bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic and prognostic value of an ejection fraction adjusted for myocardial remodeling
Authors: Chan Wei Xuan , Kaura Amit , Mulla Abdulrahim , Papadimitriou Dimitri , Glampson Benjamin , Mayer Erik , Shah Anoop S. V. , Mayet Jamil , Yap Choon Hwai 
Published: May 2024

IntroductionEjection fraction (EF) is widely used to evaluate heart function during heart failure (HF) due to its simplicity compared but it may misrepresent cardiac function during ventricular hypertrophy, especially in heart failure with preserved EF (HFpEF). To resolve this shortcoming, we evaluate a correction factor to EF, which is equivalent to computing EF at the mid-wall layer (without the need for mid-layer identification) rather than at the endocardial surface, and thus better complements other complex metrics.MethodThe retrospective cohort data was studied, consisting of 2,752 individuals (56.5% male, age 69.3 ± 16.4 years) admitted with a request of a troponin test and undergoing echocardiography as part of their clinical assessment across three centres. Cox-proportional regression models were constructed to compare the adjusted EF (EFa) to EF in evaluating risk of heart failure admissions.ResultComparing HFpEF patients to non-HF cases, there was no significant difference in EF (62.3 ± 7.6% vs. 64.2 ± 6.2%, p = 0.79), but there was a significant difference in EFa (56.6 ± 6.4% vs. 61.8 ± 9.9%, p = 0.0007). Both low EF and low EFa were associated with a high HF readmission risk. However, in the cohort with a normal EF (EF ≥ 50%), models using EFa were significantly more associative with HF readmissions within 3 years, where the leave one out cross validation ROC analysis showed a 18.6% reduction in errors, and Net Classification Index (NRI) analysis showed that risk increment classification of events increased by 12.2%, while risk decrement classification of non-events decreased by 16.6%.ConclusionEFa is associated with HF readmission in patients with a normal EF.
Prognostic value of elevated lipoprotein (a) in patients with acute coronary syndromes: a systematic review and meta-analysis
Authors: Wang Guochun , Xia Maoyin , Liang Cai , Pu Feng , Liu Sitai , Jia Dongxia 
Published: May 2024

BackgroundElevated lipoprotein (a) level was recognized as an independent risk factor for significant adverse cardiovascular events in acute coronary syndrome (ACS) patients. Despite this recognition, the consensus in the literature regarding the prognostic significance of elevated lipoprotein (a) in ACS was also limited. Consequently, we conducted a thorough systematic review and meta-analysis to evaluate the prognostic relevance of elevated lipoprotein (a) level in individuals diagnosed with ACS.Methods and resultsA thorough literature review was conducted by systematically searching PubMed, Embase, and Cochrane databases until September 2023. This review specifically examined cohort studies exploring the prognostic implications of elevated lipoprotein (a) level in relation to major adverse cardiovascular events (MACE), including death, stroke, non-fatal myocardial infarction (MI), and coronary revascularization, in patients with ACS. The meta-analysis utilized aggregated multivariable hazard ratios (HR) and their respective 95% confidence intervals (CI) to evaluate prognostic implications between high and low lipoprotein (a) levels [the cut-off of high lipoprotein (a) level varies from 12.5 to 60 mg/dl]. Among 18,168 patients in the identified studies, elevated lipoprotein (a) was independently associated with increased MACE risk (HR 1.26; 95% CI: 1.17–1.35, P &lt; 0.00001) and all-cause mortality (HR 1.36; 95% CI: 1.05–1.76, P = 0.02) in ACS patients. In summary, elevated lipoprotein (a) levels independently forecast MACE and all-cause mortality in ACS patients. Assessing lipoprotein (a) levels appears promising for risk stratification in ACS, offering valuable insights for tailoring secondary prevention strategies.Systematic Review RegistrationPROSPERO (CRD42023476543).
Workplace violence and its associated factors among nurses working in university teaching hospitals in Southern Ethiopia: a mixed approach
Authors: Anose Bereket Hegeno , Roba Adem Esmael , Gemechu Zegeye Regassa , Heliso Asnakech Zekiwos , Negassa Segni Begna , Ashamo Teshale Belayneh 
Published: May 2024

