bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety and efficacy of endovascular treatment for acute ischemic stroke of large-vessel occlusion beyond the time window based on imaging evaluation
Authors: Chen Shi-Dun , Yang Cheng-Bao , Wang Yong-Xiang , Yin Yue-Han , Gao Bu-Lang , Chen Chun-Guang 
Published: April 2024

Purpose Endovascular treatment (EVT) of acute ischemic stroke caused by large-vessel occlusion (AIS-LVO) over 24 h of onset remains controversial. This study was to explore the safety and efficacy of EVT for patients with AIS-LVO between 24 and 72 h of symptom onset after rigorous imaging evaluation. Methods Patients with AIS-LVO treated with EVT were retrospectively enrolled and divided into two groups according to the time from symptom onset to groin puncture: 64 in the over-time group (>24 h) and 257 in the within-time group (≤24 h). Outcomes included 3-month modified Rankin Scale (mRS) score, functional independence (defined as mRS 0–2), successful cerebral reperfusion, symptomatic intracranial hemorrhage (sICH), and 3-month mortality. Results Patients in the over-time group had no significant differences in the functional independence (40.6% vs 42.5%, odds ratio or OR 0.91, 95% confidence interval or CI 0.52–1.60, p = 0.753), successful reperfusion (96.7% vs 95.8%, OR 0.76, 95% CI 0.36–1.59, p = 0.467), sICH (8.3% vs 6.7%, OR 1.20, 95% CI 0.42–3.38, p = 0.735), 3-month mortality (13.3% vs 10.8%, OR 1.17, 95% CI 0.51–2.70, p = 0.716) compared with patients in the within-time group. After matching adjustment, the results did not change significantly. Conclusions The safety and effectiveness of EVT treatment for selected AIS-LVO patients with symptom onset of 24–72 h are not inferior to those treated within 6–24 h of onset, especially in a short term based on the pre-treatment advanced neuroimaging computed tomography perfusion even though further investigations are necessary to prove this finding.
Renal artery occlusion in a young woman – a tale of mysterious thrombosis
Authors: Farley Ned , Faraj Joseph , Fernando Malindu , Singh Tejas , Powell Aaron , Kumar Senthil 
Published: April 2024

Background Renal artery thrombosis is rare and limited reports exist in the young population. The most common aetiology is thromboembolic disease or abdominal trauma in this population and isolated occurrences are extremely rare. We present the case of an 18-year-old woman with spontaneous unilateral renal artery thrombosis and infarction for whom reperfusion was achieved through endovascular intervention. The aetiology of her thrombosis remains unclear and is under investigation with differential diagnoses being fibromuscular dysplasia, large and medium vessel vasculitis, and thromboembolic causes. Objective To demonstrate the value in attempting salvage of an ischaemic kidney in a young patient with an unexplained spontaneous renal thrombosis. Method JM is an 18-year-old woman who presented to a large regional tertiary hospital with 3 days of right flank pain. She had no infective symptoms and no urinary or bowel changes before admission. She was not pregnant, and her only medication was the oral contraceptive pill commenced 3 months prior. A CT angiogram demonstrated right renal artery thrombosis with renal infarction. The kidney was deemed potentially salvageable, and ultrasound defined adequate vessel calibre to access for thrombectomy in the context of a negative coagulopathy screen. Results The patient underwent thrombolysis, thrombectomy and balloon angioplasty. Intraoperatively, a thin segment of distal stenosis was identified, and angiogram reperfusion was achieved with subsequent improvement in renal function. Conclusion Renal artery thrombosis in young people is extremely rare and presents a diagnostic and management challenge requiring input from multiple teams including nephrology, rheumatology, paediatrics and vascular surgery. Systemic coagulopathy and vasculitis are differentials against anatomical aetiologies such as fibromuscular dysplasia. Our case adds to the limited literature regarding this in the young population. Renal artery thrombosis with occlusion in young people is very rare and is most often associated with a systemic coagulopathic disorder, such as antiphospholipid syndrome or structural pathology of the renal vasculature such as fibromuscular dysplasia. The work-up of a young female presenting with renal artery thrombosis without any previous medical history screens for a wide range of pathological processes.
How to follow up patients with brachial plexus birth palsy in the long term: a survey of expert opinion
Authors: de Joode Stijn G. C. J. , Schotanus Martijn G. M. , van Rhijn Lodewijk W. , Samijo Steven K. , Aly A , Amin S , Atalar A , Aydin A , Bahm J , Battiston B , Beressa H , Bhatia A , Casanas J , Celaj A , Concha R , Concha E , Cronin K , Cuadros M , Dailiana Z , Ferraresi S , Ferreira R , Fouad B , Gazarian A , Garcia A , Garg R , Kawabata H , Lin A , Mahmoud M , Nascimento A , Nelissen R , Nordmark P , Nouri S , Ozkan T , Price A , Russo S , Samijo S , Suleiman F , Valenti P , Zlotolow D 
Published: April 2024

