bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for early periventricular intraventricular hemorrhage in extremely low birth weight infants: a retrospective study
Authors: Cai Yueju , Jiang Yongjiang , Wang Ping , Zhao Xiaopeng , Song Yanyan , Li Xiaolan 
Published: April 2024

Abstract

Background
This study aimed to explore the risk factors for early periventricular intraventricular hemorrhage (PIVH) in extremely low birth weight infants (ELBWIs), provide guidance for early intervention, and improve the survival rate and life expectancy of ELBWIs.
Methods
A retrospective study was conducted on 205 ELBWIs admitted to the Women and Children's Medical Center of Guangzhou Medical University from January 2019 to December 2023. The presence and severity of PIVH were assessed through standard head ultrasound screening (HUS) using the modified Papile classification on days 1–3 and 5–7 postbirth. The infants were categorized into either the PIVH group or the non-PIVH group based on the HUS findings. Univariate analysis and logistic regression were employed to identify the risk factors associated with PIVH. The efficacy of the model was evaluated using a receiver operating characteristic (ROC) curve.
Results
Among the 205 ELBWIs (97 males and 108 females) included in the study, 82 patients (40.0%) developed PIVH, 26 patients (12.7%) had severe PIVH, and 56 patients (27.3%) had mild PIVH. Of the 82 PIVH cases, 51 occurred within 3 days after birth. The incidence rates of severe PIVH in the 23+ 1-26-, 26+ 1-28-, and 28+ 1-32-week gestational age groups were 40.0% (16/40), 10.7% (10/93), and 1.4% (1/72), respectively (χ2 = 34.392, p = 0.000). Logistic regression analysis revealed that failure to withdraw invasive ventilators within 1 week (OR = 3.668, 95% CI = 1.557–8.641, p = 0.003) and the use of vasoactive drugs within 1 week (OR = 2.193, 95% CI = 1.033–4.658, p = 0.041) were independent risk factors for PIVH (sensitivity = 68.3%).The specificity was 81.3%, and the AUC was 0.792.
Conclusion
The incidence of PIVH in extremely low birth weight infants is relatively high, particularly within the first three days after birth. The use of vasoactive drugs and delayed removal of invasive ventilators may increase the risk.
Immune checkpoint blockade therapies efficacy and toxicity in patients with impaired renal function in metastatic bladder cancer
Authors: Tural¹ Deniz , Arslan Cagatay , Selcukbiricik Fatih , Olmez Omer Fatih , Akar¹ Emre , Erman Mustafa , Ürün Yüksel , Erdem Dilek , Kilickap Saadettin 
Published: April 2024

Abstract

Background
In this study, we reported the real-life results of data from impaired renal patients with urothelial carcinoma who were treated with ICTs.
Methods
The patients were categorized into 3 different groups GFR≥60mL/min (normal), 60–30mL/min (low), and less than 30 mL/min (very low) based on GFR. The primary endpoints were the overall response rate (ORR), overall survival (OS), duration of response with ICT, and safety. Median follow-up and OS were estimated by using the Kaplan-Meier method.
Results
One hundred-five( 60.3%) of patients were GFR normal, 26.4% were GFR low with 30–60 mL/min, and %13.2 were very low group.
ORR for GFR normal, low and very low groups were 36% (n=38), 26% (n=12) and %31 (7); p=0.2, respectively. The median duration of response for GFR normal, low and very low groups were 47.2 months (95% CI, 24.5–51.4), 33.1 months (95% CI, 26.9–47), and 23.5 months (95% CI, 12.2–43.7); p=0.01, respectively. The Median OS rate for GFR normal, low and very low groups were 11.9 (7.2–16.5) months, 4.7 (1.8–7.7) and 6.8 (1.1–13.6) months, p=0.015, respectively.
In addition, GFR <60 ml/min HR=1.6; 95% CI 1.12-1.80; p=0.02, maintained a significant association with OS in multivariate analysis
Conclusions
Long-term follow-up of real-world data confirms that the overall survival rate and durable response rate with ICT were higher in patients with GFR >60mL/min. On the other hand, we demonstrated that ICT was effective and a durable response seen in a group of patients with renal inpairement who did not have an effective systemic treatment option
Narrative Identity Alterations in Autism Spectrum Disorder: A Life Story Approach
Authors: Allé Mélissa C. , Schneider Priscille , Rigoulot Lyla , Gandolphe Marie-Charlotte , Danion Jean-Marie , Coutelle Romain , Berna Fabrice 
Published: April 2024