BackgroundWorkplace violence among nurses has increased dramatically in the last decade. Still, mitigation techniques have not been well explored; many studies used a quantitative research approach, and there is a knowledge gap on the current status of workplace violence. The aim of this study was to assess the prevalence of workplace violence and associated factors among nurses working at university teaching hospitals in the South Region of Ethiopia.MethodsAn institution-based cross-sectional study was conducted using a mixed approach. A random sample of 400 nurses was interviewed for the quantitative analysis, and nine key informants were interviewed for the qualitative analysis. Descriptive statistics were used to summarize the data. A logistic regression model was used to analyze the data. An adjusted odds ratio with a 95% confidence interval and a corresponding p-value &lt; 0.05 was used to determine the association between variables. The qualitative data were transcribed and translated, then themes were created, followed by thematic analysis using Open Code version 4.02.ResultsThe prevalence of workplace violence was 61.3% within the last 12 months. Nurses working in emergency departments [AOR = 4.27, 95% CI: 2.21, 8.24], nurses working in inpatient departments [AOR = 2.58, 95% CI: 1.40, 4.72], the number of nurses in the same working unit from one to five [AOR = 2.36, 95% CI: 1.21, 4.63], and six to ten staff nurses [AOR = 2.12, 95% CI: 1.17, 3.85], nurses routinely making direct physical contact [AOR = 2.77, 95% CI: 1.55, 4.95], and nurses' work time between 6 pm and 7 am [AOR = 1.68, 95% CI: 1.00, 2.82] were factors significantly associated with workplace violence.ConclusionIn this study, the prevalence of workplace violence against nurses was high. We identified factors significantly associated with workplace violence among nurses. Interventions should focus on early risk identification, the management of violent incidents, and the establishment of violence protection strategies that consider contextual factors to reduce workplace violence.
The impact of serum uric acid on psoriasis: NHANES 2005–2014 and Mendelian randomization
Authors: Hu Minghui , Wang Yangyang , Xu Wenwu , Bai Juan , Tang Xingming 
Published: May 2024

Background:Psoriasis is a chronic systemic inflammatory disease, and hyperuricemia is a common comorbidity in patients with psoriasis. However, the exact relationship between uric acid levels and psoriasis remains unclear. This study aimed to explore the association between uric acid levels and psoriasis.Methods:Observational study participant data (≥16 years, n = 23,489) from NHANES 2003–2014. We conducted analyses using a weighted multiple logistic regression model. Genetic data sets for uric acid levels and psoriasis were obtained from the IEU database. We selected genetically independent loci closely associated with serum uric acid levels as instrumental variables and performed Mendelian randomization analyses using five complementary methods: inverse variance weighting (IVW), MR-Egger, weighted median, simple mode, and weighted mode.Results:After adjusting for other covariates, the results revealed no significant association between serum uric acid levels and psoriasis (b = 0.999, 95% CI: 0.998, 1.001, p = 0.275). Subgroup analyses stratified by gender and ethnicity showed no significant association between sUA and psoriasis in any of the subgroups. Furthermore, the MR analysis involved the selection of 227 SNPs that were associated with both sUA and psoriasis. IVW results demonstrated no causal relationship between sUA and psoriasis (OR = 0.282, 95% CI: -0.094–0.657, p = 0.142).Conclusion:Our study suggests that uric acid levels are not significantly causally related to psoriasis. This finding provides valuable insights for the treatment and prevention of psoriasis, indicating that merely reducing uric acid levels may not be an effective strategy to reduce the risk of psoriasis onset.
Identification of key genes affecting ventilator-induced diaphragmatic dysfunction in diabetic mice
Authors: Xing Rongchun , Yu Haibo , Yu Jiangtao , Zeng Rong , Xiang Zhijun , Ma Haoli , Li Gang , Zhao Yan 
Published: May 2024

