim-Cruz Filipe , Bouça Raquel , Barbosa Elisabete , Carneiro Silvestre , Sousa-Pinto Bernardo 
Published: July 2024

Abstract

Background
Gastric Cancer (GC) is the fifth most common cancer worldwide. Early stages of GC began being detected, giving rise to a new concern, Quality of Life. This study aimed to systematically assess the effects of different GC reconstruction techniques on postoperative type 2 diabetes mellitus (T2DM), hypertension (HBP), and body mass index (BMI) reduction rate and to provide an overview of recent research on oncometabolic surgery (OS).
Methods
We performed a systematic review and meta-analysis by searching three databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a meta-analysis of risk ratios and mean differences to estimate the impact of duodenal bypass, Roux-en-Y reconstruction, and residual stomach on T2DM, HBP, and BMI reduction rate. Heterogeneity was assessed using the I2 statistics.
Results
At the end of the follow-up, the duodenal bypass group compared to Billroth I had a significantly higher postoperative remission of T2DM and HBP, with a relative risk (RR) of 1.43 (95%confidence interval (95%CI)[1.27; 1.62]) and 1.3 (95%CI[1.00; 1.69]), respectively. Compared with the Billroth II group, Roux-en-Y reconstruction had significantly greater T2DM remission after gastrectomy (RR = 1.19; 95%CI[1.08; 1.31]), while HBP showed no significant differences. Regarding the improvement of HBP, total gastrectomy was significantly superior to subtotal gastrectomy (95%CI[1.01; 2.64]). A trend towards Roux-en-Y Esophagojejunostomy as the best option for T2DM remission was observed (95%CI[0.98; 2.77]; p = 0.06).
Discussion
Gastrectomy with Roux-en-Y reconstruction appears to be the most effective treatment for T2DM remission. Further research is needed to assess the impact of OS on metabolic diseases.
Feasibility and safety evaluation of remimazolam tosylate in geriatric patients during bronchoscopy ： A single-centre randomized controlled trial
Authors: Huang Yaqin , Yu Yang , Lei Weiping , Sun Jianliang 
Published: July 2024

Abstract

Background: Fiberoptic bronchoscopy has developed rapidly as a routine test, especially it played an important role during the COVID-19. The suitable options for moderate sedation medications is necessary. The present study aimed to evaluate the feasibility and safety of remimazolam tosylate in geriatric patients undergoing fiberoptic bronchoscopy.
Methods This study is a single-center randomized controlled trial. A total of 105 geriatric patients undergoing fiberoptic bronchoscopy were divided into 3 groups (n=35) randomly. Group A (remimazolam group); Group B (midazolam group); in Group C (control group). Record the all patients’ vital signs and the rate of adverse events.
Results A total of 105 patients were enrolled and 97 actual patients (34 patients in group A, 30 patients in group B, and 33 patients in group C) were analyzed in the end. Compared with group C, the vital sign in group A and B are more stable at T1, T2, T3, and T4 (P<0.05).The frequency of hypertension in group A and group B was significantly lower than that in group C(P<0.05). Compared with group B, the onset time and recovery time of group A were shortened (both P<0.05). The satisfaction of patients and operators in group A and group B was higher than that in group C (P<0.05).
Conclusions In the sduty we found that intravenous injection of remazolam tosylate 0.2 mg/kg, fentanyl 0.5 μg/kg for sedation, and additional anesthesia with fentanyl 25 μg every 5 to 10 minutes if necessary is effictive and safe for geriatricpatients during fiberoptic bronchoscopy .
Trial registration:This study was registered with the Chinese clinical trial registry (ChiCTR2100047459),the Registration Date is 2021/06/19.
Assessing the practice of Total Neoadjuvant Therapy for rectal cancer: an online survey among Radiation Oncology Departments in Germany and German-Speaking Regions of Austria and Switzerland
Authors: Knippen Stefan , Hildebrandt Guido , Putz Florian , Gossé Lasse Leon , Ritz Jörg-Peter , Duma Marciana-Nona 
Published: July 2024