Abstract

Autism spectrum disorder (ASD) is characterized by an alteration of the sense of self, particularly self-continuity. While former studies focused on the recollection and narrative of single past events, the present study aimed to explore autistic individuals’ narrative identity by assessing for the first time their life story, described as the most integrated form of personal narrative and the closest to the self. A comparison of the narrative coherence of autistic individuals’ life stories (n = 22) with those of nonautistic participants (n = 22) revealed that global coherence, particularly causal-motivational coherence, was lower in the life narratives of autistic individuals. Additionally, typical narrative beginnings at birth and elaborated endings were less frequent in autistic individuals. In comparison with the nonautistic group, the ASD group included personal events in their life narratives that were self-rated as more negative and associated with negative feelings at retrieval, along with having lower life impacts. The present study provides evidence for an impaired narrative identity in ASD. We discussed how this effect could be related to a lower narrative coherence and an impaired temporal framework, possibly associated with a lack of others’ perspective-taking.
Clinical profile and treatment of patients with Vulvar Cancer: experience from a novice Gynecologic Oncology unit in Sub Saharan Africa
Authors: Birara Malede , Gudu Wondimu , Mekonen Tadios , Abdu Amani 
Published: April 2024

Abstract

Introduction
Vulvar cancer is rare accounting approximately for 4% of gynecologic malignancies. The prevalence of vulvar cancer rising in sub-Saharan Africa primarily attributed to high incidence of HIV infections. This study aims to explore clinic-pathologic profile and treatment of patients at a novice gynecologic oncology unit in Ethiopia.
Methodology
A descriptive cross-sectional study was conducted, among vulvar cancer patients treated at Saint Paul’s Hospital millennium medical college in Ethiopia, gynecology oncologic unit from 2016 to 2020. Data was collected from patients’ medical records and hospital registries using a simple data extraction format. Data was analyzed using IBM SPSS 23.1 computer statistical software.
Results
The magnitude of vulvar cancer was 3.6%, with mean age of patients being 42 years. Commonest symptoms were vulvar swelling, itching, and ulceration. The average duration of symptoms was 12 months and 66 percent of patients were HIV positive. The mean lesion size was 5 cm, with squamous cell carcinoma being the most prevalent (82%). Disease was early stage in 56% percent of patients. Fifty seven Percent were given treatment. Surgery was done to 37% of patients, postoperative wound complications rate being 30 percent. 43 percent had Postoperative follow-up and among those who adhered to follow-up, 85 individuals were disease-free at the last assessment, with only one case of recurrent disease.
Conclusions
Vulvar cancer is not uncommon being more prevalent among HIV patients. Early diagnosis and staging are crucial for improved patient outcomes. Interventions to raise awareness, implementing screening programs, and ensuring early referrals are imperative.
Characterization of Diabetic Kidney Disease in 235 Patients: Clinical and Pathological Insights with or without Concurrent Non-Diabetic Kidney Disease
Authors: Jiang Mengjie , Chen Hongyu , Luo Jing , Chen Jinhan , Gao Li , Zhu Qin 
Published: April 2024

Abstract

BACKGROUND This study aimed to explore the clinical and pathological features of patients with diabetic kidney disease (DKD), with and without non-diabetic kidney disease (NDKD), through a retrospective analysis. The objective was to provide clinical insights for accurate identification.METHODS A retrospective analysis of 235 patients admitted to the Department of Nephrology at Hangzhou Hospital of Traditional Chinese Medicine was conducted between July 2014 and December 2022. These patients underwent renal biopsy and received a pathology-based diagnosis of DKD. They were categorized into the DKD group (93 cases) and the DKD + NDKD group (142 cases).RESULTS In the DKD group, nodular diabetic glomerulosclerosis was the most prevalent, accounting for 63% of cases. In the DKD + NDKD group, the predominant pathological types were coupled with acute and chronic tubulointerstitial lesions, and IgA nephropathy, accounting for 40.14% and 35.21%, respectively. Clinical correlation analysis revealed associations between glomerular grading, tubulointerstitial lesions, renal arteriolar vitelliform lesions, renal vascular atherosclerosis, and clinical parameters such as 24-hour urine protein, hemoglobin, and urinary specific gravity. Multifactorial logistic regression analysis identified independent factors affecting DKD + NDKD, including body mass index, blood creatinine level, microscopic erythrocyte grade, urinary immunoglobulin G/creatinine ratio, and serum immunoglobulin A.CONCLUSION This study provides important insights into the pathological and clinical features of DKD and identifies independent factors associated with DKD + NDKD.
ENSO-Former: Spatiotemporal fusion network based on multivariate and dual-branch Transformer for ENSO prediction
Authors: Fang Wei , Sha Yu 
Published: April 2024