BackgroundMechanical ventilation (MV) is often required in critically ill patients. However, prolonged mechanical ventilation can lead to Ventilator-induced diaphragmatic dysfunction (VIDD), resulting in difficulty in extubation after tracheal intubation, prolonged ICU stay, and increased mortality. At present, the incidence of diabetes is high in the world, and the prognosis of diabetic patients with mechanical ventilation is generally poor. Therefore, the role of diabetes in the development of VIDD needs to be discovered.MethodsMV modeling was performed on C57 mice and DB mice, and the control group was set up in each group. After 12 h of mechanical ventilation, the muscle strength of the diaphragm was measured, and the muscle fiber immunofluorescence staining was used to verify the successful establishment of the MV model. RNA sequencing (RNA-seq) method was used to detect mRNA expression levels of the diaphragms of each group, and then differential expressed gene analysis, Heatmap analysis, WGCNA analysis, Venn analysis, GO and KEGG enrichment analysis were performed. qRT-PCR was used to verify the expression of the selected mRNAs.ResultsOur results showed that, compared with C57 control mice, the muscle strength and muscle fiber cross-sectional area of mice after mechanical ventilation decreased, and DB mice showed more obvious in this respect. RNA-seq showed that these differential expressed (DE) mRNAs were mainly related to genes such as extracellular matrix, collagen, elastic fiber and Fbxo32. GO and KEGG enrichment analysis showed that the signaling pathways associated with diabetes were mainly as follows: extracellular matrix (ECM), protein digestion and absorption, PI3K-Akt signaling pathway, calcium signaling pathway, MAPK signaling pathway and AGE-RAGE signaling pathway in diabetic complications, etc. ECM has the closest relationship with VIDD in diabetic mice. The key genes determined by WGCNA and Venn analysis were validated by quantitative real-time polymerase chain reaction (qRT-PCR), which exhibited trends similar to those observed by RNA-seq.ConclusionVIDD can be aggravated in diabetic environment. This study provides new evidence for mRNA changes after mechanical ventilation in diabetic mice, suggesting that ECM and collagen may play an important role in the pathophysiological mechanism and progression of VIDD in diabetic mice, and provides some clues for the research, diagnosis, and treatment of VIDD in diabetic context.
BCSLinker: automatic method for constructing a knowledge graph of venous thromboembolism based on joint learning
Authors: Cai Fenghua , He Jianfeng , Liu Yunchuan , Zhang Hongjiang 
Published: May 2024

BackgroundVenous thromboembolism (VTE) is characterized by high morbidity, mortality, and complex treatment. A VTE knowledge graph (VTEKG) can effectively integrate VTE-related medical knowledge and offer an intuitive description and analysis of the relations between medical entities. However, current methods for constructing knowledge graphs typically suffer from error propagation and redundant information.MethodsIn this study, we propose a deep learning-based joint extraction model, Biaffine Common-Sequence Self-Attention Linker (BCSLinker), for Chinese electronic medical records to address the issues mentioned above, which often occur when constructing a VTEKG. First, the Biaffine Common-Sequence Self-Attention (BCsSa) module is employed to create global matrices and extract entities and relations simultaneously, mitigating error propagation. Second, the multi-label cross-entropy loss is utilized to diminish the impact of redundant information and enhance information extraction.ResultsWe used the electronic medical record data of VTE patients from a tertiary hospital, achieving an F1 score of 86.9% on BCSLinker. It outperforms the other joint entity and relation extraction models discussed in this study. In addition, we developed a question-answering system based on the VTEKG as a structured data source.ConclusionThis study has constructed a more accurate and comprehensive VTEKG that can provide reference for diagnosing, evaluating, and treating VTE as well as supporting patient self-care, which is of considerable clinical value.
Pulmonary alveolar microlithiasis combined with gastric mucosal calcification: a case report
Authors: Li Wen-Zhuo , Liu Shuo , Luo Ji-Li , Xia Jing 
Published: May 2024

BackgroundPulmonary alveolar microlithiasis (PAM) is a rare disease whose clinical and imaging manifestations are non-specific, characterized by the deposition of microliths, which primarily consist of calcium and phosphorus, within the alveoli. In the cases of PAM, patients combined with calcification of other organs such as gastric mucosal calcification are less common.Case presentationA 59-year-old woman was admitted to our hospital due to cough producing white, foamy sputum, accompanied by dyspnea and fever for 20 days. The CT scan showed diffuse ground-glass opacities and calcification of the gastric mucosa. Lung tissue biopsy revealed the presence of calcification and granulomatous foreign bodies in the interstitium and alveolar cavity. In the later stages, she developed painful skin petechiae. For this patient, the diagnosis of PAM, gastric mucosal calcification, and purpura fulminans was made. However, the genetic test results hinted that the patient and her son had a heterozygous mutation in the FBN1 gene, but her daughter's genetic test results were normal. Although the patient received anti-infection treatment, steroids, and oxygen therapy, her condition did not improve.ConclusionWe reported a rare case of PAM combined with calcification of other organs and purpura fulminans. Treatment of steroids did not show any benefit. The causative mechanism and effective treatment of this disease remain unclear. More treatments need to be explored.
The distribution and antibiotic-resistant characteristics and risk factors of pathogens associated with clinical biliary tract infection in humans
Authors: Chen Shayan , Lai Wenbin , Song Xuejing , Lu Jiongtang , Liang Jianxin , Ouyang Hao , Zheng Weihua , Chen Jianjun , Yin Zhenggang , Li Huimin , Zhou Yong 
Published: May 2024

