bluuebunny/crossref_metadata_2025_split huggingface dataset:
Causal associations between pediatric asthma and united airways disease: a two-sample Mendelian randomization analysis
Authors: Gao Tongxun , Cai Qiuhan , Hu Siyuan , Zhu Rongxin , Wang Jixuan 
Published: June 2024

BackgroundPrior observational research has indicated a potential link between pediatric asthma and united airways disease (UAD). However, these findings could be subject to confounding factors and reverse causation. Therefore, our study utilizes Mendelian randomization (MR) method to further investigate the causal relationship between pediatric asthma and UAD.MethodsWe conducted a comprehensive two-sample Mendelian randomization (MR) analysis to investigate the association between pediatric asthma and seven groups of UAD, including chronic sinusitis, chronic rhinitis, nasopharyngitis and pharyngitis, chronic diseases of tonsils and adenoids, chronic laryngitis and laryngotracheitis, chronic bronchitis, bronchiectasis, chronic obstructive pulmonary disease (COPD). The present study employed a range of methods for two-sample MR analysis, including inverse variance weighted (IVW), MR-Egger regression, Simple mode, weighted median, and weighted models. The conclusion of the MR analysis primarily relies on the IVW results, while other analytical methods are utilized as supplementary evidence to ensure result robustness in this MR analysis. And sensitivity analyses were conducted, including heterogeneity test, horizontal pleiotropy test, MR-PRESSO test, and leave-one-out analysis to validate the results.ResultsThe results of the MR analysis indicate significant causal effects of pediatric asthma on chronic rhinitis, nasopharyngitis and pharyngitis (IVW: OR = 1.15, 95%CI: 1.05–1.26, p-value = 0.003), chronic diseases of tonsils and adenoids (IVW: OR = 1.07, 95%CI: 1.00–1.15, p-value = 0.038), chronic bronchitis (IVW: OR = 1.51, 95%CI: 1.42–1.62, p-value &lt;0.001), bronchiectasis (IVW: OR = 1.51, 95%CI: (1.30–1.75), p-value &lt;0.001), and COPD (IVW: OR = 1.43, 95%CI: 1.34–1.51, p-value &lt;0.001). However, no significant causal association was observed between pediatric asthma and chronic sinusitis (IVW: OR = 1.00, 95%CI: 1.00–1.00, p-value = 0.085), chronic laryngitis and laryngotracheitis (IVW: OR = 1.05, 95%CI: 0.90–1.21, p-value = 0.558).ConclusionOur findings support a potential causal relationship between pediatric asthma and UAD, suggesting that pediatric asthma may be a potential risk factor for various UAD.
Clinical features, immunologic parameter and treatment outcome of Chinese tuberculosis patients with or without DM
Authors: Tong Fengjun , Lai Jie , Lu Zhenhui , Bao Zhijian , Cao Junyan 
Published: June 2024

BackgroundThe coexistence of diabetes mellitus (DM) and pulmonary tuberculosis (PTB) poses a significant health concern globally, with their convergence presenting a considerable challenge to healthcare systems. Previous research has highlighted that comorbidities can mutually influence and exacerbate immune disorders. However, there is a paucity of data on the impact of DM on immunological features and treatment responses in the TB population in China.MethodsFrom January 2020 to June 2022, 264 cases of pulmonary tuberculosis patients (82 DM patients and 182 non-DM patients) hospitalized in our center were selected. 80 patients with TB with DM (TB-DM) and 80 patients with TB without DM (TB-NDM) were enrolled into the final analysis by propensity score matching for age, gender and involved lung field at a ratio of 1:1. The clinical characteristics, immunological features and treatment response were compared between the two groups.ResultsAfter propensity score matching, no differences in the general features such as age gender, involved lung field, the incidence of retreatment and WBC count were found between the two groups. Compared to TB-NDM group, the TB-DM group exhibited a higher positive rate of sputum smear and incidence of cavitary lesions. Immunological features analysis revealed that the TB-DM patients had higher levels of TNF-α [pg/ml; 8.56 (7.08–13.35) vs. 7.64 (6.38–10.14) p = 0.033] and IL-8 [pg/ml; 25.85 (11.63–58.40) vs. 17.56 (6.44–39.08) p = 0.003] but lower CD8+ T lymphocyte count [cells/mm3; 334.02 (249.35–420.71) VS 380.95 (291.73–471.25) p = 0.038]. However, there was no significant difference in serum IL-6 concentration and CD4+ T lymphocyte count between the two groups. After 2 months of anti-tuberculosis treatment, 39 (24.4%) cases had suboptimal treatment response, including 23 (28.7%) TB-DM patients and 16 (20%) TB-NDM patients. There was no difference in suboptimal response rate (SRR) was found between the two groups (p = 0.269). The multivariate logistic regression analysis indicated that retreatment for TB [AOR: 5.68 (95%CI: 2.01–16.08), p = 0.001], sputum smear positivity [AOR: 8.01 (95%CI: 2.62–24.50), p = 0.001] were associated with SRR in all participants, and in TB-DM group, only sputum smear positivity [AOR: 16.47 (1.75–155.12), p = 0.014] was positive with SRR.ConclusionDM is a risk factor for pulmonary cavity formation and sputum smear positivity in TB population. Additionally, TB-DM patients is characterized by enhanced cytokine responses and decreased CD8+ T lymphocytes. The retreatment for TB and sputum smear positivity were associated with the occurrence of suboptimal treatment response.
The impact of ketamine on pain-related outcomes after thoracotomy: a systematic review with meta-analysis of randomized controlled trials
Authors: Zhaksylyk Aruzhan , Abdildin Yerkin G. , Sultangazin Suienish , Zhumakanova Aigerim , Viderman Dmitriy 
Published: June 2024