Abstract

El Niño Southern Oscillation (ENSO) is a natural climate phenomenon. Mainly characterized by the periodic variation of sea surface temperature anomalies in the eastern equatorial Pacific. It has significant impacts on global climate change. The traditional ENSO prediction methods rely on complex physical models and empirical rules, but these methods still have significant biases and uncertainties. We design a novel multi-head spatiotemporal convolutional attention module, TSCA Block. The module employs a dual-branch structure to fully exploit spatiotemporal features, where the spatiotemporal attention mechanism is used to capture long-term dependencies in time and space. Subsequent convolutional modules are used to locally enhance features. In addition, we also propose a spatiotemporal fusion prediction model based on multivariable and dual-branch Transformers, called ENSO-Former. By repeating basic building blocks at multiple stages and adopting long skip connections between shallow and deep layers, it captures multiscale features and dynamic changes of ENSO more effectively. We train using multiple meteorological factors, initially pre-training with various model-simulated data, followed by fine-tuning using transfer learning on reanalysis datasets. Experimental results show that the model achieves a correlation skill of 0.51 for predicting ENSO 20 months in advance during the period from 1983 to 2021. Compared to the current state-of-the-art deep learning model, the correlation skill is improved by 0.06. The source code will be available at https://github.com/shaxiaoyuyu/ensoformer.git.
The suture fixation of the levonorgestrel-releasing intrauterine device with hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion
Authors: Mao Min , Gou Yuanqin , Luo Zhigui , Li Yuanhong , Tong Yu 
Published: April 2024

Abstract

Background: This study aimed to investigate the safety and efficacy ofsuture fixation of the levonorgestrel-releasing intrauterine device (LNG-IUD) by hysteroscope for the treatment of adenomyosis in patients at high risk of device expulsion.
Methods: 21 patients with large symptomaticadenomyosis were sewed and fixed with the LNG-IUD in the uterus by hysteroscopy to prevent the device expulsion.
Results:In this prospective case series, all 21 patients were successfully sewed and fixed with the LNG-IUD in the uterus by hysteroscopy. The amount of menstruation was significantly decreased and dysmenorrhea was significantlyrelieved in 3, 6, and 12 months after surgery compared with before surgery. Only one patient underwent a laparoscopic hysterectomy due to dysmenorrhea which was not alleviated one month later. Serious IUD complications including expulsion and perforation were not observed. There was no development of new side effects than LNG-IUD insertion.
Conclusion: Suture fixation of the LNG-IUD by hysteroscope is a safe, effective, and minimally invasive surgical procedure to prevent the device expulsion. It is a good solution for the treatment of patients with large symptomatic adenomyosis.
Uncovering CARD14 features in cancer
Authors: Manils Joan , Bespalov Daniil , Pino Dayana , Vidal-Guirao Sonia , Franquesa Julia , Lopez-Ramajo Daniel , Filgaira Ingrid , Wan Li , O'Sullivan Paul A , Ley Steven C , Forcales Sonia Vanina , Rojas Juan Jose , Izquierdo-Serra Merce , Soler Concepcio 
Published: April 2024

Abstract

Aberrant caspase recruitment domain family member 14 (CARD14) signaling has been strongly associated with inflammatory skin conditions. CARD14 acts as a scaffold protein, ultimately activating the transcription factor NF-KB. Although primarily studied in the context of inflammation, recent research has suggested its potential implications in tumorigenesis. In this study, we gathered TCGA tumor data to gauge the involvement of CARD14 in cancer, including genetic alterations, expression patterns, survival correlations, immune cell infiltration and functional interactions across diverse cancer types. We found heightened CARD14 expression in different tumors, which was associated with patient outcomes; hence, CARD14 could be used as a prognostic biomarker in several cancers, highlighting its potential clinical relevance.
A scattered volume emitter micropixel architecture for ultraefficient light extraction from DUV LEDs
Authors: Fajri Faris Azim Ahmad , Mukherjee Anjan , Naskar Suraj , Noorden Ahmad Fakhrurrazi Ahmad , Abass Aimi 
Published: April 2024