Abstract

Background
Total neoadjuvant therapy (TNT) of rectal cancer improves rates of pathological complete remission and progression-free survival. With improved clinical response rates, interest grew in a non-operative approach/Watch and Wait (WaW) for this disease. In 2020, the working groups of ACO/AIO/ARO published a consensus statement on the use of TNT, including a non-operative approach. However, the best combination scheme remains unclear. Despite the increasing use of TNT, there is a lack of comprehensive data on its current implementation and practices. To address this knowledge gap, a multicenter survey was conducted to capture the use of TNT protocols in German-speaking radiotherapy departments.
Methods
At the beginning of 2023, a GDPR-compliant online survey was conducted in Germany, Austria, and German speaking Switzerland. The questionnaire comprised 43 questions covering various aspects of TNT, including chemotherapy and WaW concepts.
Results
Most respondents (98.4%) confirmed awareness of the consensus on TNT for rectal cancer. Institutions treated an average of 30.22 rectal cancer patients annually. Most respondents (76.2%) reported treating over 80% of patients neoadjuvantly. Regarding TNT, 33.3% treated 21-50% with such a protocol. No significant association was found between the institution type and TNT application.
In 62/63 cases, tumor board discussion was standard before offering TNT. VMAT was the predominant technique (82.5%). For rectal cancer dosing, the 50/50.4Gy scheme was most common, followed by 45Gy with a boost and the 5x5Gy scheme. Dosing schemes for TNT varied slightly, with more participants reporting the use of 5x5Gy compared to radiation therapy for rectal cancer in general. CBCT was the primary IGRT method (88.9%). Larger hospitals typically administered chemotherapy themselves, while private practices collaborated with medical oncologists (p<0.0001). The most common concurrent chemotherapy drugs were 5-Fluorouracil/Capecitabine (64.4%) and Oxaliplatin (37.3%). A WaW strategy was reported to be institutional implemented by 63.8%. The timing of offering WaW was split, with 50% offering it after radiochemotherapy and 47% during the informed consent talk. For planned WaW 62% prefer normofractionated TNT.
Conclusion
TNT appears to be widely implemented in the German-speaking radio-oncological community, regardless of the type of institution. Image-guided therapy, multidisciplinary team decisions, and internal guidelines play an important role. TNT seems to have already altered treatment protocols for rectal cancer towards an organ-preserving approach in selected cases. In these WaW cases, normofractionation appears to be preferred over hypofractionation.
Experimental Temperature Monitoring of ISRU Moon Bricks with Embedded FBG Sensors
Authors: Ferro Carlo Giovanni , Aimasso Alessandro , Bertone Matteo , Torre Roberto , Pietro Gabriele Di , Vedova Matteo Davide Lorenzo Dalla 
Published: July 2024

Abstract

The construction of lunar infrastructure requires innovative materials and technologies to ensure sustainability and safety in the harsh lunar environment. This paper presents the development of "moon bricks" fabricated using in situ lunar regolith and a minimal binder, integrated with Fiber Bragg Grating (FBG) sensors. These sensors transform the bricks into smart components capable of monitoring temperature or stress induced deformation during both manufacturing phase and operational lifespan. The incorporation of FBG sensors facilitates real-time, on-condition maintenance, thereby enhancing the safety and reliability of lunar outposts and associated infrastructures.This study focuses on the experimental validation of temperature monitoring within smart bricks under low-temperature conditions in a climatic chamber. The results demonstrate good agreement for static measurements, providing a preliminary validation for the instrumentation. This research marks a significant step towards realizing sensorized building blocks with local resources, thus paving the way for advanced, intelligent lunar construction, ensuring long-term structural integrity and operational safety.
Microcephaly with or without chorioretinopathy, lymphedema, or mental retardation (MCLMR)- The new lacunae: A case report
Authors: Silva Nuno Álvaro Ferreira , Silva Renato Emílio Santos , Magalhães António Augusto 
Published: July 2024