ObjectiveThis meta-analysis aims to examine how effective ketamine is in the management of acute and preventing chronic post-thoracotomy pain by synthesizing the available research.MethodA systematic literature search was conducted across PubMed, Scopus, and Cochrane Library till May 2023. Randomized Controlled Trials (RCT) examining the influence of ketamine on post-thoracotomy pain in adults were included. The intervention group included ketamine plus morphine, while the control group included morphine only. The outcome measures were opioid intake and pain scores at rest and on moving/coughing. Evidence quality was evaluated using the Cochrane Risk of Bias and GRADE assessment.ResultsNine articles comprising 556 patients were selected for meta-analysis. The intervention group had a significant decrease in pain at rest (Std. Mean Difference (SMD = −0.60 with 95% CI [−0.83, −0.37]) and on movement/cough (SMD = −0.73 [−1.27, −0.18]) in the first postoperative days. Also, the ketamine group had lower opioid consumption (mg) in comparison with controls (SMD = −2.75 [−4.14, −1.36],p-value = 0.0001) in postoperative days 1-3. There was no data to assess the long-term effect of ketamine on chronic pain.ConclusionThis meta-analysis shows that ketamine use can lower acute pain levels and morphine use after thoracotomy. In the future, larger RCTs using standardized methods and assessing both short-term and long-term analgesic effects of ketamine are necessary to deepen the understanding of the issue.
Case report: A healthy baby achieved after preimplantation genetic testing from an infertile woman with hereditary leiomyomatosis and renal cell cancer syndrome
Authors: Hu Qianhui , Zhang Qing , Guo Mengxi , Ding Haixia , Xi Ji , Zhang Meiling , Wang Min , Zhang Lin , Li Shuyuan , Wu Dandan , Li Wen 
Published: June 2024

BackgroundHereditary leiomyomatosis and renal cell cancer (HLRCC) is a rare autosomal dominant inheritable disease caused by Fumarate hydratase (FH) gene germline mutation. It is speculated that for HRLCC infertility women with multiple uterine leiomyomas, preimplantation genetic testing may help block transmission of mutated FH gene during pregnancy.Case presentationWe present the case of a 26-year-old nulligravida with a history of early-onset uterine leiomyomatosis had a heterozygous nonsense mutation [NM_000143.4 (FH): c.1027C &gt; T(p.Arg343Ter)] in the HRLLC gene. After ovulation induction and in vitro fertilization, preimplantation genetic testing for monogenic disorders (PGT-M) on embryos revealed the absence of the pathogenic allele in two blastomeres. Uterine fibroids were identified before embryo transfer, leading to a submucosal myomectomy and long period of pituitary suppression by Gonadotropin-releasing hormone analog (GnRHa). The patient achieved a healthy live birth after the second cycle of frozen–thawed embryo transfer.ConclusionThis case details the successful treatment of an infertile patient with an HRLLC family history, resulting in a healthy birth through myomectomy and PGT-M selected embryo transplantation. Our literature search indicates the first reported live birth after HRLLC-PGT-M.
Clinical diagnosis and treatment of seven patients diagnosed pneumonia caused by Chlamydia abortus: a case series report
Authors: Wen Ya , Du Yanjia , Shi Xiaoyan , Zeng Zixiong 
Published: June 2024

