bluuebunny/crossref_metadata_2025_split huggingface dataset:
External validation of the CARDOT score for predicting respiratory complications after thoracic surgery
Authors: Pipanmekaporn Tanyong , Kitswat Pakaros , Leurcharusmee Prangmalee , Runraksar Thanaporn , Bunchungmongkol Nutchanart , Khorana Jiraporn , Tantraworasin Apichat , Lapisatepun Panuwat , Saokaew Surasak 
Published: June 2024

Abstract

Background
Respiratory complications after thoracic surgery are common and can lead to increased perioperative morbidity and mortality. Although several clinical risk scores for the prediction of respiratory complications have been proposed, these scores are not specific for thoracic surgery. In addition, few clinical risk scores have been adopted in clinical practice due to the lack of external validation. Our thoracic-specific risk score, the CARDOT score, showed good predictive performance for postoperative respiratory complications during score development. This study aimed to validate the CARDOT score in an external dataset and determine the score performance after including the neutrophil-lymphocyte ratio (NLR) to the score as an additive predictor.
Methods
A retrospective cohort study of consecutive thoracic surgical patients at a single tertiary hospital in northern Thailand was conducted. The development and validation datasets were collected between 2006 and 2012 and from 2015 to 2021, respectively. Six prespecified predictive factors were identified, and formed a predictive score, the CARDOT score (chronic obstructive pulmonary disease, American Society of Anesthesiologists physical status, right-sided operation, duration of surgery, oxygen saturation, thoracotomy), was calculated. The external performance of the CARDOT score was evaluated in terms of discrimination by using the area under the receiver operating characteristic (AuROC) curve and calibration.
Results
The incidence of respiratory complications was 15.7% (171 of 1088) in the development dataset and 24.6% (370 of 1642), in the validation dataset. The CARDOT score had good discriminative ability for both the development and validation datasets (AuROC 0.789 (95% CI 0.753–0.827) and 0.758 (95% CI 0.730–0.787), respectively). The CARDOT score showed good calibration in both datasets. A high NLR (≥ 4.5) significantly increased the risk of respiratory complications after thoracic surgery (P < 0.001). The AuROC of the CARDOT score with the NLR showed significantly greater discrimination power than that of the CARDOT score alone (P = 0.008).
Conclusions
The CARDOT score had consistent discriminative performance in the external validation dataset. This tool may be beneficial in settings where preoperative pulmonary function tests are not routinely performed.
Surgical Apgar Score and Controlling Nutritional Status Score can be Predictors of Major Postoperative Complications After Spine Surgery
Authors: Sunami Takahiro , Miura Kousei , Shibao Yosuke , Okuwaki Shun , Sakashita Kotaro , Shimizu Tomoaki , Gamada Hisanori , Noguchi Hiroshi , Takahashi Hiroshi , Funayama Toru , Koda Masao , Yamazaki Masashi 
Published: June 2024

Abstract

Assessing intraoperative hemodynamics with Surgical Apgar Score (SAS) and preoperative nutritional status with the Controlling Nutritional Status (CONUT) score are said to be useful to predict postoperative complications in many surgical services, but little is reported in the field of spinal surgery. The purpose of this study was to assess the utility of SAS and the CONUT score for predicting the risk of major postoperative complications after spinal surgery. We included 659 people who undergone spinal surgery in our institute in eight consecutive years. The occurrence of postoperative major complications was investigated. Background clinical information, surgical information including the SAS and the CONUT score, and the length of postoperative hospital stay were collected. The risk factors of postoperative complications were assessed statistically. Complications occurred in 117 cases (17.8%). The multivariate analysis showed that history of diabetes mellitus (odds ratio [OR], 1.81: P = 0.035), coronary disease (OR, 3.33; P = 0.009), American Society of Anesthesiologists Physical Status (OR, 1.71; P = 0.025), use of instruments (OR, 2.07; P = 0.026), operation time (OR, 1.30; P < 0.001), SAS (OR, 0.59; P < 0.001), and CONUT (OR, 1.34; P < 0.001) were independent risk factors of major complications after spinal surgery. Assessing the intraoperative hemodynamics with SAS and preoperative nutritional status with the CONUT score was useful in predicting major postoperative complications after spinal surgery. People who are detected as high risked people should be managed carefully after spinal surgery.
Elucidating microstructural alterations in neurodevelopmental disorders: application of advanced diffusion-weighted imaging in children with Rasopathies
Authors: Plank Julia , Gozdas Elveda , Dai Erpeng , McGhee Chloe , Raman Mira , Green Tamar 
Published: June 2024