Abstract

Deep ultraviolet light-emitting diodes (DUV LEDs) typically suffer from strong parasitic absorption in the p-epitaxial layer and rear metal contact/mirror. This problem is exacerbated by a significant portion of the multiquantum well (MQW) emissions having a strong out-of-plane dipole component, contributing to emission in widely oblique directions outside the exit cone of the emitting surface. Here, an architecture that exploits heavy oblique emission is proposed by using scattered volume emitter micropixels that are spaced apart and embedded in a low-index dielectric buffer film with a patterned top surface. This approach significantly increases the surface-to-volume ratio of the semiconductor and does not require a high-index (e.g., sapphire) substrate or a lens to achieve high extraction efficiency. Depending on the assumed epilayer absorption, the hybrid wave and ray optical simulations demonstrated a 3- to 6-fold increase in light extraction efficiency compared to that of a conventional planar design with a sapphire substrate reference. An extraction efficiency three times greater than that of a recent nanotextured DUV LED design was also demonstrated. This architecture paves the way for DUV LEDs to have a plug efficiency comparable to that of mercury lamps while still being significantly smaller.
MicroRNA-195-5p suppresses metastasis by targeting VEGFA in nasopharyngeal carcinoma
Authors: Li Xian , zhu Qin , Xie Liang , Liu Xiang-Lin , Hu Jing-Ye , Yi Wei 
Published: April 2024

Abstract

Background
MicroRNA (miRNA) plays an important role in nasopharyngeal carcinoma (NPC). We aimed to identify a microRNA that can help us understand the molecular mechanism and develop target therapy for NPC.
Methods:
MiRNA expression levels in 18 specimens of nasopharyngeal carcinoma were firstly analysed using quantitative real-time PCR (qRT-PCR). Then we further detected vascular endothelial growth factor A (VEGFA) protein with immunohistochemistry in 108 paraffin-embedded samples from the First Affiliated Hospital of Guangzhou Medical University (Guangzhou, China). The cell line Hone1, 5-8F, CNE1 and CNE2 were employed in transwell invasion assay, western blot, RT-PCR and dual luciferase assay.
Results:
We found miR-195-5p had a lower expression level in high metastasis potential NPC, compared with low metastasis potential NPC (p < 0.05). In in-vitro experiment, the over expressed miR-195-5p resulted in significant decrease in migration and invasion of NPC cells. In contrast, the down-regulation of miR-195-5p increased their migration and invasion. By using dual luciferase assay, we found a binding site between miR-195-5p and 3’-UTR of VEGFA. Through direct binding, miR-195-5p can suppress VEGFA in NPC cell. The results of immunohistochemistry showed that patients with high expression of VEGFA had a poor distance-metastasis free survival (p < 0.05).
Conclusions:
It was concluded that the expression level of miR-195-5p in patients with NPC was associated with metastasis by targeting VEGFA, which suggests that miR-195-5p is a potential biomarker of prognosis and molecular therapeutic target in NPC.
Hepatic Steatosis affects the Outcome of Anti- tuberculosis Treatment in Pulmonary Tuberculosis Patients
Authors: Du Zhi-xiang , Yang Yuan , Gong Yu-xiang , Liu Xing , Chen Miao-yang , Wang Li , Liu Hong-li , Zhang Yu , Hu Chun-mei , YANG Jiang-hua , Hao Ming-da , Li Yang , Yang Yong-feng 
Published: April 2024

Abstract

Background:
Pulmonary Tuberculosis (PTB) remains the leading cause of death from infectious diseases worldwide. Few studies have investigated hepatic steatosis's effect on PTB's progression and prognosis.
Methods: We selected 785 PTB patients in this study. And 174 PTB patients were enrolled in the statistical analysis. Patients with positive sputum smears for over eight weeks are clustered in the Extension Group. Conversely, the other patients are clustered in the Unextended Group. The clinical data were used to analyze the risk factors for the time of smear conversion.
Results:
Eleven different factors were obtained from the clinical data of PTB patients. According to clinical significance, correlation detection, collinearity diagnosis, and chest package score, six factors were enrolled into the model. The logistics regression analysis confirmed that Hepatic steatosis and IL-18 were positively correlated with the smear conversion (β= 2.401, OR =11.036, 95% CI = 2.489-48.934; β= 2.396, OR =10.984, 95% CI = 1.832-65.862). On the contrary, the T-SPOT was negatively correlated with the smear conversion (β= -4.199, OR =0.015, 95% CI = 0.001-0.172).
Conclusions:
Hepatic steatosis is confirmed as an independent risk factor affecting smear conversion time in PTB. The levels of serum cytokines, such as IL-6 and IL-18, are significantly related to the outcome of anti-tuberculosis treatment. Previous studies have confirmed that hepatic steatosis is associated with abnormal serum cytokines. Therefore, more attention is needed for the PTB patients with hepatic steatosis.
Derivation and Validation of Generalized Sepsis-induced Acute Respiratory Failure Phenotypes Among Critically Ill Patients: A Retrospective Study
Authors: Choudhary Tilendra , Upadhyaya Pulakesh , Davis Carolyn M. , Yang Philip , Tallowin Simon , Lisboa Felipe A. , Schobel Seth A. , Coopersmith Craig M. , Elster Eric A. , Buchman Timothy G. , Dente Christopher J. , Kamaleswaran Rishikesan 
Published: April 2024