IntroductionBiliary Infection in patients is a common and important phenomenon resulting in severe complications and high morbidity, while the distributions and drug resistance profiles of biliary bacteria and related risk factors are dynamic. This study explored the characteristics of and risk factors for biliary infection to promote the rational use of antibiotics in clinically.MethodsBacterial identification and drug susceptibility testing were completed using the Vitek 2 Compact analysis system. The distribution and antibiotic-resistant characteristics of 3,490 strains of biliary bacteria in patients at Nankai Hospital from 2019 to 2021 were analyzed using Whonet 5.6 and SPSS 26.0 software. We then retrospectively analyzed the clinical data and risk factors associated with 2,340 strains of Gram-negative bacilli, which were divided into multidrug-resistant bacteria (1,508 cases) and non-multidrug-resistant bacteria (832 cases) by a multivariate Cox regression model.Results and discussionA total of 3,490 pathogenic bacterial strains were isolated from bile samples, including 2,340 (67.05%) Gram-negative strains, 1,029 (29.48%) Gram-positive strains, and 109 (4.56%) fungal strains. The top five pathogenic bacteria were Escherichia coli, Klebsiella pneumoniae, Enterococcus faecium, Enterococcus faecalis, and Pseudomonas aeruginosa. The rate of Escherichia coli resistance to ciprofloxacin increased (p &lt; 0.05), while the resistance to amikacin decreased (p &lt; 0.05). The resistance of Klebsiella pneumoniae to cephalosporins, carbapenems, β-lactamase inhibitors, cephalases, aminoglycosides, and quinolones increased (p &lt; 0.05), and the resistance of Pseudomonas aeruginosa to piperacillin, piperacillin/tazobactam, ticacillin/clavulanic acid, and amicacin declined significantly (p &lt; 0.05). The resistance of Enterococcus faecium to tetracycline increased by year (p &lt; 0.05), and the resistance of Enterococcus faecalis to erythromycin and high-concentration gentamicin declined (p &lt; 0.05). Multivariate logistic regression analysis suggested that the administration of third- or fourth-generation cephalosporins was an independent risk factor for biliary infection. In summary, Gram-negative bacilli were the most common pathogenic bacteria isolated from biliary infection patients, especially Escherichia coli, and the rates and patterns of drug resistance were high and in constant flux; therefore, rational antimicrobial drug use should be carried out considering risk factors.
Distinct profiles of cerebral oxygenation in focal vs. secondarily generalized EEG seizures in children undergoing cardiac surgery
Authors: Lin Rouyi , Du Na , Ning Shuyao , Zhang Mingjie , Feng Jinqing , Chen Xinxin , Ma Li , Li Jia 
Published: May 2024

