bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between gut microbiota dysbiosis and poor functional outcomes in acute ischemic stroke patients with COVID-19 infection
Authors: Chen Jiaying , Gao Xuxuan , Liang Jingru , Wu Qiheng , Shen Linlin , Zheng Yifeng , Ma Yu , Peng Yuping , He Yan , Yin Jia 
Published: May 2024

ABSTRACT

Acute ischemic stroke (AIS) patients with active COVID-19 infection often have more severe symptoms and worse recovery. COVID-19 infection can cause gut microbiota dysbiosis, which is also a risk factor for poor outcomes in AIS patients. However, the association between gut microbiota and functional outcomes among AIS patients with COVID-19 infection has not been fully clarified yet. In this study, we performed 16S rRNA gene sequencing to characterize the gut microbial community among AIS patients with acute COVID-19 infection, AIS patients with post-acute COVID-19 infection, and AIS patients without COVID-19 infection. We found that AIS patients with acute COVID-19 experienced poorer recovery and significant gut dysbiosis, characterized by higher levels of
Enterobacteriaceae
and lower levels of
Ruminococcaceae
and
Lachnospiraceae
. Furthermore, a shorter time window (less than 28 days) between COVID-19 infection and stroke was identified as a risk factor for poor functional outcomes in AIS patients with COVID-19, and the enrichment of
Enterobacteriaceae
was indicated as a mediator in the relationship between infection time window and poor stroke outcomes. Our findings highlight the importance of early intervention after COVID-19 infection, especially by regulating the gut microbiota, which plays a role in the prognosis of AIS patients with COVID-19 infection.

IMPORTANCE

The gut microbiota plays an important role in the association between respiratory system and cerebrovascular system through the gut-lung axis and gut-brain axis. However, the specific connection between gut bacteria and the functional outcomes of acute ischemic stroke (AIS) patients with COVID-19 is not fully understood yet. In our study, we observed a significant decrease in bacterial diversity and shifts in the abundance of key bacterial families in AIS patients with acute COVID-19 infection. Furthermore, we identified that the time window was a critical influence factor for stroke outcomes, and the enrichment of
Enterobacteriaceae
acted as a mediator in the relationship between the infection time window and poor stroke outcomes. Our research provides a new perspective on the complex interplay among AIS, COVID-19 infection, and gut microbiota dysbiosis. Moreover, recognizing
Enterobacteriaceae
as a potential mediator of poor stroke prognosis offers a novel avenue for future exploration and therapeutic interventions.
Favorable impact of PD1/PD-L1 antagonists on bone remodeling: an exploratory prospective clinical study and ex vivo validation
Authors: Gassner Tamara , Chittilappilly Christina , Pirich Theo , Neuditschko Benjamin , Hackner Klaus , Lind Judith , Aksoy Osman , Graichen Uwe , Klee Sascha , Herzog Franz , Wiesner Christoph , Errhalt Peter , Pecherstorfer Martin , Podar Klaus , Vallet Sonia 
Published: May 2024

BackgroundSkeletal morbidity in patients with cancer has a major impact on the quality of life, and preserving bone health while improving outcomes is an important goal of modern antitumor treatment strategies. Despite their widespread use in early disease stages, the effects of immune checkpoint inhibitors (ICIs) on the skeleton are still poorly defined. Here, we initiated a comprehensive investigation of the impact of ICIs on bone health by longitudinal assessment of bone turnover markers in patients with cancer and by validation in a novel bioengineered 3D model of bone remodeling.MethodsAn exploratory longitudinal study was conducted to assessserum markers of bone resorption (C-terminal telopeptide, CTX) and formation (procollagen type I N-terminal propeptide, PINP, and osteocalcin, OCN) before each ICI application (programmed cell death 1 (PD1) inhibitor or programmed death-ligand 1 (PD-L1) inhibitor) for 6 months or until disease progression in patients with advanced cancer and no evidence of bone metastases. To validate the in vivo results, we evaluated osteoclast (OC) and osteoblast (OB) differentiation on treatment with ICIs. In addition, their effect on bone remodeling was assessed by immunohistochemistry, confocal microscopy, and proteomics analysis in a dynamic 3D bone model.ResultsDuring the first month of treatment, CTX levels decreased sharply but transiently. In contrast, we observed a delayed increase of serum levels of PINP and OCN after 4 months of therapy. In vitro, ICIs impaired the maturation of preosteoclasts by inhibiting STAT3/NFATc1 signaling but not JNK, ERK, and AKT while lacking any direct effect on osteogenesis. However, using our bioengineered 3D bone model, which enables the simultaneous differentiation of OB and OC precursor cells, we confirmed the uncoupling of the OC/OB activity on exposure to ICIs by demonstrating impaired OC maturation along with increased OB differentiation.ConclusionOur study indicates that the inhibition of the PD1/PD-L1 signaling axis interferes with bone turnover and may exert a protective effect on bone by indirectly promoting osteogenesis.
Sex‐Related Differences in Patients With Hypertrophic Cardiomyopathy Undergoing Alcohol Septal Ablation
Authors: Alabdaljabar Mohamad S. , Elhadi Mohamed , Geske Jeffrey B. , Klarich Kyle W. , Guerrero Mayra , Eleid Mackram F. 
Published: May 2024