Abstract

Background: Septic patients who develop acute respiratory failure (ARF) requiring mechanical ventilation represent a heterogenous subgroup of critically ill patients with widely variable clinical characteristics. Identifying distinct phenotypes of these patients may reveal insights about the broader heterogeneity in the clinical course of sepsis. We aimed to derive novel phenotypes of sepsis-induced ARF using observational clinical data and investigate their generalizability across multi-ICU specialties, considering multi-organ dynamics.
Methods: We performed a multi-center retrospective study of ICU patients with sepsis who required mechanical ventilation for ≥24 hours. Data from two different high-volume academic hospital systems were used as a derivation set with N=3,225 medical ICU (MICU) patients and a validation set with N=848 MICU patients. For the multi-ICU validation, we utilized retrospective data from two surgical ICUs at the same hospitals (N=1,577). Clinical data from 24 hours preceding intubation was used to derive distinct phenotypes using an explainable machine learning-based clustering model interpreted by clinical experts.
Results: Four distinct ARF phenotypes were identified: A (severe multi-organ dysfunction (MOD) with a high likelihood of kidney injury and heart failure), B (severe hypoxemic respiratory failure [median P/F=123]), C (mild hypoxia [median P/F=240]), and D (severe MOD with a high likelihood of hepatic injury, coagulopathy, and lactic acidosis). Patients in each phenotype showed differences in clinical course and mortality rates despite similarities in demographics and admission co-morbidities. The phenotypes were reproduced in external validation utilizing an external MICU from second hospital and SICUs from both centers. Kaplan-Meier analysis showed significant difference in 28-day mortality across the phenotypes (p<0.01) and consistent across both centers. The phenotypes demonstrated differences in treatment effects associated with high positive end-expiratory pressure (PEEP) strategy.
Conclusion: The phenotypes demonstrated unique patterns of organ injury and differences in clinical outcomes, which may help inform future research and clinical trial design for tailored management strategies.
Reducing adverse events associated with pediatric cardiac catheterization: A quality improvement project focusing on decreasing unnecessary blood transfusions
Authors: Wilhelm Michael , Torgeson Jenna , Cook Connor , Erdmann Alexandra , Boriosi Juan , Lamers Luke 
Published: April 2024

Abstract

Objective: To describe interventions and outcomes of a quality improvement (QI) project to reduce red blood cell transfusion (RBCT) within 72 hours of pediatric cardiac catheterization.
Methods: Using Plan-Do-Study-Act (PDSA) methodology we applied interventions including: 1. Intraprocedural - to reduce hemodilution, blood loss, and excessive anticoagulation, 2. Standardization of institutional transfusion criteria, and 3. “Hard stop” requiring QI team approval prior to elective RBCT. Primary outcome measures were frequency of RBCT from IMPACT quarterly reports and cases between transfusions (CBT). Length of stay (LOS) was a countermeasure. Characteristics of patients who did and did not receive RBCT were compared.
Results: 698 pediatric cardiac catheterizations occurred between 4/2017-8/2023. Intraprocedural interventions did not alter frequency of RBCT or CBT. Standardized transfusion guidelines followed by the “hard stop” decreased RBCT frequency from 10% to 1.9% and increased CBT without increasing LOS. Patients requiring RBCT were younger (medians 0.31 vs 2.4 years), smaller (5.2 vs 11.8 kg) and had longer procedures (2.24 vs 1.57 hours) all p<0.001. Single ventricle patients were more likely to have RBCT than simple biventricular patients (14.1% vs 3.1%; RR = 4.57, 95% CI: 2.29–10.4; p < 0.001). Procedure type (diagnostic vs. intervention) and starting hemoglobin concentration were comparable between groups.
Conclusion: Programmatic adherence to standardized peri-procedural transfusion guidelines successfully decreased RBCT without compromising patient care or increasing LOS. Younger age, lower weight, procedure length, and single ventricle physiology were all associated with RBCT risk.