There is no generally accepted diagnostic, treatment and follow-up algorithm for brachial plexus birth palsy in the current literature. This study evaluates the opinion of experts in the field of brachial plexus birth palsy surgery, to provide a follow-up guideline. A total of 35 experts attending an international meeting with a mean of 21.5 years (SD 10.1) of experience in the field filled out a questionnaire to evaluate the following: (1) the surgeons’ background; (2) clinical follow-up; (3) radiological follow-up; and (4) International Classification of Functioning, Disability and Health (ICF) domains. A mean of 40 new brachial plexus birth palsy patients were seen per year by each expert, of which 36% needed surgery. In total, 27 experts scheduled a regular follow-up every year and the majority (83%) believed that standardized long-term clinical follow-up is necessary. However, standardized radiological follow-up is not necessary. Only 13 of 34 participants used patient-reported outcome measures to investigate ICF domains. Level of evidence: V
Four-year variation in pathogen distribution and antimicrobial susceptibility of urosepsis: a single-center retrospective analysis
Authors: Wu Yu-yun , Li Pei , Huang Zi-ye , Liu Jian-he , Yang Bo-wei , Zhou Wen-bo , Duan Fei , Wang Guang , Li Jiong-ming 
Published: April 2024

Background: Urosepsis is a common disease in urology, which is characterized by high treatment costs and high mortality. In the treatment of sepsis, anti-infection therapy is the most important means. However, the effect of empirical anti-infection therapy is often not ideal. Therefore, it is necessary to continuously monitor the prevalence of bacterial isolates in the blood culture of patients with urinary sepsis and their sensitivity to antibacterial drugs. This is of great significance to improve the efficacy of empirical antibiotic therapy for urosepsis. Objective: To elucidate the landscape of prevailing bacterial profiles and their antimicrobial susceptibilities in urosepsis cases, and to furnish robust clinical evidence to underpin the timely initiation of empirical antibiotic treatment. Methods: Collect the basic information and blood culture results of patients with urosepsis hospitalized from 2017 to 2020. Retrospective analysis of bacterial species and antimicrobial susceptibility in urosepsis and changes over 4 years. Results: Gram-negative bacteria (178 isolates, 75.11%) constituted the main pathogens causing urosepsis, followed by Gram-positive bacteria (46 isolates, 19.41%) and fungus (13 isolates, 5.48%). The sensitivity of ertapenem, meropenem, amikacin, and imipenem to Gram-negative bacteria all exceeded 85%. The sensitivity rates of levofloxacin, gentamicin, and ciprofloxacin are decreasing every year ( p < 0.05). Tigecycline, vancomycin, and linezolid exhibited excellent sensitivity against Gram-positive bacteria. Among fungi, fluconazole demonstrated universal sensitivity, while itraconazole-resistant isolates have been found, and amphotericin B is still effective. Conclusion: Analysis of blood culture results of patients more accurately reflected the etiology of urosepsis, mainly Escherichia coli, Enterococcus, and Klebsiella pneumoniae. If there are no definitive blood culture results, empiric treatment of urosepsis should not include fluoroquinolone antibiotics. Cefepime, cefoxitin, and ceftazidime are the most sensitive antibiotics to Gram-negative bacteria besides carbapenem antibiotics. In addition, the current situation regarding extended-spectrum β-lactamase-producing bacteria and carbapenem-resistant Enterobacteriaceae bacteria resistance is extremely concerning with limited therapeutic options available. Strengthening antibiotic management practices and exploring novel antibacterial agents can help mitigate this issue.
Domestic and Global Causes for Exchange Rate Volatility: Evidence From Turkey
Authors: Ozkaya Ata , Altun Omer 
Published: April 2024