ObjectivesSeizures are common in children undergoing cardiopulmonary bypass (CPB). Cerebral oxygen saturation (ScO2) by near-infrared spectroscopy is routinely monitored in many centers, but the relations between the levels and changes of ScO2 and brain injuries remain incompletely understood. We aimed to analyze the postoperative profiles of ScO2 and cerebral blood flow velocity in different types of EEG seizures in relation to brain injuries on MRI.MethodsWe monitored continuous EEG and ScO2 in 337 children during the first 48 h after CPB, which were analyzed in 3 h periods. Cerebral blood flow peak systolic velocity (PSV) in the middle cerebral artery was measured daily by transcranial Doppler. Postoperative cerebral MRI was performed before hospital discharge.ResultsBased on the occurrence and spreading types of seizures, patients were divided into three groups as patients without seizures (Group N; n = 309), those with focal seizures (Group F; n = 13), or with secondarily generalized seizures (Group G; n = 15). There were no significant differences in the onset time and duration of seizures and incidence of status epilepticus between the two seizures groups (Ps ≥ 0.27). ScO2 increased significantly faster across Group N, Group G, and Group F during the 48 h (p &lt; 0.0001) but its overall levels were not significantly different among the three groups (p = 0.30). PSV was significantly lower (p = 0.003) but increased significantly faster (p = 0.0003) across Group N, Group G, and Group F. Group F had the most severe brain injuries and the highest incidence of white matter injuries on MRI among the three groups (Ps ≤ 0.002).ConclusionPostoperative cerebral oxygenation showed distinct profiles in secondarily generalized and particularly focal types of EEG seizures in children after CPB. A state of ‘overshooting’ ScO2 with persistently low PSV was more frequently seen in those with focal seizures and more severe brain injury. Information from this study may have important clinical implications in detecting brain injuries when monitoring cerebral oxygenation in this vulnerable group of children after CPB.
Mendelian randomization analysis does not reveal a causal association between migraine and Meniere’s disease
Authors: Zhang Kangjia , Zhang Yong , Wu Weijing , Lai Ruosha 
Published: May 2024

BackgroundAccording to observational research, migraine may increase the risk of Meniere’s disease (MD). The two have not, however, been proven to be causally related.MethodsUsing Mendelian random (MR) analysis, we aimed to evaluate any potential causal relationship between migraine and MD. We extracted single-nucleotide polymorphisms (SNPs) from large-scale genome-wide association studies (GWAS) involving European individuals, focusing on migraine and MD. The main technique used to evaluate effect estimates was inverse-variance weighting (IVW). To assess heterogeneity and pleiotropy, sensitivity analyses were carried out using weighted median, MR-Egger, simple mode, weighted mode, and MR-PRESSO.ResultsThere was no discernible causative link between genetic vulnerability to MD and migraine. The migraine dose not increase the prevalence of MD in the random-effects IVW method (OR = 0.551, P = 0.825). The extra weighted median analysis (OR = 0.674, P = 0.909), MR-Egger (OR = 0.068, P = 0.806), Simple mode (OR = 0.170, P = 0.737), and Weighted mode (OR = 0.219, P= 0.760) all showed largely consistent results. The MD dose not increase the prevalence of migraine in the random-effects IVW method (OR = 0.999, P = 0.020). The extra weighted median analysis (OR = 0.999, P = 0.909), MR-Egger (OR = 0.999, P = 0.806), Simple mode (OR = 0.999, P = 0.737), and Weighted mode (OR = 1.000, P = 0.760).Conclusion and significanceThis Mendelian randomization study provides casual evidence that migraine is not a risk factor for MD and MD is also not a risk factor for migraine.
Vertebral artery hypoplasia and hemodynamic impairment in transient global amnesia: a case control study
Authors: Werner Ralph , Ekstrom Alexandra , Kureck Ingo , Wöhrle Johannes C. 
Published: May 2024

IntroductionThe aetiology of transient global amnesia (TGA) is still a matter of debate. Besides ischemia of the mesial temporal lobe including the hippocampus, migraine-like mechanisms, epileptic seizures affecting mnestic structures, or venous congestion in the (para) hippocampal area due to jugular vein insufficiency have been discussed. We assessed the diameters of the intracranial arteries of TGA patients compared to controls to identify differences that support the hypothesis of reduced hippocampal perfusion as a pivotal factor in the pathophysiology of TGA.MethodsWe reviewed magnetic resonance imaging time of flight angiographies (TOF-MRA) that were acquired during in-patient treatment of 206 patients with acute TGA.ResultsThe diameters of the vertebral artery (VA) in the V4 segment, the proximal basilar artery, and the internal carotid arteries were measured manually. We compared the findings with TOF-MRA images of an age and sex matched control group of neurological patients without known cerebrovascular pathology. In TGA patients the diameter of the right VA was significantly (p &lt; 0.01) smaller compared to controls (2.09 mm vs. 2.35 mm). There were no significant differences in the diameters of the other vessels. Only the fetal variant of the posterior cerebral artery was slightly more common in TGA.DiscussionThe smaller diameter (hypoplasia) of the right VA supports the hypothesis of a contribution of hemodynamic factors to the pathophysiology of TGA. The fact that hypoplasia represents a congenital condition might be the explanation why previous studies failed to find an increased rate of the classical (acquired) vascular risk factors.