bluuebunny/crossref_metadata_2025_split huggingface dataset:
Renin in critically ill patients
Authors: Kotani Yuki , Chappell Mark , Landoni Giovanni , Zarbock Alexander , Bellomo Rinaldo , Khanna Ashish K. 
Published: May 2024

AbstractThe renin-angiotensin system (RAS) constitutes one of the principal mechanisms to maintain hemodynamic and fluid homeostasis. However, most research until now on RAS primarily focuses on its relationship with hypertension and its role in critically ill hypotensive populations is not well understood. With the approval of angiotensin II (Ang II) in the United States and Europe, following a phase 3 randomized controlled trial showing efficacy in catecholamine-resistant vasodilatory shock, there is growing interest in RAS in critically ill patients. Among the fundamental components of RAS, renin acts as the initial stimulus for the entire system. In the context of hypotension, its release increases in response to low blood pressure sensed by renal baroreceptors and attenuated negative Ang II feedback loop. Thus, elevated renin could reflect disease severity and predict poor outcomes. Studies investigating this hypothesis have validated the prognostic accuracy of renin in various critically ill populations, with several reports indicating its superiority to lactate for mortality prediction. Accordingly, renin reduction has been used to assess the effectiveness of Ang II administration. Furthermore, renin holds potential to identify patients who might benefit from Ang II treatment, potentially paving the way for personalized vasopressor management. Despite these promising data, most available evidence is derived from retrospective analysis and necessitates prospective confirmation. The absence of a rapid, point-of-care and reliable renin assay presents another hurdle to its integration into routine clinical practice. This narrative review aims to describe the current understanding and future directions of renin as a biomarker during resuscitation of critically ill patients.
Statistical convergence of integral form of modified Szász–Mirakyan operators: an algorithm and an approach for possible applications
Authors: Bhardwaj Neha , Singh Rashmi , Chaudhary Aryan , Shankar Achyut , Kumar Rahul 
Published: May 2024

AbstractIn this study, we take into account the of modified Szász–Mirakyan–Kantorovich operators to obtain their rate of convergence using the modulus of continuity and for the functions in Lipschitz space. Then, we obtain the statistical convergence of this form. In addition, we determine the weighted statistical convergence and compare it with the statistical one for the same operator. Medical applications and traditional mathematics; one way to get a close approximation of the Riemann integrable functions is through the use of the Kantorovich modification of positive linear operators. The use of Kantorovich operators is tremendously helpful from a medical point of view. Their application is shown as an approximation of the rate of convergence in respect of modulus of continuity.
A pair of centro-symmetric heteroclinic orbits coined
Authors: Wang Haijun , Pan Jun , Ke Guiyao , Hu Feiyu 
Published: May 2024

AbstractAlthough the axis-symmetric heteroclinic orbits of Lorenz-like systems have been intensively studied in the past decades, scholars seem to pay scant attention to the centro-symmetric ones. To achieve this target, the present paper introduces a new subquadratic centro-symmetric three-dimensional Lorenz-like system: $\dot{x}=a(y - x)$

x
˙

=
a
(
y
−
x
)
, $\dot{y}=cx - \sqrt[3]{x^{2}}z$

y
˙

=
c
x
−

x
2

3

z
, $\dot{z}= -bz + \sqrt[3]{x^{2}}y$

z
˙

=
−
b
z
+

x
2

3

y
, and proves the existence of a pair of centro-symmetric to $E_{0}$

E
0

and $E_{\pm}$

E
±

combining the definitions of α-limit and ω-limit set, Lyapunov functions. The effectiveness and correctness of the theoretical conclusions are verified via a few numerical examples. Not only does the study provide new ideas for finding heteroclinic orbits, but also it poses an interesting question that the existence of heteroclinic orbits may depend on the degrees of the considered models.
Opportunistic screening for long-term muscle wasting in critically ill patients: insights from an acute pancreatitis cohort
Authors: Kolck Johannes , Hosse Clarissa , Leimbach Alexandra , Beetz Nick L. , Auer Timo A. , Collettini Federico , Fehrenbach Uli , Pille Christian , Geisel Dominik 
Published: May 2024

Abstract
Objectives
To assess the feasibility of long-term muscle monitoring, we implemented an AI-guided segmentation approach on clinically indicated Computed Tomography (CT) examinations conducted throughout the hospitalization period of patients admitted to the intensive care unit (ICU) with acute pancreatitis (AP). In addition, we aimed to investigate the potential of muscle monitoring for early detection of patients at nutritional risk and those experiencing adverse outcomes. This cohort served as a model for potential integration into clinical practice.