BackgroundChlamydia abortus pneumonia is very rare in normal people. At present, there is a lack of clinical data on the clinical characteristics and diagnosis and treatment experience of patients with this type of infection. Our team had recently treated 7 cases of these patients. This study aims to comprehensively summarize and analyze the clinical characteristics and treatment methods of Chlamydia abortus pneumonia, and to provide clinical evidence for the diagnosis and treatment of Chlamydia abortus pneumonia.MethodsClinical data were retrospectively collected from patients diagnosed with Chlamydia abortus pneumonia through metagenomic next-generation sequencing (mNGS) at the Department of Pulmonary and Critical Care Medicine, Meizhou People’s Hospital.ResultsSeven patients with Chlamydia abortus pneumonia reported a history of poultry exposure, experiencing fever alongside respiratory or digestive symptoms. Marked elevation of blood inflammation markers, accompanied by hypoproteinemia and liver damage, was observed. Chest CT scans revealed pneumonia and pleural effusion. Chlamydia abortus was detected in blood or bronchoalveolar lavage fluid (BALF) through mNGS, often co-occurring with Chlamydia psittaci or other bacteria infections. Notably, Doxycycline demonstrated efficacy in treating Chlamydia abortus.ConclusionChlamydia abortus infection is a zoonotic disease, particularly among individuals with a history of poultry exposure, and mNGS emerges as a reliable diagnostic tool for its detection. Chlamydia abortus infection manifests with systemic and lung inflammation, effectively addressed through Doxycycline therapy.
DRB1 locus alleles of HLA class II are associated with modulation of the immune response in different serological profiles of HIV-1/Epstein-Barr virus coinfection in the Brazilian Amazon region
Authors: Pereira Leonn Mendes Soares , dos Santos França Eliane , Costa Iran Barros , Lima Igor Tenório , Jorge Erika Vanessa Oliveira , de Souza Mendonça Mattos Patrícia Jeanne , Freire Amaury Bentes Cunha , de Paula Ramos Francisco Lúzio , Monteiro Talita Antonia Furtado , Macedo Olinda , Sousa Rita Catarina Medeiros , Freitas Felipe Bonfim , Costa Igor Brasil , Vallinoto Antonio Carlos Rosário 
Published: June 2024

BackgroundEpstein–Barr virus (EBV) infection involves distinct clinical and serological profiles. We evaluated the frequency of alleles of locus DRB1 of HLA class II in different serological profiles of EBV infection among HIV-1 infected patients.MethodsWe recruited 19 patients with primary infection, 90 with serological transition and 467 with past infection by EBV, HIV-1 co-infection was 100% in primary infection and approximately 70% in other serological profiles. EBV viral load was quantified by real-time PCR, T lymphocyte quantification and cytokine level analysis were performed by flow cytometry, and HLA locus genotyping was performed by PCR-SSO.ResultsThe DRB1*09 allele was associated with primary infection (p: 0.0477), and carriers of the allele showed changes in EBV viral load (p: 0.0485), CD8(+) T lymphocyte counts (p: 0.0206), double-positive T lymphocyte counts (p: 0.0093), IL-4 levels (p: 0.0464) and TNF levels (p: 0.0161). This allele was also frequent in HIV-coinfected individuals (p: 0.0023) and was related to the log10 HIV viral load (p: 0.0176) and CD8(+) T lymphocyte count (p: 0.0285). In primary infection, the log10 HIV viral load was high (p: 0.0060) and directly proportional to the EBV viral load (p: 0.0412). The DRB1*03 allele correlated with serological transition (p: 0.0477), EBV viral load (p: 0.0015), CD4(+) T lymphocyte count (p: 0.0112), CD8(+) T lymphocyte count (p: 0.0260), double-negative T lymphocyte count (p: 0.0540), IL-4 levels (p: 0.0478) and IL-6 levels (p: 0.0175). In the serological transition group, the log10 HIV viral load was high (p: 0.0060), but it was not associated with the EBV viral load (p: 0.1214). Past infection was related to the DRB1*16 allele (p: 0.0477), with carriers displaying IgG levels (p: 0.0020), CD4(+) T lymphocyte counts (p: 0.0116) and suggestive CD8(+) T count alterations (p: 0.0602). The DRB01*16 allele was also common in HIV-1 patients with past EBV infection (p: 0.0192); however, the allele was not associated with clinical markers of HIV-1 infection.ConclusionOur results suggest that HLA class II alleles may be associated with the modulation of the serological profiles of the immune response to Epstein-Barr virus infection in patients coinfected with HIV-1.
Is the sFlt-1/PlGF ratio efficient in predicting adverse neonatal outcomes in small-for-gestational-age newborns? A prospective observational multicenter cohort study
Authors: Kosińska-Kaczyńska Katarzyna , Chaberek Katarzyna , Szymecka-Samaha Natalia , Brawura-Biskupski-Samaha Robert , Czapska Agnieszka , Żebrowska Kinga , Dera Norbert , Madzelewski Jan , Góra Jakub , Borawski Kacper , Włoch Weronika , Scholz Anna 
Published: June 2024

