bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of BlockBuster laryngeal mask with Air‐Q intubating laryngeal airway as a conduit for fiber‐optic guided intubation in children: A prospective randomized controlled study
Authors: Soni Lipika , Kumar Kanil Ranjith , Sinha Renu , Ayub Arshad , Patel Nishant 
Published: April 2024

AbstractBackgroundThe pediatric sizes of BlockBuster supraglottic airway (SGA) have been introduced recently. Its efficacy as a conduit for endotracheal intubation in children has not been assessed. Newer devices are often compared with Air‐Q SGA to assess their intubating capability.AimsThe primary objective was to compare the time taken for fiber‐optic‐guided intubation through the BlockBuster and the Air‐Q SGAs.MethodsSixty children aged 6 months to 12 years with normal airways were randomized into two groups: Air‐Q SGA (Group A) and Blockbuster SGA (Group B). After administration of general anesthesia, an appropriately sized SGA was inserted. The time taken for fiber‐optic‐guided intubation through the SGA, success, ease, and time for SGA insertion and removal were noted. The glottic view was graded by fiber‐optic bronchoscopy.ResultsDemographic parameters were comparable. The time to intubate with the BlockBuster 62.40 ± 17.2 s was comparable to the Air‐Q 60.8 ± 18.5 s (mean difference 1.6 s, 95% CI −7.65 to10.85; p = .73). The average time for SGA insertion in BlockBuster and Air‐Q was 14.57 ± 3.2 s and 16.67 ± 5.39 s, respectively (mean difference −2.1, 95% CI −4.39 to 0.19 s; p = .07). The first‐attempt intubation success and overall intubation success rates were comparable in both groups, 96.7% and 100%, respectively. In Group B, 25/3/1/1/0 cases had a glottic view grade of 1/2/3/4/5, respectively. In Group A, 23/3/2/2/0 cases had grade of 1/2/3/4/5 glottic views respectively. The average time to SGA removal was comparable between the BlockBuster (20.17 ± 5.8 s) and the Air‐Q (22.5 ± 12.8 s) groups (mean difference −2.3 s, 95% CI −7.5 to 2.82 s; p = .37). None of the children had any perioperative complications.ConclusionBlockBuster SGA may be a useful alternative to Air‐Q for SGA‐assisted, fiber‐optic‐guided tracheal intubation in children.
Heavy metal stress and mitogen activated kinase transcription factors in plants: Exploring heavy metal‐ROS influences on plant signalling pathways
Authors: Niekerk Lee‐Ann , Gokul Arun , Basson Gerhard , Badiwe Mihlali , Nkomo Mbukeni , Klein Ashwil , Keyster Marshall 
Published: April 2024

AbstractDue to their stationary nature, plants are exposed to a diverse range of biotic and abiotic stresses, of which heavy metal (HM) stress poses one of the most detrimental abiotic stresses, targeting diverse plant processes. HMs instigate the overproduction of reactive oxygen species (ROS), and to mitigate the adverse effects of ROS, plants induce multiple defence mechanisms. Besides the negative implications of overproduction of ROS, these molecules play a multitude of signalling roles in plants, acting as a central player in the complex signalling network of cells. One of the ROS‐associated signalling mechanisms is the mitogen‐activated protein kinase (MAPK) cascade, a signalling pathway which transduces extracellular stimuli into intracellular responses. Plant MAPKs have been implicated in signalling involved in stress response, phytohormone regulation, and cell cycle cues. However, the influence of various HMs on MAPK activation has not been well documented. In this review, we address and summarise several aspects related to various HM‐induced ROS signalling. Additionally, we touch on how these signals activate the MAPK cascade and the downstream transcription factors that influence plant responses to HMs. Moreover, we propose a workflow that could characterise genes associated with MAPKs and their roles during plant HM stress responses.
The latest Jurassic–earliest Cretaceous climate and oceanographic changes in the Western Tethys: The Transdanubian Range (Hungary) perspective
Authors: Lodowski Damian G. , Szives Ottilia , Virág Attila , Grabowski Jacek 
Published: April 2024