Materials
Retrospective cohort study including 100 patients suffering from AP that underwent a minimum of three CT scans during hospitalization, totaling 749 assessments. Sequential segmentation of psoas muscle area (PMA) was performed and was relative muscle loss per day for the entire monitoring period, as well as for the interval between each consecutive scan was calculated. Subgroup and outcome analyses were performed including ANOVA. Discriminatory power of muscle decay rates was evaluated using ROC analysis.

Results
Monitoring PMA decay revealed significant long-term losses of 48.20% throughout the hospitalization period, with an average daily decline of 0.98%. Loss rates diverged significantly between survival groups, with 1.34% PMA decay per day among non-survivors vs. 0.74% in survivors. Overweight patients exhibited significantly higher total PMA losses (52.53 vs. 42.91%; p = 0.02) and average PMA loss per day (of 1.13 vs. 0.80%; p = 0.039). The first and the maximum decay rate, in average available after 6.16 and 17.03 days after ICU admission, showed convincing discriminatory power for survival in ROC analysis (AUC 0.607 and 0.718). Both thresholds for maximum loss (at 3.23% decay per day) and for the initial loss rate (at 1.98% per day) proved to be significant predictors of mortality.

Conclusions
The innovative AI-based PMA segmentation method proved robust and effortless, enabling the first comprehensive assessment of muscle wasting in a large cohort of intensive care pancreatitis patients. Findings revealed significant muscle wasting (48.20% on average), particularly notable in overweight individuals. Higher rates of initial and maximum muscle loss, detectable early, correlated strongly with survival. Integrating this tool into routine clinical practice will enable continuous muscle status tracking and early identification of those at risk for unfavorable outcomes.
Feedback loop between hypoxia and energy metabolic reprogramming aggravates the radioresistance of cancer cells
Authors: Shi Zheng , Hu Cuilan , Zheng Xiaogang , Sun Chao , Li Qiang 
Published: May 2024

AbstractRadiotherapy is one of the mainstream approaches for cancer treatment, although the clinical outcomes are limited due to the radioresistance of tumor cells. Hypoxia and metabolic reprogramming are the hallmarks of tumor initiation and progression and are closely linked to radioresistance. Inside a tumor, the rate of angiogenesis lags behind cell proliferation, and the underdevelopment and abnormal functions of blood vessels in some loci result in oxygen deficiency in cancer cells, i.e., hypoxia. This prevents radiation from effectively eliminating the hypoxic cancer cells. Cancer cells switch to glycolysis as the main source of energy, a phenomenon known as the Warburg effect, to sustain their rapid proliferation rates. Therefore, pathways involved in metabolic reprogramming and hypoxia-induced radioresistance are promising intervention targets for cancer treatment. In this review, we discussed the mechanisms and pathways underlying radioresistance due to hypoxia and metabolic reprogramming in detail, including DNA repair, role of cancer stem cells, oxidative stress relief, autophagy regulation, angiogenesis and immune escape. In addition, we proposed the existence of a feedback loop between energy metabolic reprogramming and hypoxia, which is associated with the development and exacerbation of radioresistance in tumors. Simultaneous blockade of this feedback loop and other tumor-specific targets can be an effective approach to overcome radioresistance of cancer cells. This comprehensive overview provides new insights into the mechanisms underlying tumor radiosensitivity and progression.
Anti-pruritic effect of L-carnitine against chloroquine-induced pruritus mediated via nitric oxide pathway
Authors: Seemab Kiran , Khan Arif-ullah , Khan Muhammad Imran , Qazi Neelum Gul , Minhas Amber Mahmood , Ali Fawad 
Published: May 2024

Abstract
Background
Pruritus, or itching, is a distressing symptom associated with various dermatological and systemic diseases. L-carnitine (βeta hydroxy-γ-tri methyl amino-butyric acid), is a naturally occurring substance, it controls numerous physiological processes. The present research aims to identify L-carnitine for its anti-pruritic effect via nitric oxide-dependent mechanism.

Methods
Chloroquine-induced pruritus serves as an experimental model to investigate possible therapeutic interventions. In this study, we evaluated the efficacy of L-carnitine in combating oxidative stress, nitric oxide, and inflammatory cytokines in a chloroquine-induced pruritus model.

