bluuebunny/crossref_metadata_2025_split huggingface dataset:
V-A ECMO for neonatal coxsackievirus B fulminant myocarditis: a case report and literature review
Authors: Li Xingchao , Sun Li , Xi Shibing , Hu Yaofei , Yu Zhongqin , Liu Hui , Sun Hui , Jing Weili , Yuan Li , Liu Hongyan , Li Tao 
Published: May 2024

BackgroundNeonatal (enteroviral) myocarditis (NM/NEM) is rare but unpredictable and devastating, with high mortality and morbidity. We report a case of neonatal coxsackievirus B (CVB) fulminant myocarditis successfully treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO).Case presentationA previously healthy 7-day-old boy presented with fever for 4 days. Progressive cardiac dysfunction (weak heart sounds, hepatomegaly, pulmonary edema, ascites, and oliguria), decreased left ventricular ejection fraction (LVEF) and fractional shortening (FS), transient ventricular fibrillation, dramatically elevated creatine kinase-MB (405.8 U/L), cardiac troponin I (25.85 ng/ml), and N-terminal pro-brain natriuretic peptide (NT-proBNP &gt; 35,000 ng/L), and positive blood CVB ribonucleic acid indicated neonatal CVB fulminating myocarditis. It was refractory to mechanical ventilation, fluid resuscitation, inotropes, corticosteroids, intravenous immunoglobulin, and diuretics during the first 4 days of hospitalization (DOH 1–4). The deterioration was suppressed by V-A ECMO in the next 5 days (DOH 5–9), despite the occurrence of bilateral grade III intraventricular hemorrhage on DOH 7. Within the first 4 days after ECMO decannulation (DOH 10–13), he continued to improve with withdrawal of mechanical ventilation, LVEF &gt; 60%, and FS &gt; 30%. In the subsequent 4 days (DOH 14–17), his LVEF and FS decreased to 52% and 25%, and further dropped to 37%–38% and 17% over the next 2 days (DOH 18–19), respectively. There was no other deterioration except for cardiomegaly and paroxysmal tachypnea. Through strengthening fluid restriction and diuresis, and improving cardiopulmonary function, he restabilized. Finally, notwithstanding NT-proBNP elevation (&gt;35,000 ng/L), cardiomegaly, and low LVEF (40%–44%) and FS (18%–21%) levels, he was discharged on DOH 26 with oral medications discontinued within 3 weeks postdischarge. In nearly three years of follow-up, he was uneventful, with interventricular septum hyperechogenic foci and mild mitral/tricuspid regurgitation.ConclusionsDynamic cardiac function monitoring via real-time echocardiography is useful for the diagnosis and treatment of NM/NEM. As a lifesaving therapy, ECMO may improve the survival rate of patients with NM/NEM. However, the “honeymoon period” after ECMO may cause the illusion of recovery. Regardless of whether the survivors of NM/NEM have undergone ECMO, close long-term follow-up is paramount to the prompt identification and intervention of abnormalities.
Large scale implementation of effective early literacy instruction
Authors: Gillon Gail , McNeill Brigid , Scott Amy , Gath Megan , Macfarlane Angus , Taleni Tufulasi 
Published: May 2024

IntroductionLarge-scale implementation of Multi-Tiered Systems of Support (MTSS) to enhance children's early literacy success is critically important to address global literacy challenges. This paper describes one such initiative, the Better Start Literacy Approach (BSLA), which was specifically designed for large-scale implementation in New Zealand.MethodsBetween February 2020 and May 2023 over 3,000 teachers in 819 schools across New Zealand implemented BSLA, with baseline data available for 29,795 5-year-old children. Teachers implemented novel online assessments to monitor children's early literacy growth.ResultsIn comparison to an internal control group, accelerated progress in children's phonic, and phoneme awareness skills was evident after 10 weeks of BSLA Tier 1 (universal) teaching. After 30 weeks, there were significant gains in word reading, spelling, listening comprehension and oral narrative abilities; growth did not differ based on gender, ethnicity, or socioeconomic status. Children with greater learning needs who received BSLA Tier 2 (small group targeted teaching) caught up to their peers in word reading and spelling skills.ConclusionsWith appropriate resourcing, planning and engagement with communities, successful large-scale implementation of evidenced-based early literacy approaches is possible within a relatively short time. Culturally responsive implementation within MTSS frameworks holds much promise for raising literacy achievement for all children.
Accuracy of a novel real-time continuous glucose monitoring system: a prospective self-controlled study in thirty hospitalized patients with type 2 diabetes
Authors: Ge Shenghui , Zhang Hui , Wang Jun , Li Huiqin , Su Xiaofei , Ding Dafa , Ma Jianhua 
Published: May 2024