Background
Previous studies have shown that women with hypertrophic obstructive cardiomyopathy (HCM) have worse long‐term outcomes irrespective of intervention. However, the outcomes of patients undergoing alcohol septal ablation (ASA) based on sex have not been described. Hence, this study aimed to evaluate pressure changes and long‐term mortality in patients with HCM undergoing ASA based on sex.

Methods and Results

This is a single‐center retrospective study evaluating hemodynamic changes and long‐term mortality in patients with HCM treated with ASA according to sex. A total of 259 patients were included (aged 68.4±11.9 years, 62.2% women). Women had higher age and baseline pressures at the time of ASA, with a greater percent reduction in mean left atrial pressure (men versus women: 2.2% versus 15.9%, respectively;
P
=0.02). Women had better survival (median survival rate of men versus women: 8.6 versus 12.5 years, respectively;
P
=0.011). On Cox multivariable regression, predictors of mortality were age (per group change <60 years, 61–70 years, 71–80 years, and >80 years; hazard ratio [HR], 1.45 [95% CI, 1.10–1.91],
P
=0.008), female sex (HR, 0.59 [95% CI, 0.35–0.99],
P
=0.048), chronic kidney disease (HR, 1.88 [95% CI, 1.06–3.33],
P
=0.031), and left ventricular outflow tract gradient reduction ≤86% (HR, 1.91 [95% CI, 1.14–3.19],
P
=0.014).

Conclusions
Women with HCM undergoing ASA are older and have higher left‐sided baseline pressures compared with men yet have better survival. Further studies exploring the mechanisms of differential outcomes according to sex in patients with HCM undergoing ASA are needed.
Computer Tools for Modeling Swing in a Jazz Ensemble
Authors: Friberg Anders , Gulz Torbjörn , Wettebrandt Claes 
Published: May 2024

Abstract
In a jazz ensemble, the timing patterns within each instrument and between instruments vary systematically depending on the instrument, tempo, style, and other parameters. A set of computer tools is described to modify these timing parameters according to previous measurements, allowing a large flexibility to account for individual differences and preferences. Four different jazz trio recordings were transcribed and annotated, and the tools were then used to recreate or modify the timing patterns in synthesized versions. These tools can be used for pedagogical purposes in which a music example can be played with different timing interpretations. It can also be used as a tool for research in which controlled factorial experiments can be designed.
Time and Distance Perception in Highly Dynamic Environments
Authors: Kaul Robert , Jipp Meike 
Published: May 2024