Results
L-carnitine treatment significantly reduced scratching behavior compared to the disease group (***P < 0.001 vs. chloroquine group), indicating its antipruritic potential. The markers of oxidative stress, GST, GSH, Catalase, and LPO were dysregulated in the disease model, but administration of L-carnitine restored GST, GSH, and Catalase levels and decreased LPO levels (***P < 0.001 vs. chloroquine group), thereby alleviating oxidative stress. L-carnitine also reduced nitric oxide synthase (NOS) activity, suggesting that it modulates nitric oxide signaling pathways involved in pruritus. In addition, L-carnitine lowered levels of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), inflammatory marker nuclear factor kappa B (p-NFκB) and also reduces an inflammatory enzyme, cyclooxygenase-2 (COX-2), determined by ELISA (Enzyme-Linked Immunosorbent Assay) (***P < 0.001 vs. chloroquine group). It downregulates nNOS mRNA expression confirmed by real-time polymerase chain reaction (RT-PCR).

Conclusion
These findings highlight the therapeutic effects of L-carnitine in alleviating chloroquine-induced pruritus.
Subtotal esophagectomy and concurrent reconstruction with free jejunal flap for primary esophageal cancer after pancreatoduodenectomy
Authors: Moriwake Kazuya , Noma Kazuhiro , Kawasaki Kento , Matsumoto Tasuku , Hashimoto Masashi , Kato Takuya , Maeda Naoaki , Tanabe Shunsuke , Shirakawa Yasuhiro , Fujiwara Toshiyoshi 
Published: May 2024

Abstract
Background
Pancreatoduodenectomy and subtotal esophagectomy are widely considered the most invasive and difficult surgical procedures in gastrointestinal surgery. Subtotal esophagectomy after pancreatoduodenectomy is expected to be extremely difficult due to complicated anatomical changes, and selecting an appropriate intestinal reconstruction method will also be a difficult task. Therefore, perhaps because the method is considered impossible, there have been few reports of subtotal esophagectomy after pancreatoduodenectomy.

Case presentation
A 73-year-old man with a history of pancreatoduodenectomy was diagnosed with superficial thoracic esophageal squamous cell carcinoma. Definitive chemoradiation therapy was recommended at another hospital; however, he visited our department to undergo surgery. We performed the robot-assisted thoracoscopic subtotal esophagectomy. There were some difficulties with the reconstruction: the gastric tube could not be used, the reconstruction was long, and the organs reconstructed in the previous surgery had to be preserved. However, the concurrent reconstruction was achieved with the help of a free jejunal flap and vascular reconstruction. All reconstructions from the previous surgery, including the remnant stomach, were preserved via regional abdominal lymph node dissection. After reconstruction, intravenous indocyanine green showed that circulation in the reconstructed intestines was preserved. On postoperative day 1, no recurrent nerve paralysis was observed during laryngoscopy. The patient could start oral intake smoothly 2 weeks after surgery and did not exhibit any postoperative complications related to the reconstruction. The patient was transferred to another hospital on postoperative day 21.

Conclusions
Owing to the free jejunal flap interposition method, we safely performed one stage subtotal esophagectomy and concurrent reconstruction, preservation of the remnant stomach, and pancreaticobiliary reconstruction in patients with a history of pancreatoduodenectomy. We believe that this method is acceptable and useful for patients undergoing complicated reconstruction.
Grid connection method of gravity energy storage generator motor based on voltage index sensitivity analysis
Authors: Wang Qingshan , Li Yan , Zhang Qun , He Darui 
Published: May 2024