Abstract

Neurodevelopmental disorders (NDDs) can severely impact functioning yet effective treatments are limited. Greater insight into the neurobiology underlying NDDs is critical to the development of successful treatments. Using a genetics-first approach, we investigated the potential of advanced diffusion-weighted imaging (DWI) techniques to characterize the neural microstructure unique to neurofibromatosis type 1 (NF1) and Noonan syndrome (NS). In this prospective study, children with NF1, NS, and typical developing (TD) were scanned using a multi-shell DWI sequence optimized for neurite orientation density and dispersion imaging (NODDI) and diffusion kurtosis imaging (DKI). Region-of-interest and tract-based analysis were conducted on subcortical regions and white matter tracts. Analysis of covariance, principal components, and linear discriminant analysis compared between groups. 88 participants were included: 31 NS, 25 NF1, and 32 TD. Subcortical regions differed between NF1 and NS, particularly in the thalamus where the neurite density index (NDI), orientation dispersion index (ODI), and mean kurtosis (MK) were lower in NF1 compared to NS (p < .001). The middle cerebellar peduncle showed lower NDI and MK in NF1 compared to NS (both p < .001). Multivariate analyses distinguished between groups using NDI, ODI, and MK measures. Differences in neural microstructure were detected between neurofibromatosis type 1 and Noonan syndrome, particularly in subcortical regions and the middle cerebellar peduncle, in line with pre-clinical evidence. Advanced DWI techniques detected subtle alterations not found in prior work using conventional diffusion tensor imaging.
Multimaterial design strategies and microstructural characterization of stainless steel 316-Inconel 718 developed by wire-based Directed Energy Deposition
Authors: ALCÁZAR JULIA UREÑA , Álvarez-Leal Marta 
Published: June 2024

Abstract

The combination of different material properties to face severe conditions has been always demanded by different industrial sectors. For instance, in gas turbine components, excellent mechanical properties at high temperatures and corrosive environments are required. Traditionally, this has been achieved by conventional manufacturing of multiple materials with several steps and joining processes. However, manufacturing the entire component within the same process by additive manufacturing and the combination of two different materials is presented as a potential via to explore. In this research, the additive manufacturing of stainless steel (SS316L) and Nickel-based Inconel superalloy (IN718) multimaterial through different design strategies approaches has been developed and investigated by wire-based Laser Directed Energy Deposition (DED) technology. Direct transition between materials was applied and three multimaterial sandwich structures (S1, S2 and S3) were designed and successfully manufactured. The microstructure obtained in the three different regions (IN718, IN718/SS316 and SS316) was evaluated in both XY and XZ build directions. Rockwell C hardness was measured along the cross-sections of all samples to compare the different properties of the three samples developed. Defective microstructural features like big porosity, cracks or lack-of-fusion at the SS316/IN718 interphases were not evidenced for S2 and S3 strategies. Multimaterial samples showed very fine microstructures corresponding to the DED processing, and secondary phases such as intermetallic-compounds or carbides were not found. Smooth transitions between materials were obtained which also led to a gradient in microstructure and hardness properties. S3 sample showed the highest hardness value, being the IN718 value even higher compared to conventional IN718 material.
Comorbidities confound metabolomics studies of human disease
Authors: Jaagura Madis , Kronberg Jaanika , Reigo Anu , Aasmets Oliver , Nikopensius Tiit , Võsa Urmo , Bomba Lorenzo , Estrada Karol , Wuster Arthur , Esko Tõnu , Org Elin , team Estonian Biobank research team Estonian Biobank research 
Published: June 2024