AimsThe present study aimed to investigate the accuracy of the Glunovo® real-time continuous glucose monitoring system (rtCGMS).MethodsWe conducted a 14-day interstitial glucose level monitoring using Glunovo® rtCGMS on thirty hospitalized patients with type 2 diabetes. The flash glucose monitoring (FGM) was used as a self-control. Consistency tests, error grid analysis, and calculation of the mean absolute relative difference (MARD) were performed using R software to assess the accuracy of Glunovo® rtCGMS.ResultsGlunovo® exhibited an overall MARD value of 8.89% during hospitalization, compared to 10.42% for FGM. The overall percentages of glucose values within ±10%/10, ± 15%/15, ± 20%/20, ± 30%/30, and ±40%/40 of the venous blood glucose reference value were 63.34%, 81.31%, 90.50%, 97.29%, and 99.36% for Glunovo®, respectively, compared with 61.58%, 79.63%, 88.31%, 96.22% and 99.23% for FGM. The Clarke Error Grid Analysis showed that 99.61% of Glunovo® glucose pairs and 100.00% of FGM glucose pairs within zones A and B.ConclusionOur study confirms the superior accuracy of Glunovo® in monitoring blood glucose levels among hospitalized patients with type 2 diabetes.
Daytime plasma cortisol and cortisol response to dexamethasone suppression are associated with a prothrombotic state in hypertension
Authors: Brosolo Gabriele , Da Porto Andrea , Bulfone Luca , Vacca Antonio , Bertin Nicole , Vivarelli Cinzia , Catena Cristiana , Sechi Leonardo A. 
Published: May 2024

Background and aimsA prothrombotic state was demonstrated in patients with Cushing’s syndrome and is involved in the development and progression of cardiovascular and renal damage in hypertensive patients. This study was designed to examine the relationships between cortisol secretion and the hemostatic and fibrinolytic systems in hypertension.MethodsIn 149 middle-aged, nondiabetic, essential hypertensive patients free of cardiovascular and renal complications, we measured hemostatic markers that express the spontaneous activation of the coagulation and fibrinolytic systems and assessed daily cortisol levels (8 AM, 3 PM, 12 AM; area under the curve, AUC-cortisol) together with the cortisol response to dexamethasone overnight suppression (DST-cortisol).ResultsPlasma levels of D-dimer (D-dim), prothrombin fragment 1 + 2 (F1 + 2), and von Willebrand factor (vWF) were progressively and significantly higher across tertiles of AUC-cortisol and DST-cortisol, whereas no differences were observed in fibrinogen, tissue plasminogen activator, plasminogen activator inhibitor-1, antithrombin III, protein C, and protein S. D-dim, F1 + 2, and vWF were significantly and directly correlated with age and both AUC-cortisol and DST-cortisol. Multivariate regression analysis showed that both AUC-cortisol and DST-cortisol were related to plasma D-dim, F1 + 2, and vWF independently of age, body mass index, blood pressure, and renal function.ConclusionGreater daily cortisol profile and cortisol response to overnight suppression are independently associated with a prothrombotic state in hypertensive patients and might contribute to the development of organ damage and higher risk of cardiovascular complications.
Integration of very small modular reactors and renewable energy resources in the microgrid
Authors: Raza Muhammad Kazim , Alghassab Mohammed , Altamimi Abdullah , Khan Zafar A. , Abbas Kazmi Syed Ali , Ali Majid , Diala Uchenna 
Published: May 2024

Hybrid microgrids, integrating local energy resources, present a promising but challenging solution, especially in areas with limited or no access to the national grid. Reliable operation of off-grid energy systems necessitates sustainable energy sources, given the intermittent nature of renewables. While fossil fuel diesel generators mitigate risks, they increase carbon emissions. This study assesses the viability of integrating a very small modular renewable energy reactor into a microgrid for replacing conventional diesel generators, substantially curbing greenhouse gas emissions. A comprehensive analysis, including design and economic evaluation, was conducted for an off-grid community microgrid with an annual generation and load of 8.5 GWh and 7.8 GWh, respectively. The proposed microgrid configurations incorporate very small modular reactors, alongside solar, wind, and battery storage systems. MATLAB modeling and simulation across eight cases, accounting for seasonal variations, demonstrate the technical and economic feasibility of case 7. This configuration, integrating modular reactors, photovoltaics, wind turbines, and battery storage, satisfactorily meets load demands. Notably, it boasts a high internal rate of return up to ∼31% and a shorter payback period of around 4 years compared to alternative scenarios.
Machine learning in the prediction of immunotherapy response and prognosis of melanoma: a systematic review and meta-analysis
Authors: Li Juan , Dan Kena , Ai Jun 
Published: May 2024