Abstract
Space- and time-based tasks, like flying airplanes, driving cars, or the manual controlled rendezvous and docking of spacecrafts can be very demanding for pilots, drivers, or astronauts, depending on selected trajectories, approaching speeds, or distracting information. One characteristic of highly dynamic environments is that persons have to consider their spatial position in relation to surrounding elements based on passing time, detected speed, and trajectories to avoid collisions with other objects. An inadequate perception of the own position in relation to other objects and passing time can lead to impaired decision-making processes, resulting in errors or collisions. A framework for the explanation of cognitive processes involved in perception, anticipation, and decision-making in dynamic environments is provided by the concept of situation awareness. Based on this framework persons must perceive relevant elements, integrate them in a coherent mental representation and anticipate the development of the current situation in the near future, to plan safe upcoming maneuvers. Thus, for safe maneuvers anticipation processes are playing a major role in decision-making and action selection. In this paper it is proposed that time and distance perceptions are central features of anticipation processes in dynamic situations. It is suggested to combine theories like the attentional-gate model and time-to-contact with the framework of situation awareness to explain anticipation processes in dynamic environments. The major aim is to develop precise cognitive models of persons acting in dynamic situations. Such cognitive models can be the basis for the development and parameterization of assistance systems, supporting anticipation in dynamic environments.
Effects of N-acetylcysteine on the expressions of UCP1 and factors related to thyroid function in visceral adipose tissue of obese adults: a randomized, double-blind clinical trial
Authors: Sohouli Mohammad Hassan , Eslamian Ghazaleh , Ardehali Seyed Hossein , Raeissadat Seyed Ahmad , Shimi Ghazaleh , Pourvali Katayoun , Zand Hamid 
Published: May 2024

Abstract
Background
Evidences have shown that obesity is influenced by various factors, including various hormones such as thyroid hormones and the body’s metabolism rate. It seems that practical solutions such as weight loss diets and common drugs can affect these potential disorders. In this study, we investigate one of these common drugs, N-Acetylcysteine (NAC), on expressions of UCP1 and factors related to thyroid function in adults with obesity.

Methods and analysis
The current investigation was carried out as a randomized clinical trial (RCT) including 43 adults with obesity who were potential candidates for bariatric surgery. These individuals were randomly divided into two groups: 600 mg of NAC (n = 22) or placebo (n = 21) for a duration of 8 weeks. Visceral adipose tissue was utilized in the context of bariatric surgery to investigate the gene expression of UCP1 and thyroid function. Polymerase chain reaction (PCR) was performed in duplicate for UCP1, DIO2, DIO3, THRα and β, and 18s RNA (as an internal control) using the provided instructions to investigate the expression of the respective genes.

Results
Our findings revealed that after 8 weeks compared to placebo, NAC caused a significant decrease in the expression of the DIO3 gene as one of the genes related to thyroid function and metabolism. However, regarding other related genes, no statistically significant was found (despite the increase in UCP1, DIO2, and THRα expression and decrease in THRβ expression). In addition, after adjustment of possible confounders, no significant effect was observed on anthropometric factors and serum levels of thyroid hormones.

Conclusion
The results of this study indicate that, following an 8-week period, NAC effectively decreases the expression of the DIO3 gene in the visceral fat tissue, in comparison to the placebo.
A transformer model for cause-specific hazard prediction
Authors: Oliver Matthieu , Allou Nicolas , Devineau Marjolaine , Allyn Jèrôme , Ferdynus Cyril 
Published: May 2024

Abstract
Backgroud
Modelling discrete-time cause-specific hazards in the presence of competing events and non-proportional hazards is a challenging task in many domains. Survival analysis in longitudinal cohorts often requires such models; notably when the data is gathered at discrete points in time and the predicted events display complex dynamics. Current models often rely on strong assumptions of proportional hazards, that is rarely verified in practice; or do not handle sequential data in a meaningful way. This study proposes a Transformer architecture for the prediction of cause-specific hazards in discrete-time competing risks. Contrary to Multilayer perceptrons that were already used for this task (DeepHit), the Transformer architecture is especially suited for handling complex relationships in sequential data, having displayed state-of-the-art performance in numerous tasks with few underlying assumptions on the task at hand.

Results
Using synthetic datasets of 2000–50,000 patients, we showed that our Transformer model surpassed the CoxPH, PyDTS, and DeepHit models for the prediction of cause-specific hazard, especially when the proportional assumption did not hold. The error along simulated time outlined the ability of our model to anticipate the evolution of cause-specific hazards at later time steps where few events are observed. It was also superior to current models for prediction of dementia and other psychiatric conditions in the English longitudinal study of ageing cohort using the integrated brier score and the time-dependent concordance index. We also displayed the explainability of our model’s prediction using the integrated gradients method.