Abstract

Background: Microcephaly with or without chorioretinopathy, lymphedema, or mental retardation is a rare autosomal dominant disease caused by mutations in KIF11 which disrupt EG5 protein function, impacting the development and maintenance of retinal and lymphatic structures due to its expression in the retinal photoreceptor cilia.
The primary ocular finding in MCLMR is chorioretinopathy. Additional features can include microphthalmia, angle-closure glaucoma, persistent hyperplastic primary vitreous, cataract, pseudo-coloboma, persistent hyaloid artery, and myopic or hypermetropic astigmatism.
The appearance of the chorioretinal lesions as white to pinkish, round, non-elevated atrophic areas devoid of blood vessels resembles the lacunae in Aicardy syndrome. Due to the lack of systematic description of the lesions and significant phenotypical variability, there is an impending need for a detailed report of each case.
Case presentation: A child with microcephaly detected in the third trimester of gestation began her following in the ophthalmology department due to a non-visually significant cataract. Shortly after, she developed nystagmus and large-angle alternating esotropia with cross-fixation. Her fundus initially showed a pallid optic disc and pigmentary changes, developing thereafter retinal lacunae and a retinal fold. Her differential diagnosis accompanied the dynamic changes in her fundus, which included congenital infections, Leber´s congenital and Aicardy syndrome. At 19 months old, genetic testing identified a heterozygous mutation (c.1159C>T, p.Arg387*) in the KIF11 gene. The patient underwent bilateral medial rectus muscle recession surgery at 2 years old for persistent esotropia, with significant improvement. Refraction revealed a hyperopic astigmatism in both eyes (+0.25 -2.50x180 OD and +0.75 -2.00x170 OS). She continues to require right eye patching for 2 hours daily.
Conclusions: This case report expands the phenotypic spectrum of MCLMR by demonstrating a unique combination of retinal features which sheds new light on differential diagnosis from Aicardy syndrome. Our findings emphasize the significant phenotypic variability associated with MCLMR, particularly regarding ocular involvement. This underscores the importance of detailed clinical evaluation and comprehensive reporting of cases to improve our understanding of the disease spectrum and genotype-phenotype correlations.
Mortality prediction in Mexican older COVID-19 patients using the Charlson comorbidity index: a case- control study from a reconverted COVID-19 hospital
Authors: Camacho-Moll María Elena , Medina-Gauna César Eduardo , Garza Brenda Ludmila Rodríguez-de la , Dávila-Valero Julio Cesar , de León Mario Bermúdez - 
Published: July 2024

Abstract

Objectives: We aim to describe the predisposing factors for COVID-19 pneumonia and in-hospital death as an outcome of COVID-19 in a Mexican aged cohort of northeast Mexico. The use of CCI to predict mortality in this population will also be investigated.
Study design: A case-control study was performed in a total of 356 records from patients of 60 years old and above. Records were collected from November 2019 to August 2022 from a reconverted COVID-19 hospital located in Nuevo León, Mexico, from which 332 records were included in the study.
Main outcome measures: Stepwise multivariate logistical regression models were used to determine COVID-19 pneumonia or outcome odds ratio (OR) and 95% Confidence Interval (CI).
Results: Age, dyspnea, sO2/FiO2, and body mass index (BMI) were associated with COVID-19 pneumonia whereas respiratory frequency, BMI, sO2/FiO2 (Saturation of oxygen/Fraction of inspired oxygen ratio) and CCI were associated with death due to COVID-19. An increased hazard ratio of mortality of 2.1 (p < 0.001) was observed in patients with a CCI below 3.
Conclusions: CCI revealed to be not appropriate to predict mortality in geriatric Mexican population, a deeper analysis is required when using CCI in such population.
The reconstruction of fingertip injury with partial defect of nailbed and skin by hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein transplantation：a retropective study
Authors: Zheng Peng , Wang Lina , Zhou Yimin , Lao Kecheng , Li Xiuzhong , Fan Xiao 
Published: July 2024