AbstractThe Jurassic/Cretaceous transition was characterized by several distinct palaeoenvironmental processes and events, amongst which some of the best known are the late Tithonian–early Berriasian aridization and the late Berriasian tectonic reactivation in the Neotethyan Collision Belt. This study aims to reconstruct the latest Jurassic–earliest Cretaceous palaeoenvironment and its evolution in the area of the Transdanubian Range (Hárskút and Lókút successions, Hungary), and provide new data on the relation between climate changes, palaeoceanography and marine ecosystems. Herein, calcareous nannofossil and geochemical data are presented and put into a geochronological framework in order to evaluate and compare palaeoenvironmental signals recorded in the two studied successions; the resultant scenario is compared with published literature data from both the western Tethyan region and northern Europe. Accordingly, in the Transdanubian Range, the relatively humid climate of the early Tithonian was followed by the late Tithonian–early Berriasian arid phase and the late Berriasian humidification. Besides, two intervals of palaeoceanographic perturbations were documented in the upper Tithonian–lowermost Berriasian (OD I), and the lower/upper Berriasian transition beds (OD II); these are manifested by the record of seafloor hypoxia and elevated accumulations of micronutrients, as well as changes in calcareous nannofossil assemblages. In the view of this study, the most probable trigger of the late Tithonian–early Berriasian aridization was a restriction in the atmospheric circulation (including monsoons), which was forced by climate cooling and lowering thermal gradient between landmasses and the ocean. Under such conditions, the mechanism of a wind‐induced water mixing might become less efficient, driving seawater stratification, seafloor hypoxia and increased burial of nutrients. Although the humid climate of the late Berriasian likely resumed the monsoon‐type circulation, the tectonic reactivation and uplift in the NeoTethyan Collision Belt might have effectively separated the Bakony Basin from the ‘open’ NeoTethys, which hampered the marine circulation and efficient water mixing in the former.
Fluid Dynamic Study of the Penn State Pediatric Total Artificial Heart
Authors: Kubicki Cody , Raich Emma , Selinsky Peter , Ponnaluri Sailahari , Weiss William J. , Manning Keefe B. 
Published: April 2024

Abstract
Penn State University is developing a pediatric total artificial heart (TAH) as a bridge-to-transplant device that supports infants and small children with single ventricle anomalies or biventricular heart failure to address high waitlist mortality rates for pediatric patients with severe congenital heart disease (CHD). Two issues with mechanical circulatory support devices are thrombus formation and thromboembolic events. This in vitro study characterizes flow within Penn State's pediatric total artificial heart under physiological operating conditions. Particle image velocimetry (PIV) is used to quantify flow within the pump and to calculate wall shear rates (WSRs) along the internal pump surface to identify potential thrombogenic regions. Results show that the diastolic inflow jets produce sufficient wall shear rates to reduce thrombus deposition potential along the inlet side of the left and right pumps. The inlet jet transitions to rotational flow, which promotes wall washing along the apex of the pumps, prevents flow stasis, and aligns flow with the outlet valve prior to systolic ejection. However, inconsistent high wall shear rates near the pump apex cause increased thrombogenic potential. Strong systolic outflow jets produce high wall shear rates near the outlet valve to reduce thrombus deposition risk. The right pump, which has a modified outlet port angle to improve anatomical fit, produces lower wall shear rates and higher thrombus susceptibility potential (TSP) compared to the left pump. In summary, this study provides a fluid dynamic understanding of a new pediatric total artificial heart and indicates thrombus susceptibility is primarily confined to the apex, consistent with similar pulsatile heart pumps.
Murine norovirus mutants adapted to replicate in human cells reveal a post-entry restriction
Authors: Budicini Melissa R. , Rodriguez-Irizarry Valerie J. , Maples Robert W. , Pfeiffer Julie K. 
Published: April 2024

ABSTRACT

RNA viruses lack proofreading in their RNA polymerases and therefore exist as genetically diverse populations. By exposing these diverse viral populations to selective pressures, viruses with mutations that confer fitness advantages can be enriched. To examine factors important for viral tropism and host restriction, we passaged murine norovirus (MNV) in a human cell line, HeLa cells, to select mutant viruses with increased fitness in non-murine cells. A major determinant of host range is expression of the MNV receptor CD300lf on mouse cells, but additional host factors may limit MNV replication in human cells. We found that viruses passaged six times in HeLa cells had enhanced replication compared with the parental virus. The passaged viruses had several mutations throughout the viral genome, which were primarily located in the viral non-structural coding regions. Although viral attachment was not altered for the passaged viruses, their replication was higher than the parental virus when the entry was bypassed, suggesting that the mutant viruses overcame a post-entry block in human cells. Three mutations in the viral NS1 protein were sufficient for enhanced post-entry replication in human cells. We found that the human cell-adapted MNV variants had reduced fitness in murine BV2 cells and infected mice, with reduced viral titers. These results suggest a fitness tradeoff, where increased fitness in a non-native host cell reduces fitness in a natural host environment. Overall, this work suggests that MNV tropism is determined by the presence of not only the viral receptor but also post-entry factors.