Conclusions
Our model provided state-of-the-art prediction of cause-specific hazards, without adopting prior parametric assumptions on the hazard rates. It outperformed other models in non-proportional hazards settings for both the synthetic dataset and the longitudinal cohort study. We also observed that basic models such as CoxPH were more suited to extremely simple settings than deep learning models. Our model is therefore especially suited for survival analysis on longitudinal cohorts with complex dynamics of the covariate-to-outcome relationship, which are common in clinical practice. The integrated gradients provided the importance scores of input variables, which indicated variables guiding the model in its prediction. This model is ready to be utilized for time-to-event prediction in longitudinal cohorts.
The role of the immune system in early-onset schizophrenia: identifying immune characteristic genes and cells from peripheral blood
Authors: Chen Zi , Li Yuxue , Gao Yao , Fan Xiaoxuan , Du Xinzhe , Li Xinrong , Liu Zhifen , Liu Sha , Cao Xiaohua 
Published: May 2024

Abstract
Background
Early-onset schizophrenia (EOS) is a type of schizophrenia (SCZ) with an age of onset of < 18 years. An abnormal inflammatory immune system may be involved in the occurrence and development of SCZ. We aimed to identify the immune characteristic genes and cells involved in EOS and to further explore the pathogenesis of EOS from the perspective of immunology.

Methods
We obtained microarray data from a whole-genome mRNA expression in peripheral blood mononuclear cells (PBMCs); 19 patients with EOS (age range: 14.79 ± 1.90) and 18 healthy controls (HC) (age range: 15.67 ± 2.40) were involved. We screened for differentially expressed genes (DEGs) using the Limma software package and modular genes using weighted gene co-expression network analysis (WGCNA). In addition, to identify immune characteristic genes and cells, we performed enrichment analysis, immune infiltration analysis, and receiver operating characteristic (ROC) curve analysis; we also used a random forest (RF), a support vector machine (SVM), and the LASSO-Cox algorithm.

Results
We selected the following immune characteristic genes: CCL8, PSMD1, AVPR1B and SEMG1. We employed a RF, a SVM, and the LASSO-Cox algorithm. We identified the following immune characteristic cells: activated mast cells, CD4+ memory resting T cells, resting mast cells, neutrophils and CD4+ memory activated T cells. In addition, the AUC values of the immune characteristic genes and cells were all > 0.7.

Conclusion
Our results indicate that immune system function is altered in SCZ. In addition, CCL8, PSMD1, AVPR1B and SEMG1 may regulate peripheral immune cells in EOS. Further, immune characteristic genes and cells are expected to be diagnostic markers and therapeutic targets of SCZ.
Spontaneous coronary artery dissection in patients with prior psychophysical stress: a systematic review of case reports and case series
Authors: Hosseini Kaveh , Fallahtafti Parisa , Roudbari Payam , Soleimani Hamidreza , Jahromi Negin Abiri , Jameie Mana , Jenab Yaser , Moradi Ali , Ajam Ali , Heydari Narges , Kuno Toshiki , Narula Nupoor , Kampaktsis Polydoros N. 
Published: May 2024

Abstract
Background
Spontaneous coronary artery dissection (SCAD) is an underdiagnosed cause of acute coronary syndrome, particularly in younger women. Due to limited information about SCAD, case reports and case series can provide valuable insights into its features and management. This study aimed to comprehensively evaluate the features of SCAD patients who experienced psychophysical stress before the SCAD event.

Methods
We conducted an electronic search of PubMed, Scopus, and Web of Science from inception until January 7, 2023. We included case reports or series that described patients with SCAD who had experienced psychophysical stress before SCAD. Patients with pregnancy-associated SCAD were excluded from our analysis.