AbstractThe basic requirements for the grid connection of the generator motor of the gravity energy storage system are: the phase sequence, frequency, amplitude, and phase of the voltage at the generator end and the grid end must be consistent. However, in actual working conditions, there will always be errors in the voltage indicators of the generator and grid terminals, resulting in transient impulse currents. In addition, due to the difference between gravity energy storage systems and conventional power generation units, frequent switching between charging and discharging operating conditions is required according to the needs of the power grid. Each switching requires the completion of the generator motor startup and grid connection. If there is always a significant error in the voltage indicators between the generator and grid terminals during frequent grid connection, stable transient surge currents will be generated. Without human intervention, long-term operation will bring hidden dangers to the safety of the grid connected system, leading to a series of consequences such as equipment aging and even damage. In response to the above issues, this article establishes a gravity energy storage power generation/motor grid connection model. Through simulation analysis, the variation law of the weight of the impact of different terminal voltage indicators on the grid connected transient impulse current is summarized. A grid connection method for gravity energy storage systems based on sensitivity analysis of voltage grid connection indicators is proposed. Through simulation verification, this method can significantly reduce the grid connected transient impulse current while improving the success rate of grid connection, The correctness and practicality of the proposed method have been fully verified.
Endosulfan induces reproductive & genotoxic effect in male and female Swiss albino mice
Authors: Priya  , Kumar Arun , Ali Mohammad , Srivastava Abhinav , Kumar Ranjit , Ghosh Ashok Kumar 
Published: May 2024

Abstract
Background
Toxicity by pesticide has become a global health issue and leaves a harmful impact on human health via various ways. The people exposed to pesticides in the rural population get affected by the harmful effects of it as they enter the human body system through skin, inhalation, oral administration, food chain and many more ways. The present work is designed to study the toxic effect of endosulfan in male (n=30) and female (n=30) Swiss albino mice. Endosulfan was administered by oral gavage (oral administration) method, at the dose of 3.5 mg/Kg body weight daily for period of 3 weeks, 5 weeks and 7 weeks. After the completion of the treatment, the mice were sacrificed and their ovary and testis tissues were dissected out to check the degeneration. The blood was collected for karyotyping, biochemical and hormonal analysis of pesticide induced genotoxicity. After 7 weeks of administration with Endosulfan, various abnormalities were observed in male and female mice.

Results
Treatment with endosulfan at the dose of 3.5 mg/Kg body weight caused a higher degree of degeneration in the reproductive organ of Swiss albino mice . Treatment by this pesticide generated degeneration in long duration of dosage for 3,5 and 7 weeks. Ovaries of endosulfan administered groups showed degenerated germinal epithelium, Graffian follicles and corpus luteum. In testis of endosulfan treated mice, microscopic examination showed that there is significant damage and reduction in the tissue of seminiferous tubules and primordial germ cells. High degree of degeneration caused the disarrangement and deformation of spermatogonia with the decrease in the number of Sertoli cells. Biochemical and hormonal properties was also affected by endosulfan treatment. There was significant 5 folds decrease in the testosterone value of endosulfan in 7 weeks treated mice in comparison to control (p < 0.0001) and similarly there was significant elevation in the estrogen levels found in 7th week endosulfan treated mice. It also influenced the level of free radicals as there was significant decrease (p < 0.0001) in the value in catalase levels in 7 weeks endosulfan treated male and female mice, while significant (p < 0.0001) increase in the values of lipid peroxidation levels as 8 folds and 10 folds in 7 weeks endosulfan treated male and female Swiss albino mice respectively. This study hence speculates that the endosulfan exposed population are at the risk of reproductive health hazards.

Conclusions
The present study thus concludes that, endosulfan after 7 weeks of exposure caused significant reproductive damage to both male and female Swiss albino mice groups. Moreover, the karyotyping study also correlated the genotoxic damage in the mice.
Image quality and patient satisfaction in cone-beam and multidetector computed tomography of the wrist: a randomized trial
Authors: Reidelbach Carolin S. , Neubauer Claudia , Geissler Ann-Kristin H. , Lampert Florian , Zajonc Horst , Simunovic Filip , Bamberg Fabian , Kotter Elmar , Goerke Sebastian M. , Neubauer Jakob 
Published: May 2024

Abstract
Background
Musculoskeletal cone-beam computed tomography (CBCT) is an imaging technique for wrist assessment. In this study, we compared image quality and patient satisfaction between CBCT and multidetector computed tomography (MDCT) in traumatic wrist patients in a dose-matched setting.

Methods
We prospectively enrolled traumatic patients who were scheduled for CT of the wrist. Patients were randomly assigned to CBCT or MDCT. Radiation dose was kept identical between both modalities. Subsequently, patients were asked to complete a questionnaire regarding the examination. Measurements of contrast-to-noise ratio (CNR) were performed. Three blinded readers independently rated image quality on Likert scales.