IntroductionFetuses with growth abnormalities are at an increased risk of adverse neonatal outcomes. The aim of this study was to investigate if placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1), or the sFlt-1/PlGF ratio were efficient predictive factors of adverse neonatal outcomes in small-for-gestational-age (SGA) newborns.MethodsA prospective observational multicenter cohort study was performed between 2020 and 2023. At the time of the SGA fetus diagnosis, serum angiogenic biomarker measurements were performed. The primary outcome was an adverse neonatal outcome, diagnosed in the case of any of the following: &lt;34 weeks of gestation: mechanical ventilation, sepsis, necrotizing enterocolitis, intraventricular hemorrhage grade III or IV, and neonatal death before discharge; ≥34 weeks of gestation: Neonatal Intensive Care Unit hospitalization, mechanical ventilation, continuous positive airway pressure, sepsis, necrotizing enterocolitis, intraventricular hemorrhage grade III or IV, and neonatal death before discharge.ResultsIn total, 192 women who delivered SGA newborns were included in the study. The serum concentrations of PlGF were lower, leading to a higher sFlt-1/PlGF ratio in the adverse outcome group. No significant differences in sFlt-1 levels were observed between the groups. Both PlGF and sFlt-1 had a moderate correlation with adverse neonatal outcomes (PlGF: R − 0.5, p &lt; 0.001; sFlt-1: 0.5, p &lt; 0.001). The sFlt-1/PlGF ratio showed a correlation of 0.6 (p &lt; 0.001) with adverse outcomes. The uterine artery pulsatility index (PI) and the sFlt-1/PlGF ratio were identified as the only independent risk factors for adverse outcomes. An sFlt-1/PlGF ratio of 19.1 exhibited high sensitivity (85.1%) but low specificity (35.9%) in predicting adverse outcomes and had the strongest correlation with them. This ratio allowed the risk of adverse outcomes to be assessed as low with approximately 80% certainty.DiscussionThe sFlt-1/PlGF ratio seems to be an efficient predictive tool in adverse outcome risk assessment. More studies on large cohorts of SGA-complicated pregnancies with and without preeclampsia are needed to develop an optimal and detailed formula for the risk assessment of adverse outcomes in SGA newborns.
Machine learning is an effective method to predict the 3-month prognosis of patients with acute ischemic stroke
Authors: Huang Qing , Shou Guang-Li , Shi Bo , Li Meng-Lei , Zhang Sai , Han Mei , Hu Fu-Yong 
Published: June 2024

Background and objectivesUpwards of 50% of acute ischemic stroke (AIS) survivors endure varying degrees of disability, with a recurrence rate of 17.7%. Thus, the prediction of outcomes in AIS may be useful for treatment decisions. This study aimed to determine the applicability of a machine learning approach for forecasting early outcomes in AIS patients.MethodsA total of 659 patients with new-onset AIS admitted to the Department of Neurology of both the First and Second Affiliated Hospitals of Bengbu Medical University from January 2020 to October 2022 included in the study. The patient’ demographic information, medical history, Trial of Org 10,172 in Acute Stroke Treatment (TOAST), National Institute of Health Stroke Scale (NIHSS) and laboratory indicators at 24 h of admission data were collected. The Modified Rankine Scale (mRS) was used to assess the 3-mouth outcome of participants’ prognosis. We constructed nine machine learning models based on 18 parameters and compared their accuracies for outcome variables.ResultsFeature selection through the Least Absolute Shrinkage and Selection Operator cross-validation (Lasso CV) method identified the most critical predictors for early prognosis in AIS patients as white blood cell (WBC), homocysteine (HCY), D-Dimer, baseline NIHSS, fibrinogen degradation product (FDP), and glucose (GLU). Among the nine machine learning models evaluated, the Random Forest model exhibited superior performance in the test set, achieving an Area Under the Curve (AUC) of 0.852, an accuracy rate of 0.818, a sensitivity of 0.654, a specificity of 0.945, and a recall rate of 0.900.ConclusionThese findings indicate that RF models utilizing general clinical and laboratory data from the initial 24 h of admission can effectively predict the early prognosis of AIS patients.
Finding the limits of deep learning clinical sensitivity with fractional anisotropy (FA) microstructure maps
Authors: Gaviraghi Marta , Ricciardi Antonio , Palesi Fulvia , Brownlee Wallace , Vitali Paolo , Prados Ferran , Kanber Baris , Gandini Wheeler-Kingshott Claudia A. M. 
Published: June 2024