Understanding which factors influence exchange rate movements is important for understanding economic development, trade patterns, investment decisions, and for designing economic policies. In this study, we allow for monetary, domestic and global financial variables to assess the relevant importance of each of the variables to exchange rate volatility in the case of Turkey. The paper investigates the dynamics of exchange rate volatility of the Turkish lira in a complementary perspective by employing both Generalized autoregressive conditional heteroskedasticity (GARCH) method and Lyapunov exponents over the period from March 1, 2019 to November 11, 2021. Firstly, decomposing the impact of domestic and global financial variables, the results of the GARCH model indicate that the exchange rate volatility is affected by Volatility index (VIX) and Credit default swaps (CDS). This result suggests that the exchange rate shocks experienced are mainly caused by global factors, therefore policymakers should focus on volatility spillovers caused by global financial markets. Secondly, detected positive maximal Lyapunov exponent shows that complexity in foreign exchange markets has been increased, market expectations lead to multiple-equilibria and diverging volatility eventually will generate recurrent spikes in currency value. These complementary findings have important implications for interventions of Central banks and preventing systemic risks, as well as portfolio and risk management. JEL Classification: C32, G14, G15.
Applicability of individualized metabolic surgery score for prediction of diabetes remission after endoscopic sleeve gastroplasty
Authors: Gala Khushboo , Ghusn Wissam , Brunaldi Vitor , Vargas Eric J. , Storm Andrew C. , Acosta Andres , Dayyeh Barham K. Abu 
Published: April 2024

Background: Endoscopic sleeve gastroplasty (ESG) is a safe and effective obesity treatment. The individualized metabolic score (IMS) is a validated score that uses preoperative variables predicting T2D remission (DR) in bariatric surgery. Objectives: We evaluated the applicability of using the IMS score to predict DR in patients after ESG. Design/Methods: We performed a retrospective review of patients with obesity and T2D who underwent ESG. We calculated DR, IMS score, and severity, and divided patients based on IMS category. Results: The cohort comprised 20 patients: 25% (5) mild, 55% (11) moderate, and 20% (4) severe IMS stages. DR was achieved in 60%, 45.5%, and 0% of patients with mild, moderate, and severe IMS scores ( p = 0.08), respectively. IMS score was significantly associated with DR ( p = 0.03), with the area under the curve of the receiver operating characteristic for predicting DR 0.85. Conclusion: These pilot data demonstrate that the IMS score appears to be useful in predicting DR after ESG.
Modified Delphi panel consensus recommendations for management of severe aplastic anemia
Authors: Babushok Daria V. , DeZern Amy E. , de Castro Carlos M. , Rogers Zora R. , Beenhouwer David , Broder Michael S. , Fanning Suzanne R. , Gibbs Sarah N. , Hanna Rabi , Maciejewski Jaroslaw P. , Scott Bart L. , Tantravahi Srinivas K. , Wlodarski Marcin W. , Yermilov Irina , Patel Bhumika J. 
Published: April 2024

Abstract
Severe aplastic anemia (SAA) is a rare hematologic condition for which there is no clear management algorithm. A panel of 11 experts on adult and pediatric aplastic anemia was assembled and, using the RAND/University of California, Los Angeles modified Delphi panel method, evaluated &gt;600 varying patient care scenarios to develop clinical recommendations for the initial and subsequent management of patients of all ages with SAA. Here, we present the panel’s recommendations to rule out inherited bone marrow failure syndromes, on supportive care before and during first-line therapy, and on first-line (initial management) and second-line (subsequent management) therapy of acquired SAA, focusing on when transplant vs medical therapy is most appropriate. These recommendations represent the consensus of 11 experts informed by published literature and experience. They are intended only as general guidance for experienced clinicians who treat patients with SAA and are in no way intended to supersede individual physician and patient decision making. Current and future research should validate this consensus using clinical data. Once validated, we hope these expert panel recommendations will improve outcomes for patients with SAA.
Ginsenoside Rh2 shifts tumor metabolism from aerobic glycolysis to oxidative phosphorylation through regulating the HIF1-α/PDK4 axis in non-small cell lung cancer
Authors: Liu Xiyu , Li Jingjing , Huang Qingqing , Jin Mingming , Huang Gang 
Published: April 2024

Abstract
Background
Ginsenoside Rh2 (G-Rh2), a steroidal compound extracted from roots of ginseng, has been extensively studied in tumor therapy. However, its specific regulatory mechanism in non-small cell lung cancer (NSCLC) is not well understood. Pyruvate dehydrogenase kinase 4 (PDK4), a central regulator of cellular energy metabolism, is highly expressed in various malignant tumors. We investigated the impact of G-Rh2 on the malignant progression of NSCLC and how it regulated PDK4 to influence tumor aerobic glycolysis and mitochondrial function.