IMPORTANCE
Viruses infect specific species and cell types, which is dictated by the expression of host factors required for viral entry as well as downstream replication steps. Murine norovirus (MNV) infects mouse cells, but not human cells. However, human cells expressing the murine CD300lf receptor support MNV replication, suggesting that receptor expression is a major determinant of MNV tropism. To determine whether other factors influence MNV tropism, we selected for variants with enhanced replication in human cells. We identified mutations that enhance MNV replication in human cells and demonstrated that these mutations enhance infection at a post-entry replication step. Therefore, MNV infection of human cells is restricted at both entry and post-entry stages. These results shed new light on factors that influence viral tropism and host range.
Harnessing the power of IFN for therapeutic approaches to COVID-19
Authors: Viox Elise G. , Bosinger Steven E. , Douek Daniel C. , Schreiber Gideon , Paiardini Mirko 
Published: April 2024

ABSTRACT

Interferons (IFNs) are essential for defense against viral infections but also drive recruitment of inflammatory cells to sites of infection, a key feature of severe COVID-19. Here, we explore the complexity of the IFN response in COVID-19, examine the effects of manipulating IFN on SARS-CoV-2 viral replication and pathogenesis, and highlight pre-clinical and clinical studies evaluating the therapeutic efficacy of IFN in limiting COVID-19 severity.
Prediction of high-risk emergency department revisits from a machine-learning algorithm: a proof-of-concept study
Authors: Sung Chih-Wei , Ho Joshua , Fan Cheng-Yi , Chen Ching-Yu , Chen Chi-Hsin , Lin Shao-Yung , Chang Jia-How , Chen Jiun-Wei , Huang Edward Pei-Chuan 
Published: April 2024

BackgroundHigh-risk emergency department (ED) revisit is considered an important quality indicator that may reflect an increase in complications and medical burden. However, because of its multidimensional and highly complex nature, this factor has not been comprehensively investigated. This study aimed to predict high-risk ED revisit with a machine-learning (ML) approach.MethodsThis 3-year retrospective cohort study assessed adult patients between January 2019 and December 2021 from National Taiwan University Hospital Hsin-Chu Branch with high-risk ED revisit, defined as hospital or intensive care unit admission after ED return within 72 hours. A total of 150 features were preliminarily screened, and 79 were used in the prediction model. Deep learning, random forest, extreme gradient boosting (XGBoost) and stacked ensemble algorithm were used. The stacked ensemble model combined multiple ML models and performed model stacking as a meta-level algorithm. Confusion matrix, accuracy, sensitivity, specificity and area under the receiver operating characteristic curve (AUROC) were used to evaluate performance.ResultsAnalysis was performed for 6282 eligible adult patients: 5025 (80.0%) in the training set and 1257 (20.0%) in the testing set. High-risk ED revisit occurred for 971 (19.3%) of training set patients vs 252 (20.1%) in the testing set. Leading predictors of high-risk ED revisit were age, systolic blood pressure and heart rate. The stacked ensemble model showed more favourable prediction performance (AUROC 0.82) than the other models: deep learning (0.69), random forest (0.78) and XGBoost (0.79). Also, the stacked ensemble model achieved favourable accuracy and specificity.ConclusionThe stacked ensemble algorithm exhibited better prediction performance in which the predictions were generated from different ML algorithms to optimally maximise the final set of results. Patients with older age and abnormal systolic blood pressure and heart rate at the index ED visit were vulnerable to high-risk ED revisit. Further studies should be conducted to externally validate the model.
Impact of age, comorbidities and relevant changes on surveillance strategy of intraductal papillary mucinous neoplasms: a competing risk analysis
Authors: Crippa Stefano , Marchegiani Giovanni , Belfiori Giulio , Rancoita Paola Vittoria Maria , Pollini Tommaso , Burelli Anna , Apadula Laura , Scarale Maria Giovanna , Socci Davide , Biancotto Marco , Vanella Giuseppe , Arcidiacono Paolo Giorgio , Capurso Gabriele , Salvia Roberto , Falconi Massimo 
Published: April 2024

Objective
Cost-effectiveness of surveillance for branch-duct intraductal papillary mucinous neoplasms (BD-IPMNs) is debated. We combined different categories of risks of IPMN progression and of IPMN-unrelated mortality to improve surveillance strategies.