Results
A total of 125 patients (mean age 35 years [standard deviation 16]; 91 men) were included. A total of 108 patients returned the questionnaire. With equivalent dose, CNRs were higher in CBCT compared to MDCT (p < 0.001) and the median ratings of image quality were better for CBCT compared to MDCT (p ≤ 0.04). Patients only rated positioning in CBCT as more comfortable than in MDCT (p < 0.001), while there were no further differences regarding satisfaction with both modalities.

Conclusions
At equivalent dose settings to MDCT, CBCT showed a high image quality for the depiction of bony structures, soft tissue and artifacts in wrist examinations of trauma patients. Overall, patients were equally satisfied with both methods. Altogether, CBCT might be a promising alternative for wrist imaging. However, further studies with more different devices are needed.
Probiotic potential of lactic acid bacteria isolated from yaks
Authors: He Yuanyuan , Li Feiran , Xu Mengen , Jin Chao , Zhang Yu , Nawaz Shah , Kulyar Muhammad Fakhar-e-Alam , Iqbal Mudassar , Qin Zhen , Li Jiakui 
Published: May 2024

AbstractThe prevalence of bacterial digestive diseases in plateau animals has caused considerable losses to the Tibetan livestock industry. Therefore, this study aimed to isolate safe lactic acid bacteria (LAB) with beneficial probiotic properties to protect yaks from intestinal diseases. After 16S rDNA matching, four strains of Lactobacillus fermentum (A4), Pediococcus pentosaceus (A3.4 and A1.2), and Pediococcus acidilactici (B1.9) were isolated from the intestinal tissues and content of healthy yaks. The results indicated that A4 was more tolerant to bile salt (0.3%), while A3.4 had better stability in an acidic (pH = 3.0) environment. The results of the antibacterial activity test suggested that the isolates inhibited most pathogenic bacteria by up to 20%, except for A3.4, which inhibited Pasteurella and Staphylococcus aureus by more than 20%. Moreover, the results of the antioxidant test demonstrated that A4 and A3.4 had potent antioxidant activity. In addition, the drug sensitivity test revealed that the isolates were susceptible to commonly used antibiotics. In terms of safety, the isolates promoted growth, enhanced intestinal development, and protected the intestinal barrier without causing any adverse effects. In conclusion, LAB isolated from yak intestinal contents are potential probiotics with excellent antibacterial properties.
The Effect of Thiazide Diuretics on Urinary Prostaglandin E2 Excretion and Serum Sodium in the General Population
Authors: Geurts Frank , Rudolphi Crissy F , Pelouto Anissa , van der Burgh Anna C , Salih Mahdi , Imenez Silva Pedro Henrique , Fenton Robert A , Chaker Layal , Hoorn Ewout J 
Published: May 2024

AbstractContextThiazide-induced hyponatremia is one of the most common forms of hyponatremia, but its pathogenesis is incompletely understood. Recent clinical data suggest links with prostaglandin E2 (PGE2) and a single nucleotide polymorphism (SNP) in the prostaglandin transporter gene (SLCO2A1), but it is unknown if these findings also apply to the general population.ObjectiveTo study the associations between serum sodium, thiazide diuretics, urinary excretions of PGE2, and its metabolite (PGEM), and the rs34550074 SNP in SLCO2A1 in the general population.DesignProspective population-based cohort study (Rotterdam Study).SettingGeneral population.Participants2178 participants (65% female, age 64 ± 8 years)Intervention(s)None.Main Outcome Measure(s)Serum sodium levels.ResultsHigher urinary PGE2 excretion was associated with lower serum sodium: difference in serum sodium for each 2-fold higher PGE2 −0.19 mmol/L [95% confidence interval (CI) −0.31 to −0.06], PGEM −0.29 mmol/L (95% CI −0.41 to −0.17). This association was stronger in thiazide users (per 2-fold higher PGE2 −0.73 vs −0.12 mmol/L and PGEM −0.6 vs −0.25 mmol/L, P for interaction &lt;.05 for both). A propensity score matching analysis of thiazide vs non-thiazide users yielded similar results. The SNP rs34550074 was not associated with lower serum sodium or higher urinary PGE2 or PGEM excretion in thiazide or non-thiazide users.ConclusionSerum sodium is lower in people with higher urinary PGE2 and PGEM excretion, and this association is stronger in thiazide users. This suggests that PGE2-mediated water reabsorption regulates serum sodium, which is relevant for the pathogenesis of hyponatremia in general and thiazide-induced hyponatremia specifically.