Method
We examined the inhibitory effect of G-Rh2 on NSCLC through I proliferation assay, migration assay and flow cytometry in vitro. Subsequently, we verified the ability of G-Rh2 to inhibit tumor growth and metastasis by constructing subcutaneous tumor and metastasis models in nude mice. Proteomics analysis was conducted to analyze the action pathways of G-Rh2. Additionally, we assessed glycolysis and mitochondrial function using seahorse, PET-CT, Western blot, and RT-qPCR.

Result
Treatment with G-Rh2 significantly inhibited tumor proliferation and migration ability both in vitro and in vivo. Furthermore, G-Rh2 inhibited the tumor’s aerobic glycolytic capacity, including glucose uptake and lactate production, through the HIF1-α/PDK4 pathway. Overexpression of PDK4 demonstrated that G-Rh2 targeted the inhibition of PDK4 expression, thereby restoring mitochondrial function, promoting reactive oxygen species (ROS) accumulation, and inducing apoptosis. When combined with sodium dichloroacetate, a PDK inhibitor, it complemented the inhibitory capacity of PDKs, acting synergistically as a detoxifier.

Conclusion
G-Rh2 could target and down-regulate the expression of HIF-1α, resulting in decreased expression of glycolytic enzymes and inhibition of aerobic glycolysis in tumors. Additionally, by directly targeting mitochondrial PDK, it elevated mitochondrial oxidative phosphorylation and enhanced ROS accumulation, thereby promoting tumor cells to undergo normal apoptotic processes.
Interplay of arsenic exposure and cigarette smoking on oxidative DNA damage in healthy males
Authors: Nemati-Mansour Sepideh , Mosaferi Mohammad , Babaie Javad , Mohammadpoorasl Asghar , Dehghanzadeh Reza , Nikniaz Leila , Miri Mohammad 
Published: April 2024

Abstract
Background
Long-term exposure to inorganic arsenic (As) and cigarette smoking has been associated with adverse health effects such as cancer, cardiovascular disease, and respiratory disease. Oxidative stress is one of the most well-known damage mechanisms for both. However, studies on the association with induced 8-hydroxy-2-deoxyguanosine (8-OHdG) in Iran are scarce, with no study on the interactive effect of As exposure and smoking in the literature.

Objective
This stratified cross-sectional study aimed to assess urinary and serum 8-OHdG levels in the relation to As exposure from drinking water, smoking and their interaction effect.

Methods
This study was based on 132 healthy male subjects living in villages of Hashtroud County, Iran (2021). All participants were categorized into four groups: (i) non-As exposed, never smokers (n = 33); (ii) non-As exposed, active smokers (n = 33); (iii) As exposed, never smokers (n = 33); and (iv) As exposed, active smokers (n = 33). Data on demographic and lifestyle factors were collected, and urinary and serum levels of 8-OHdG were determined by enzyme-linked immunosorbent assay (ELISA). The smoker's daily cigarette consumption and the duration of smoking were self-reported data.

Results
Participants consuming drinking water with an As concentration > 10 µg/L had significantly higher urinary total arsenic (U-tAs) concentrations (median 26.96, IQR 21.35–37.17) µg/g Cr compared to the reference group (median 19.33, IQR 17.29–23.26) µg/g Cr. There was a significant difference in the serum concentration of 8-OHdG between groups (i) and (iii), (iv) and also between groups (ii) and (iv). We did not find a significant interaction effect of As exposure and smoking on the both urinary and serum 8-OHdG levels (P > 0.05). Serum 8-OHdG (S-8OHdG) was associated with average daily intake of As (As-ADI) (β = 0.32; 95% CI 0.01, 0.04, P-value = 0.001) and cigarettes smoked per day (β = 0.3; 95% CI 0.00, 0.043, P-value = 0.046). While As-ADI (β = 0.16; 95% CI 0.001, 0.004, P-value = 0.01) and U-tAs (β = 0.6; 95% CI 0.006, 0.009, P-value < 0.001) were associated with increased urinary 8-OHdG (U-8OHdG), moderate physical activity (β = − 0.15; 95% CI − 0.07, − 0.008, P-value < 0.015) inversely decreased biomarker levels.