Abstract

The co-occurrence of multiple chronic conditions, termed multimorbidity, presents an expanding global health challenge, demanding effective diagnostics and treatment strategies. Chronic ailments such as obesity, diabetes, and cardiovascular diseases have been linked to metabolites interacting between the host and microbiota. In this study, we investigated the impact of co-existing conditions on risk estimations for 1375 plasma metabolites in 919 individuals from population-based Estonian Biobank cohort using liquid chromatography mass spectrometry (LC-MS) method. We leveraged annually linked national electronic health records (EHRs) data to delineate comorbidities in incident cases and controls for the most prevalent chronic conditions. Among the 254 associations observed across 13 chronic conditions, we primarily identified disease-specific risk factors (92%, 217/235), with most predictors (96%, 226/235) found to be related to the gut microbiome upon cross-referencing recent literature data. Accounting for comorbidities led to a reduction of common metabolite predictors across various conditions. In conclusion, our study underscores the potential of utilizing biobank-linked retrospective and prospective EHRs for the disease-specific profiling of diverse multifactorial chronic conditions.
Indoxyl Sulfate Induces Retinal Microvascular Injury via COX-2/PGE2 Activation in Diabetic Retinopathy
Authors: Zhou Lan , Sun Hongyan , Chen Gongyi , Li Cunzi , Liu Dan , Wang Xurui , Meng Ting , Jiang Zhenyou , Yang Shu , Yang Ming-Ming 
Published: June 2024

Abstract

Background
Diabetic retinopathy (DR), the leading cause of acquired blindness in the working-age population, is the most frequent microvascular complication of diabetes. Metabolic disorders are thought to contribute to the pathogenicity, but the mechanism remains largely unknown.
Methods
To explore the mechanism, we first identified differences of vitreous fluid metabolite profiles between 23 patients with DR and 12 non-diabetic controls using liquid chromatography/tandem mass spectrometry, and screened out the most distinctive metabolite-indoxyl sulfate (IS). Next, streptozotocin (STZ)-induced diabetic and IS-injected rat models were established to validate IS effects on retinal microvascular. Then, RNA sequencing was performed to discover underlying regulators in IS-treated human retinal endothelium cells (HREC). Finally, target gene knockdown of HREC and IS-injected rats treated with inhibitors (for IS production or downstream regulator) were used to verify the detailed mechanism and explore therapeutic targets for DR.
Results
Metabolomics revealed 172 significantly differential metabolites in diabetic vitreous humor, including dysregulated tryptophan metabolites indoxyl sulfate (IS). IS was found to penetrate the blood-retinal barrier and accumulate in the intraocular fluid of diabetic rats. In vivo and in vitro experiments demonstrated that elevated IS caused endothelial apoptosis and cell junction breakdown. RNA sequencing identified prostaglandin E2 (PGE2) synthetase-cyclooxygenase 2 (COX-2) as the potential target of IS. Validation experiments showed IS promoted COX-2 expression and then PGE2 secretion by biding with COX-2 transcription factor EGR1 after entry into cells via organic anion transporting polypeptides (OATP2B1). Moreover, COX-2 inhibition in vivo or EGR1/OATP2B1 siRNA in HREC attenuated IS-induced microcapillary damage and COX-2/PGE2 activation.
Conclusion
Our study revealed that IS, a uremic toxin derived from gut microbiota product indole, increased significantly and contributed to retinal microvascular damage in DR. Mechanistically, IS impaired retinal microvascular by inducing COX-2 expression and PGE2 production. Targeting gut microbiota or the PGE2 pathway may be effective strategies for DR treatment.
Implementation of autonomous mobile platform for agricultural task in corridor-like environments
Authors: Tobias Jonathan , Lim Shen Hin , Duke Mike , McGuinness Benjamin , Au Chi Kit 
Published: June 2024