BackgroundThe emergence of immunotherapy has changed the treatment modality for melanoma and prolonged the survival of many patients. However, a handful of patients remain unresponsive to immunotherapy and effective tools for early identification of this patient population are still lacking. Researchers have developed machine learning algorithms for predicting immunotherapy response in melanoma, but their predictive accuracy has been inconsistent. Therefore, the present systematic review and meta-analysis was performed to comprehensively evaluate the predictive accuracy of machine learning in melanoma response to immunotherapy.MethodsRelevant studies were searched in PubMed, Web of Sciences, Cochrane Library, and Embase from their inception to July 30, 2022. The risk of bias and applicability of the included studies were assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Meta-analysis was performed on R4.2.0.ResultsA total of 36 studies consisting of 30 cohort studies and 6 case-control studies were included. These studies were mainly published between 2019 and 2022 and encompassed 75 models. The outcome measures of this study were progression-free survival (PFS), overall survival (OS), and treatment response. The pooled c-index was 0.728 (95%CI: 0.629–0.828) for PFS in the training set, 0.760 (95%CI: 0.728–0.792) and 0.819 (95%CI: 0.757–0.880) for treatment response in the training and validation sets, respectively, and 0.746 (95%CI: 0.721–0.771) and 0.700 (95%CI: 0.677–0.724) for OS in the training and validation sets, respectively.ConclusionMachine learning has considerable predictive accuracy in melanoma immunotherapy response and prognosis, especially in the former. However, due to the lack of external validation and the scarcity of certain types of models, further studies are warranted.
Targeted proteomics-determined multi-biomarker profiles developed classifier for prognosis and immunotherapy responses of advanced cervical cancer
Authors: Li Jin , Zhang Xu , Yang Liuke , Zhu Youwei , Gao Rongrong , Zhang Tiancheng , Chen Xuwen , Fu Jun , He Gaoyang , Shi Huijuan , Peng Shenjie , Wu XiaoHua 
Published: May 2024

BackgroundCervical cancer (CC) poses a global health challenge, with a particularly poor prognosis in cases of recurrence, metastasis, or advanced stages. A single biomarker is inadequate to predict CC prognosis or identify CC patients likely to benefit from immunotherapy, presumably owing to tumor complexity and heterogeneity.MethodsUsing advanced Olink proteomics, we analyzed 92 oncology-related proteins in plasma from CC patients receiving immunotherapy, based upon the comparison of protein expression levels of pre-therapy with those of therapy-Cycle 6 in the partial response (PR) group and progressive disease (PD) group, respectively.Results55 proteins were identified to exhibit differential expression trends across pre-therapy and post-therapy in both PR and PD groups. Enriched GO terms and KEGG pathways were associated with vital oncological and immunological processes. A logistic regression model, using 5 proteins (ITGB5, TGF-α, TLR3, WIF-1, and ERBB3) with highest AUC values, demonstrated good predictive performance for prognosis of CC patients undergoing immunotherapy and showed potential across different cancer types. The effectiveness of these proteins in prognosis prediction was further validated using TCGA-CESC datasets. A negative correlation and previously unidentified roles of WIF-1 in CC immunotherapy was also first determined.ConclusionOur findings reveal multi-biomarker profiles effectively predicting CC prognosis and identifying patients benefitting most from immunotherapy, especially for those with limited treatment options and traditionally poor prognosis, paving the way for personalized immunotherapeutic treatments and improved clinical strategies.
Dietary 5-hydroxytryptophan improves sheep growth performance by enhancing ruminal functions, antioxidant capacity, and tryptophan metabolism: in vitro and in vivo studies
Authors: Sun Zhe , Aschalew Natnael D. , Cheng Long , Xia Yuanhong , Zhang Longyu , Yin Guopei , Wang Shikun , Wang Ziyuan , Dong Jianan , Zhang Weigang , Zhao Wei , Qin Guixin , Zhang Xuefeng , Zhong Rongzhen , Wang Tao , Zhen Yuguo 
Published: May 2024