Conclusion
Our findings suggest that As exposure and smoking are potential risk factors for oxidative DNA damage, and it is strongly recommended to pay more attention to the role of lifestyle factors in future studies.
Genome-wide QTL and eQTL mapping reveal genes associated with growth rate trait of the Pacific white shrimp (Litopenaeus vannamei)
Authors: Chen Xiuli , Peng Min , Yang Chunling , Li Qiangyong , Feng Pengfei , Zhu Weilin , Zhang Yongde , Zeng Digang , Zhao Yongzhen 
Published: April 2024

Abstract
Background
Growth rate is a crucial economic trait for farmed animals, but the genetic regulation of this trait is largely unknown in non-model organisms such as shrimp.

Results
In this study, we performed genome-wide phenotypic quantitative trait loci (QTL) and expression quantitative trait loci (eQTL) mapping analyses to identify genes affecting the growth rate of Pacific white shrimp (Litopenaeus vannamei), which is the most commercially-farmed crustacean worldwide. We used RNA-sequencing of 268 individuals in a mapping population, and subsequently validated our findings through gene silencing and shrimp growth experiments. We constructed a high-density genetic linkage map comprising 5533 markers spanning 44 linkage groups, with a total distance of 6205.75 cM and an average marker interval of 1.12 cM. Our analyses identified 11 QTLs significantly correlated with growth rate, and 117,525 eQTLs. By integrating QTL and eQTL data, we identified a gene (metalloreductase STEAP4) highly associated with shrimp growth rate. RNA interference (RNAi) analysis and growth experiments confirmed that STEAP4 was significantly correlated with growth rate in L. vannamei.

Conclusions
Our results indicate that the comprehensive analysis of QTL and eQTL can effectively identify genes involved in complex animal traits. This is important for marker-assisted selection (MAS) of animals. Our work contributes to the development of shrimp breeding and available genetic resources.
Urogenital cultures and preterm birth in women with cervical cerclage: a single center retrospective cohort study
Authors: Seys Evelien , Page Ann-Sophie , Deprest Jan , Lannoo Lore , van Calsteren Kristel , Devlieger Roland , van der Merwe Johannes 
Published: April 2024

Abstract
Background
The leading hypothesis of the pathogenesis of cervical insufficiency suggests a role of cervical inflammation. Urogenital tract infections could play a causative role in this process. To test this hypothesis in women with a cervical cerclage, we aimed to retrospectively examine the relationship between gestational age (GA) at delivery and positive urogenital cultures.

Methods
This single center retrospective study reviewed the records of all women with a singleton pregnancy that underwent cervical cerclage (n = 203) between 2010 and 2020 at the University Hospital of Leuven, Belgium. Transvaginal cerclages were categorized as history indicated (TVC I, n = 94), ultrasound indicated (TVC II, n = 79) and clinically indicated (TVC III, n = 20). Additionally, ten women received transabdominal cerclage (TAC). Urogenital cultures (vaginal and urine) were taken before and after cerclage with 4-week intervals. Urogenital cultures were reported ‘positive’ if urine and/or vaginal cultures showed significant growth of a microorganism. Treatment decision depended on culture growth and clinical presentation. The primary aim was to evaluate the association between the urogenital culture results and the GA at delivery, for each of the cerclage groups. Secondarily, to investigate the effect of antibiotic treatment of positive cultures on GA at delivery.

Results
Positive pre-cerclage urogenital cultures were associated with lower GA at delivery in TVC III (positive culture 26w4d ± 40d vs. negative 29w6d ± 54d, p = 0.036). For TVC I, GA at delivery was longer when pre-cerclage urogenital cultures were positive (positive culture 38w0d ± 26d vs. negative 35w4d ± 42d, p = 0.035). Overall post-cerclage urogenital cultures status was not associated with a different GA at delivery. Treating patients with pre- or post-cerclage positive urogenital cultures did also not change GA at delivery.

Conclusion
Positive urogenital cultures taken before clinically indicated cerclage intervention may be associated with lower GA at delivery. However, there seems to be no benefit of antibiotic treatment or routine urogenital cultures during follow-up of asymptomatic women after cerclage placement.