Results
In total, we included 93 case reports or series describing 105 patients with SCAD. The average patient age was 44.29 ± 13.05 years and a total of 44 (41.9%) of patients were male. Among the included SCAD patients the most prevalent comorbidities were fibromuscular dysplasia (FMD) and hypertension with the prevalence of 36.4 and 21.9%, respectively. Preceding physical stress was more frequently reported in men than in women; 38 out of 44 (86.4%) men reported physical stress, while 36 out of 61 (59.1%) females reported physical stress (p value = 0.009). On the other hand, the opposite was true for emotional stress (men: 6 (13.6%)), women: 29 (47.6%), p value < 0.001). Coronary angiography was the main diagnostic tool. The most frequently involved artery was the left anterior descending (LAD) (62.9%). In our study, recurrence of SCAD due to either the progression of a previous lesion or new SCAD in another coronary location occurred more frequently in those treated conservatively, however the observed difference was not statistically significant (p value = 0.138).

Conclusion
While physical stress seems to precede SCAD in most cases, emotional stress is implicated in females more than males.
The association between the triglyceride-glucose index and in-stent restenosis in patients undergoing percutaneous coronary intervention: a systematic review and meta-analysis
Authors: Jiang Haodong , liu Yuntong , Guo Haoyu , Liu Zhihao , Li Zhibo 
Published: May 2024

Abstract
Background
Insulin resistance (IR) can lead to cellular metabolic disorders, activation of oxidative stress, and endothelial dysfunction, contributing to in-stent restenosis (ISR). The triglyceride-glucose index (TyG index), a new indicator reflecting IR, is extensively researched in the cardiovascular field. This study, through a meta-analysis, aimed to utilize a larger combined sample size and thereby enhance the overall test efficacy to explore the TyG index-ISR relationship.

Methods
A thorough search was conducted in the PubMed, EMBASE, Web of Science, and Cochrane Library databases to find original papers and their references published between 1990 and January 2024. This search included both prospective and retrospective studies detailing the correlation between the TyG index and ISR in individuals with coronary heart disease (CHD).

Outcomes
The five included articles comprised 3,912 participants, and the odds ratio (OR) extracted from each study was combined using the Inverse Variance method. Results showed that, in the context of CHD patients, each incremental unit in the TyG index, when treated as a continuous variable, corresponded to a 42% elevation in ISR risk (95% CI 1.26–1.59, I²=13%, p < 0.005). When analyzing the TyG index categorically, the results revealed a higher ISR risk in the highest TyG index group compared to the lowest group (OR: 1.69, 95% CI 1.32–2.17, I²=0). Additionally, in patients with chronic coronary syndrome (CCS), each unit increase in the TyG index, the risk of ISR in patients increased by 37% (95% CI 1.19–1.57, I²=0%, p < 0.005). This correlation was also observable in acute coronary syndrome (ACS) patients (OR:1.48, 95% CI 1.19–1.85, I²=0, p < 0.005).

Conclusions
The TyG index, an economical and precise surrogate for IR, is significantly linked with ISR. Furthermore, this correlation is unaffected by the type of coronary heart disease.
Symptoms at stroke onset as described by patients: a qualitative study
Authors: Andersson Jenny , Rejnö Åsa , Jakobsson Sofie , Hansson Per-Olof , Nielsen Susanne J , Björck Lena 
Published: May 2024

Abstract
Background
Stroke is a common and severe disease that requires prompt care. Symptom expressions as one-sided weakness and speech difficulties are common and included in public stroke campaigns. For some patients stroke can present with subtle and less common symptoms, difficult to interpret. The symptom severity assessed by the National Institutes of Health Stroke Scale has decreased, and symptoms at onset may have changed. Therefore, we aimed to investigate how patients describe their symptoms at the onset of a first-time stroke.

Methods
The study used a qualitative descriptive design and conventional content analysis. Data were collected through recorded interviews with 27 patients aged 18 years and older hospitalised with a first-time stroke between October 2018 and April 2020. Data were analysed on a manifest level.

Results
Symptoms at stroke onset were presented in two themes: Altered Reality and Discomfort and Changed Body Functions and described in five categories. Various types of symptoms were found. All symptoms were perceived as sudden, persistent, and never experienced before and this appear as a “red thread” in the result. Regardless of symptom expressions, no specific symptom was described as more severe than another.

Conclusions
Stroke symptoms were described with a variety of expressions. Many described complex symptoms not typical of stroke, which can make it difficult to recognise the symptoms as a stroke and delay medical care. Public stroke campaigns should emphasize the importance of seeking medical care at the slightest suspicion of stroke and could be designed to help achieve this.