Abstract

The role of autonomous vehicles (AVs) in assisting people is recognised and, therefore, is in constant development in numerous fields. Specifically, the ability of AV to alleviate global stressors, including an increased potential for food shortages and the decline in workers for potentially laborious work. An area where AVs developments are particularly prevalent is in agriculture. However, the few AVs being used in agriculture are often custom-built for specific purposes and require long development time as a result. This article aims to build and evaluate a versatile architecture of a mobile platform that is implemented using off-the-shelf components so that it can be transferred to any agricultural vehicle, thus reducing the development time. The research has involved investigating and incorporating various sensors, and also developing a common software module to perform the localisation, navigation and mapping particularly suited for corridor crop agricultural environment. This architecture has been integrated and implemented on a Yamaha golf cart, infusing it with purposely positioned sensors and supportive electronics to allow a Robotic Operating System (ROS) framework to gather information and control the vehicle. As the architecture is modular in nature, it can be transferred to different customised platforms. To determine the efficacy of the mobile platform, it has gone through several outdoor field trials to test the fundamentals of an agricultural AV. The evaluation demonstrates that both mapping and navigation have satisfactory results and the mobile platform remains within 5mm of the specified distance when aiming to follow the row in a vineyard. The results from these experiments demonstrate the ability of the mobile platform to successfully transform a Yamaha golf cart into an autonomous agricultural vehicle.
Serum uric acid: an independent risk factor for cardiovascular disease in Pakistani Punjabi patients
Authors: Hussain Misbah , Ghori Muhammad Umer , Aslam Muhammad Naeem , Abbas Shahid , Shafique Muhammad , Awan Fazli Rabbi 
Published: June 2024

Abstract

Background: It is well known that serum uric acid (SUA) can increase the risk of hypertension, diabetes, obesity and dyslipidemia. However, its independent association with the risk of cardiovascular diseases (CVD) is controversial particularly in different populations. Thus, the aim of this study was to evaluate an independent association of SUA with CVD risk in a Punjabi Pakistani cohort.
Methods: For this, total 502 human subjects with/without hyperuricemia along with CVD, hypertension and/or diabetes were enrolled. Biochemical parameters including SUA were analyzed in the serum. SPSS was used to assess the role of SUA in increasing the risk of CVD independent of other key confounding factors like age, gender, dyslipidemia, hypertension, diabetes, dietary habits and life style was also assessed.
Results: SUA levels were significantly different among different forms of CVD (ACS, MI and CCF). Spearman correlation showed a significantly positive association between CVD and SUA (rho = 0.149, p <0.001). Multivariate logistic regression of SUA quartiles showed that hyperuricemia is associated with CVD [3rd quartile: OR 1.78 (CI: 1.28-2.48) p = 0.001 and 4th quartile: [OR 2.37 (CI: 1.72-3.27) p<0.001]. Moreover, this association remained significant even after adjusting for confounding factors.
Conclusion: This study showed that SUA is positively associated with CVD, thus it can act as an independent risk factor for CVD.
Association between dietary branched-chain amino acids and Multiple Chronic Conditions among older adults in Chinese communities
Authors: Song Yuanfeng , Zhang Ji , Luo Ziqiang , Wu Lanlan , Cai Zhaopei , Zhong Xiaoqi , Zeng Xiaoxue , Cao Tingxi , Chen Hong-en , Xu Shan , Wang Chang-yi 
Published: June 2024