BackgroundHydroxytryptophan (5-HTP) can regulate the synthesis of 5-Hydroxytryptamine (5-HT) and melatonin (MT). In a previous metabolome analysis, we found that 5-HTP is an effective ingredient in yeast culture for regulating rumen fermentation. However, research on the effect of this microbial product (5-HTP) as a functional feed additive in sheep production is still not well explained. Therefore, this study examined the effects of 5-HTP on sheep rumen function and growth performance using in vitro and in vivo models.MethodsA two-factor in vitro experiment involving different 5-HTP doses and fermentation times was conducted. Then, in the in vivo experiment, 10 sheep were divided into a control group which was fed a basal diet, and a 5-HTP group supplemented with 8 mg/kg 5-HTP for 60 days.ResultsThe results showed that 5-HTP supplementation had a significant effect on in vitro DMD, pH, NH3-N, acetic acid, propionic acid, and TVFA concentrations. 5-HTP altered rumen bacteria composition and diversity indices including Chao1, Shannon, and Simpson. Moreover, the in vivo study on sheep confirmed that supplementing with 8 mg/kg of 5-HTP improved rumen fermentation efficiency and microbial composition. This led to enhanced sheep growth performance and increased involvement in the tryptophan metabolic pathway, suggesting potential benefits.ConclusionDietary 5-HTP (8 mg/kg DM) improves sheep growth performance by enhancing ruminal functions, antioxidant capacity, and tryptophan metabolism. This study can provide a foundation for the development of 5-HTP as a functional feed additive in ruminants’ production.
Association between 23 drugs and inflammatory bowel disease: a two-sample Mendelian randomization study
Authors: He Lei , Deng Tuo , Huang Yurong , Yang Wangliu , Yang Jie , Song Gengqing 
Published: May 2024

BackgroundInflammatory bowel disease (IBD) is a group of diseases characterized by chronic and recurrent inflammation of the gastrointestinal tract. The etiology of IBD remains multifaceted and poorly understood, resulting in limited treatment options that primarily target disease induction and remission maintenance. Thus, the exploration of novel therapeutic options for IBD among existing medications is advantageous. Mendelian randomization analysis (MR) serves as a valuable tool in investigating the relationship between drugs and diseases. In this study, MR analysis was employed to investigate the potential causal relationship between 23 approved drugs for the treatment of various diseases and IBD.MethodWe performed a two-sample MR analysis using publicly available genome-wide association study (GWAS) statistics. The inverse variance weighting (IVW) method was used as the main analysis method, supplemented by the remaining four methods (weighted median, MR Egger regression, simple and weighted models), and Meta-analysis was performed to expand the sample size to obtain a more reliable composite causal effect. Finally, Cochran’s Q statistic and the MR-Egger test for directed pleiotropy were applied to determine whether significant heterogeneity or directed pleiotropy existed.ResultsIn the main MR analysis (IVW), drugs with a negative causal association with the risk of IBD were immunosuppressant {OR (95% CI) = 0.7389 [0.6311–0.8651], p = 0.0046} and diabetes drugs {OR (95% CI) = 0.9266 [0.8876–0.9674], p = 0.0058}. A positive causal association with the risk of IBD was found for salicylic acid and derivatives {OR (95% CI) = 1.2737 [1.0778–1.5053], p = 0.0345}. Negative causal associations with UC risk were identified for immunosuppressants {OR (95% CI) = 0.6660 [0.5133–0.8640], p = 0.0169} and diabetes medications {OR (95% CI) = 0.9020 [0.8508–0.9551], p = 0.0046}; positive causal associations with UC risk were found for β-receptor blockers {OR (95% CI) = 1.1893 [1.0823–1.3070], p = 0.0046}. A negative causal association with the risk of CD was found for immunosuppressants {OR (95% CI) = 0.6957 [0.5803–0.8341], p = 0.0023}. There was no statistically significant association between the remaining 19 drugs and IBD and subtypes.ConclusionThis MR study provides evidence suggesting that immunosuppressants have a mitigating effect on the risk of IBD and demonstrate consistent efficacy in subtypes of ulcerative colitis (UC) and Crohn’s disease (CD). Additionally, diabetes medications show potential in reducing the risk of IBD, particularly in cases of UC, while β-blockers may elevate the risk of UC. Conversely, salicylic acid and its derivatives may increase the risk of IBD, although this effect is not consistently observed in the subtypes of the disease. These findings offer new insights into the prevention and management of IBD.
Intervention with fructooligosaccharides, Saccharomyces boulardii, and their combination in a colitis mouse model
Authors: Wu Yan , Fu Hao , Xu Xu , Jin Hui , Kao Qing-jun , Teng Wei-lin , Wang Bing , Zhao Gang , Pi Xiong-e 
Published: May 2024