Abstract

Introduction:How to reconstruct fingertip injury with partial defect of nailbed and skin is a clinical problem. Our team design the hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein to reconstruct fingertip injury with partial defect of nailbed and skin for a long time. Thus, we perform the retrospective study to evaluate the effects of this technique on fingertip injury with partial defect of nailbed and skin.
Materials and methods:A retrospective analysis was performed on 40 patients with fingertip injury with partial defect of nailbed and skin admitted to our hospital from January 2016 to January 2020 who were treated by the hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein. During the follow-up, we recorded the operation time, intraoperative blood loss, the size of the transplanted flap, complications, the survival rate of the transplanted flap, total nail growth time, Semmes-Weinstein evaluating tactile sensation, two-point discrimination testing (TPD) and observed the appearance of reconstructed fingertip.
Results:The operation time was (3.62±0.47) hours, the intraoperative blood loss was (31.77±4.54) ml, the size of transplanted flap was 12 mm × 7 mm to 19 mm × 10 mm, the survival rate of the transplanted flap was 100%. During the (26.82±4.47) months follow-up, the total nail growth time was (9.14±1.78) months and there is no complications. The average tactile sensation evaluated by the Semmes-Weinstein test and the average TPD of reconstructed fingertip was (0.31±0.15) g and (7.26±1.26) mm separately. The reconstructed fingertips had beautiful appearance and walking function of foots providing flaps was not influenced.
Conclusions:The hallux toenail flap pedicled with the end of hallux digital artery and toe pulp vein transplantation is an effective method to reconstruct fingertip injury with partial defect of nailbed and skin with a beautiful appearance and excellent function.
Type of study/level of evidence Therapeutic IV.
Feasibility discrimination of anchor-relieving robot anchor-relieving operation based on anchor cable state image recognition
Authors: Liu Zhixiang , Li Zhenyu , Xie Chunxue 
Published: July 2024

Abstract

Considering that the dispersion and bending state of the anchor cable will affect the breaking operation of the anchor cable cutting tool to the anchor cable, this paper studies the anchor cable state recognition method based on image recognition. Firstly, the YOLOv8 algorithm is used to distinguish the dispersion state of the anchor cable, and then the semantic segmentation and image processing methods are used to identify the bending state of the anchor cable.The average detection accuracy of the anchor cable dispersion state recognition method based on YOLOv8 algorithm for the five types of targets of intact anchor cable, slight dispersion and complete dispersion, and locks and trays reached 89.4%.The detection accuracy of the three states of intact anchor cable, slight dispersion and complete dispersion reached more than 90%, indicating that the detection model has a good recognition effect of anchor cable dispersion state.The bending state discrimination method of anchor cable based on semantic segmentation and image processing method can realize the bending angle discrimination of intact anchor cable, overall bending and partial bending anchor cable.Firstly, the YOLOv8 target detection model is used to detect the target position of the anchor cable and the lock, and then the target is framed.Then the image in the target box is cut off, and the target segmentation of the lock and anchor cable is performed by the PSPnet semantic segmentation model.Then, the segmented mask map is transformed into an hsv color gamut, and then the lock and anchor cable are screened out by red threshold and green threshold respectively.Then, the contours of the lock and the anchor cable are detected respectively, and the minimum circumscribed rectangle of the contour is calculated.Finally, the midline of the minimum outer rectangular long side of the lock and the anchor cable is calculated respectively, and the angle between the two midlines is calculated, that is, the bending angle of the anchor cable.When the camera is perpendicular to the anchor plane, the calculated angle error is less than 2°.Through the identification of the dispersion and bending state of the anchor cable, it can be judged whether the anchor withdrawal device can complete the breaking operation of the anchor cable.
Failure Of Gallium-68 Citrate Scan To Detect Large, Enhancing Central Nervous System Tuberculomas: A Cautionary Tale
Authors: Kumar Selwyn Selva , Noronha Adrian Keith , Hephzibah Julie , Vanjare Harshad Arvind , Manesh Abi 
Published: July 2024

Abstract

Background Gallium-68 citrate is an emerging diagnostic tool for the evaluation of infections. Its performance in brain infections, specifically central nervous system (CNS) tuberculosis, is unknown. The available diagnostics for CNS tuberculosis are imprecise.Case Presentation We report a patient with large, active, enhancing, microbiologically confirmed tuberculomas in the right frontal lobe who underwent Gallium-68 PET CT. It did not show any tracer uptake in the tuberculous lesions.Conclusions We report caution in the use of Gallium-68 PET CT for CNS TB, especially with concomitant steroid use.