Abstract

Background
The association of BCAAs (isoleucine, leucine, and valine) with cardiovascular and cerebrovascular diseases has been widely recognized by researchers, but there is limited evidence to support the relationship between BCAAs and MCCs in older adults. This study aimed to explore the correlation between BCAA levels in the diets of older adults and MCCs. Methods: Based on a health management cohort project in Nanshan District of Shenzhen, 4278 individuals over 65 years old were selected as participants via multi-stage stratified sampling from May 2018 to December 2019. Data were collected using a validated semi-quantitative food frequency questionnaire, as well as anthropometric and chronic disease reports. MCC was defined as the coexistence of two or more chronic diseases, namely, hypertension, dyslipidemia, diabetes, CAD, stroke, CKD, and CLD. Multivariate unconditional logistic regression analysis was used to analyze the relationship between dietary BCAAs and MCCs in older adults, and then, gender stratification analysis was performed. A restricted cubic spline model (a fitted smooth curve) was used to determine the dose–response relationship of isoleucine with MCCs. Results: A total of 4278 older adults aged 65 and above were included in this study, with an average age of 72.73 ± 5.49 years. The cohort included 1861 males (43.50%). Regardless of whether confounding factors were corrected, isoleucine was a risk factor for MCCs (OR = 3.388, 95%CI:1.415,8.109). After gender stratification, the relationships between dietary isoleucine and MCCs (OR = 6.902, 95%CI:1.875,25.402) and between leucine (OR = 0.506,95%CI:0.309,0.830) and MCCs were significant in women, but not in men. No significant association between valine and MCCs was observed. In addition, isoleucine was a risk factor for MCCs when its intake was greater than 4.297 g/d. Conclusion: Isoleucine may play an important role in regulating age-related diseases. BCAAs such as isoleucine can be used as risk markers for MCCs in older adults.
Risk factors for mortality and antibody responses in chronic hemodialysis patients with coronavirus disease 2019: a single-center experience in China
Authors: Song Yuhuan , Cai Guangyan , Xiao Yuefei 
Published: June 2024

Abstract

Introduction: This single-center retrospective research aimed to depict the outcomes of coronavirus disease 2019 (COVID-19) in a cohort of patients from China.
Methods: We traced the outcomes of 216 MHD patients admitted to the Aerospace Center Hospital of China during a COVID-19 wave . Clinical information was assembled and compared between survivors and non-survivors. Serum immunoglobulin M (IgM) and IgG antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were detected in MHD survivors 90–120 days post-infection. Clinical information was analyzed to find outfactors influencing mortality and antibody responses.
Results: Among 216 patients, 207 (95.8%) were evaluated as COVID-19, and 25 (12.1%) passed away within 90 days. Fifty-five (26.6%) patients were needed of hospital admission. Non-survivors had lower levels of hemoglobin and serum albumin, higher levels of alkaline phosphatase, higher white blood cell counts and lower percentage of lymphocytes than survivors. Furthermore, the Clinical Frailty Scale (CFS) scores were higher in non-survivors significantly (p<0.05). Multivariate analysis showed that diabetes (HR 3.98, 95% CI 1.25–12.66, p=0.019), level of frailty according to the CFS (HR 2.10, 95% CI 1.36-3.23, p=0.001) and central venous catheter (CVC) use (hazard ratio [HR] 3.48, 95% confidence interval [CI] 1.18-10.29, p=0.024), had significant impacts on mortality. IgG was positive in 59.5%, and IgM was positive in 3.3% of patients (>1 sample/cutoff) between 90–120 days post-infection. Lower blood C-reactive protein (CRP) levels before the onset of SARS-CoV-2 infection were associated with significantly higher IgG antibody levels at 90-120 days after COVID-19 infection.
Discussion: This study identified high mortality rates of SARS-CoV-2 infection among hemodialysis patients. Risk factors associated with mortality include diabetes, frailty, and CVC access. Low level of blood CRP before SARS-CoV-2 infection may predict high antibody responses during convalescence.
Drivers of mesoscale convective aggregation and spatial humidity variability in the tropical western Pacific
Authors: Tompkins Adrian , Casallas Alejandro , de Vera Michie 
Published: June 2024

Abstract

Idealized models show aggregation of tropical convection on the mesoscale driven by radiative-cloud feedbacks. We apply a multivariate analysis of column humidity, precipitation and sea surface temperature (SST) observations to mesoscale domains in the tropical western Pacific to demonstrate
that in boreal summer and autumn, convection remains spatially random despite radiative-feedbacks acting to aggregate convection. Instead, in winter and spring, a weak meridional SST gradient exists and convection
is usually clustered over the regions of warmest SSTs, with significant
meridional humidity gradients. However, this is sporadically
interrupted by episodes of convection migration to the coldest SSTs and limited spatial humidity variance. These episodes are the result of westward propagating equatorial Rossby waves, which act to remove meridional humidity gradients. It thus appears that the drivers of mesoscale convective clustering and humidity variability in the Pacific warm pool are the SST gradients and equatorial wave dynamics.