Design
Retrospective analysis of 926 presumed BD-IPMNs lacking worrisome features (WFs)/high-risk stigmata (HRS) under surveillance. Charlson Comorbidity Index (CACI) defined the severity of comorbidities. IPMN relevant changes included development of WF/HRS, pancreatectomy or death for IPMN or pancreatic cancer. Pancreatic malignancy-unrelated death was recorded. Cumulative incidence of IPMN relevant changes were estimated using the competing risk approach.

Results
5-year cumulative incidence of relevant changes was 17.83% and 1.6% developed pancreatic malignancy. 5-year cumulative incidences for IPMN relevant changes were 13.73%, 19.93% and 25.04% in low-risk, intermediate-risk and high-risk groups, respectively. Age ≥75 (HR: 4.15) and CACI >3 (HR: 3.61) were independent predictors of pancreatic malignancy-unrelated death. 5-year cumulative incidence for death for other causes was 15.93% for age ≥75+CACI >3 group and 1.49% for age <75+CACI ≤3. 5-year cumulative incidence of IPMN relevant changes were 13.94% in patients with age <75+CACI ≤3 compared with 29.60% in those with age ≥75+CACI >3. In this group 5-year rate of malignancy-free patients was 95.56% with a 5-year survival of 79.51%.

Conclusion
Although it is not uncommon the occurrence of changes considered by current guidelines as relevant during surveillance of low risk BD-IPMNs, malignancy rate is low and survival is significantly affected by competing patients’ age and comorbidities. IPMN surveillance strategy should be tailored based on these features and modulated over time.
Preferential whole blood transfusion during the early resuscitation period is associated with decreased mortality and transfusion requirements in traumatically injured patients
Authors: Lammers Daniel , Hu Parker , Rokayak Omar , Baird Emily W , Betzold Richard D , Hashmi Zain , Kerby Jeffrey David , Jansen Jan O , Holcomb John B 
Published: April 2024

IntroductionWhole blood (WB) transfusion represents a promising resuscitation strategy for trauma patients. However, a paucity of data surrounding the optimal incorporation of WB into resuscitation strategies persists. We hypothesized that traumatically injured patients who received a greater proportion of WB compared with blood product components during their resuscitative efforts would have improved early mortality outcomes and decreased transfusion requirements compared with those who received a greater proportion of blood product components.MethodsRetrospective review from our Level 1 trauma center of trauma patients during their initial resuscitation (2019–2022) was performed. WB to packed red blood cell ratios (WB:RBC) were assigned to patients based on their respective blood product resuscitation at 1, 2, 3, and 24 hours from presentation. Multivariable regression models were constructed to assess the relationship of WB:RBC to 4 and 24-hour mortality, and 24-hour transfusion requirements.Results390 patients were evaluated (79% male, median age of 33 years old, 48% penetrating injury rate, and a median Injury Severity Score of 27). Overall mortality at 4 hours was 9%, while 24-hour mortality was 12%. A significantly decreased 4-hour mortality was demonstrated in patients who displayed a WB:RBC≥1 at 1 hour (5.9% vs. 12.3%; OR 0.17, p=0.015), 2 hours (5.5% vs. 13%; OR 0.16, p=0.019), and 3 hours (5.5% vs. 13%, OR 0.18, p<0.01), while a decreased 24-hour mortality was displayed in those with a WB:RBC≥1 at 24 hours (7.9% vs. 14.6%, OR 0.21, p=0.01). Overall 24-hour transfusion requirements were significantly decreased within the WB:RBC≥1 cohort (12.1 units vs. 24.4 units, p<0.01).ConclusionPreferential WB transfusion compared with a balanced transfusion strategy during the early resuscitative period was associated with a lower 4 and 24-hour mortality, as well as decreased 24-hour transfusion requirements, in trauma patients. Future prospective studies are warranted to determine the optimal use of WB in trauma.Level of evidenceLevel III/therapeutic
The FKBP51s Splice Isoform Predicts Unfavorable Prognosis in Patients with Glioblastoma
Authors: Giordano Carolina , Marrone Laura , Romano Simona , Della Pepa Giuseppe Maria , Donzelli Carlo Maria , Tufano Martina , Capasso Mario , Lasorsa Vito Alessandro , Quintavalle Cristina , Guerri Giulia , Martucci Matia , Auricchio Annamaria , Gessi Marco , Sala Evis , Olivi Alessandro , Romano Maria Fiammetta , Gaudino Simona 
Published: April 2024