ObjectiveTo examine the effects of an intervention with fructooligosaccharides (FOS), Saccharomyces boulardii, and their combination in a mouse model of colitis and to explore the mechanisms underlying these effects.MethodsThe effects of FOS, S. boulardii, and their combination were evaluated in a DSS-induced mouse model of colitis. To this end, parameters such as body weight, the disease activity index (DAI), and colon length were examined in model mice. Subsequently, ELISA was employed to detect the serum levels of proinflammatory cytokines. Histopathological analysis was performed to estimate the progression of inflammation in the colon. Gas chromatography was used to determine the content of short-chain fatty acids (SCFAs) in the feces of model mice. Finally, 16S rRNA sequencing technology was used to analyze the gut microbiota composition.ResultsFOS was slight effective in treating colitis and colitis-induced intestinal dysbiosis in mice. Meanwhile, S. boulardii could significantly reduced the DAI, inhibited the production of IL-1β, and prevented colon shortening. Nevertheless, S. boulardii treatment alone failed to effectively regulate the gut microbiota. In contrast, the combined administration of FOS/S. boulardii resulted in better anti-inflammatory effects and enabled microbiota regulation. The FOS/S. boulardii combination (109 CFU/ml and 107 CFU/ml) significantly reduced the DAI, inhibited colitis, lowered IL-1β and TNF-α production, and significantly improved the levels of butyric acid and isobutyric acid. However, FOS/S. boulardii 109 CFU/ml exerted stronger anti-inflammatory effects, inhibited IL-6 production and attenuated colon shortening. Meanwhile, FOS/S. boulardii 107 CFU/ml improved microbial regulation and alleviated the colitis-induced decrease in microbial diversity. The combination of FOS and S. boulardii significantly increased the abundance of Parabacteroides and decreased the abundance of Escherichia–Shigella. Additionally, it promoted the production of acetic acid and propionic acid.ConclusionCompared with single administration, the combination can significantly increase the abundance of beneficial bacteria such as lactobacilli and Bifidobacteria and effectively regulate the gut microbiota composition. These results provide a scientific rationale for the prevention and treatment of colitis using a FOS/S. boulardii combination. They also offer a theoretical basis for the development of nutraceutical preparations containing FOS and S. boulardii.
Rapid identification and prognosis evaluation by dual-phase computed tomography angiography for stroke patients with a large ischemic region in the anterior circulation treated with endovascular thrombectomy
Authors: E Yajun , Jiang Huigang , Yu Weifei , Chen Weiwei , He Hongfei 
Published: May 2024

PurposeTo investigate the value of dual-phase head-and-neck computed tomography angiography (CTA) in assessing advantages and risks associated with mechanical thrombectomy for stroke with a large ischemic region in the anterior circulation within 6 h of onset.MethodsWe retrospectively analyzed the data of patients with acute occlusion of the internal carotid artery or middle cerebral artery-M1 segment. Baseline dual-phase CTA was performed for collateral grading using the 4-point visual collateral score (0, 0% filling; 1, &gt;0% and ≤50% filling; 2, &gt;50 and &lt;100% filling; 3, 100% filling). The rates of modified Rankin score (MRS) ≤ 3 at 90 days, any intracranial hemorrhage (ICH) within 48 h, malignant cerebral edema within 24 h, and all-cause 90-day mortality were analyzed.ResultsAmong the 69 study patients, 15, 26, 17, and 11 patients had collateral grades of 0, 1, 2, and 3, respectively. At 90 days, the MRS was ≤3 in 0, 8.33, 29.41, and 36.36% of patients with grades 0, 1, 2, and 3, respectively. ICH incidence was 73.33, 57.69, 29.41, and 18.18% for grades 0, 1, 2, and 3, respectively, while the incidence of malignant brain edema was 100, 76.92, 35.29, and 0%, respectively. All-cause 90-day mortality was 53.33% for grade 0 and 30.77% for grade 1; no deaths occurred at grades 2 and 3.ConclusionCollateral grading based on dual-phase CTA enables simple and rapid preoperative evaluation prior to mechanical thrombectomy for acute anterior-circulation stroke with a large ischemic focus, particularly for patients presenting within the 6-h time window.