BackgroundQuantitative maps obtained with diffusion weighted (DW) imaging, such as fractional anisotropy (FA) –calculated by fitting the diffusion tensor (DT) model to the data,—are very useful to study neurological diseases. To fit this map accurately, acquisition times of the order of several minutes are needed because many noncollinear DW volumes must be acquired to reduce directional biases. Deep learning (DL) can be used to reduce acquisition times by reducing the number of DW volumes. We already developed a DL network named “one-minute FA,” which uses 10 DW volumes to obtain FA maps, maintaining the same characteristics and clinical sensitivity of the FA maps calculated with the standard method using more volumes. Recent publications have indicated that it is possible to train DL networks and obtain FA maps even with 4 DW input volumes, far less than the minimum number of directions for the mathematical estimation of the DT.MethodsHere we investigated the impact of reducing the number of DW input volumes to 4 or 7, and evaluated the performance and clinical sensitivity of the corresponding DL networks trained to calculate FA, while comparing results also with those using our one-minute FA. Each network training was performed on the human connectome project open-access dataset that has a high resolution and many DW volumes, used to fit a ground truth FA. To evaluate the generalizability of each network, they were tested on two external clinical datasets, not seen during training, and acquired on different scanners with different protocols, as previously done.ResultsUsing 4 or 7 DW volumes, it was possible to train DL networks to obtain FA maps with the same range of values as ground truth - map, only when using HCP test data; pathological sensitivity was lost when tested using the external clinical datasets: indeed in both cases, no consistent differences were found between patient groups. On the contrary, our “one-minute FA” did not suffer from the same problem.ConclusionWhen developing DL networks for reduced acquisition times, the ability to generalize and to generate quantitative biomarkers that provide clinical sensitivity must be addressed.
Measuring aviator workload using EEG: an individualized approach to workload manipulation
Authors: Feltman Kathryn A. , Vogl Johnathan F. , McAtee Aaron , Kelley Amanda M. 
Published: June 2024

IntroductionMeasuring an operator's physiological state and using that data to predict future performance decrements has been an ongoing goal in many areas of transportation. Regarding Army aviation, the realization of such an endeavor could lead to the development of an adaptive automation system which adapts to the needs of the operator. However, reaching this end state requires the use of experimental scenarios similar to real-life settings in order to induce the state of interest that are able to account for individual differences in experience, exposure, and perception to workload manipulations. In the present study, we used an individualized approach to manipulating workload in order to account for individual differences in response to workload manipulations, while still providing an operationally relevant flight experience.MethodsEight Army aviators participated in the study, where they completed two visits to the laboratory. The first visit served the purpose of identifying individual workload thresholds, with the second visit resulting in flights with individualized workload manipulations. EEG data was collected throughout both flights, along with subjective ratings of workload and flight performance.ResultsBoth EEG data and workload ratings suggested a high workload. Subjective ratings were higher during the high workload flight compared to the low workload flight (p &lt; 0.001). Regarding EEG, frontal alpha (p = 0.04) and theta (p = 0.01) values were lower and a ratio of beta/(alpha+theta) (p = 0.02) were higher in the baseline flight scenario compared to the high workload scenario. Furthermore, the data were compared to that collected in previous studies which used a group-based approach to manipulating workload.DiscussionThe individualized method demonstrated higher effect sizes in both EEG and subjective ratings, suggesting the use of this method may provide a more reliable way of producing high workload in aviators.