Abstract

The primary treatment for glioblastoma (GBM) is removing the tumor mass as defined by MRI. However, MRI has limited diagnostic and predictive value. Tumor-associated macrophages (TAM) are abundant in GBM tumor microenvironment (TME) and are found in peripheral blood (PB). FKBP51 expression, with its canonical and spliced isoforms, is constitutive in immune cells and aberrant in GBM. Spliced FKBP51s supports M2 polarization. To find an immunologic signature that combined with MRI could advance in diagnosis, we immunophenotyped the macrophages of TME and PB from 37 patients with GBM using FKBP51s and classical M1-M2 markers. We also determined the tumor levels of FKBP51s, PD-L1, and HLA-DR. Tumors expressing FKBP51s showed an increase in various M2 phenotypes and regulatory T cells in PB, indicating immunosuppression. Tumors expressing FKBP51s also activated STAT3 and were associated with reduced survival. Correlative studies with MRI and tumor/macrophages cocultures allowed to interpret TAMs. Tumor volume correlated with M1 infiltration of TME. Cocultures with spheroids produced M1 polarization, suggesting that M1 macrophages may infiltrate alongside cancer stem cells. Cocultures of adherent cells developed the M2 phenotype CD163/FKBP51s expressing pSTAT6, a transcription factor enabling migration and invasion. In patients with recurrences, increased counts of CD163/FKBP51s monocyte/macrophages in PB correlated with callosal infiltration and were accompanied by a concomitant decrease in TME-infiltrating M1 macrophages. PB PD-L1/FKBP51s connoted necrotic tumors. In conclusion, FKBP51s identifies a GBM subtype that significantly impairs the immune system. Moreover, FKBP51s marks PB macrophages associated with MRI features of glioma malignancy that can aid in patient monitoring.

Significance:
Our research suggests that by combining imaging with analysis of monocyte/macrophage subsets in patients with GBM, we can enhance our understanding of the disease and assist in its treatment. We discovered a similarity in the macrophage composition between the TME and PB, and through association with imaging, we could interpret macrophages. In addition, we identified a predictive biomarker that drew more attention to immune suppression of patients with GBM.
Abstract 4174: The Association of Coffee Consumption With Wave Reflections in Hypertensive Patients
Authors: Vlachopoulos Charalambos , Alexopoulos Nikolaos , Vyssoulis Gregory , Pietri Panagiota , Zervoudaki Alexandra , Aznaouridis Konstantinos , Aggeli Konstantina , Stefanadis Christodoulos 
Published: April 2024

Introduction: Wave reflections are important markers and prognosticators of cardiovascular risk, and have been implicated in the pathogenesis of systolic hypertension. Caffeine increases acutely wave reflections. Furthermore, chronic coffee consumption is associated with increased wave reflections in normotensive subjects. Hypothesis: In the present study we aimed to assess the association between chronic coffee consumption and wave reflections in hypertensive patients.
Methods: We examined 228 never treated hypertensives (age 50.7±11.9 years, 143 males) under no medication. Frequency of coffee consumption was assessed using a validated food frequency questionnaire. According to the distribution of coffee consumption, we categorized daily coffee consumption as:

none

low (<200 ml/day)

moderate (200 – 450 ml/day) and

high (>450 ml/day).

Augmentation Index (AIx) was measured non-invasively as an index of wave reflections, using SphygmoCor®. Analysis of covariance (ANCOVA) was applied to evaluate the association between AIx and coffee intake after adjusting for several potential confounders.

Results: AIx was found to be increased with increasing degree of daily coffee consumption when adjusted for gender, age, height, smoking status, heart rate, mean pressure, HDL cholesterol and hsCRP (p<0.02, Figure

). Systolic, diastolic, pulse and mean pressures were not different among the 4 groups of daily coffee consumption.

Conclusions: Increased daily coffee consumption is associated with enhanced wave reflections in hypertensive patients. This finding may have important implications for the management of these patients.