bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the drainage of irrigation through the ureteral access sheath have an impact on the results of primary retrograde intrarenal surgery?
Authors: Chandramohan Vaddi , Siddalinga Swamy PM , Ramakrishna Paidakula , Soundarya Ganesan , Babu Manas , Hemnath Anandan , Panda Rakesh 
Published: February 2024

Purpose: One of the risk factors associated with post-operative fever and infections is the amount of fluid absorbed by the kidney. We conducted a prospective study to analyse the effects of irrigation fluid inflow and outflow on post-operative complications and stone-free rate. Material and methods: We did a prospective study on all primary retrograde intrarenal surgery (RIRS) cases performed at our hospital between JAN 2020 and JAN 2023. The fluid draining out of the access sheath was collected in a measuring container until the flexible scope was inside the access sheath. The amount of fluid retained by the body was measured by calculating the difference between the quantity of irrigation fluid utilised and the output from the access sheath. Results: A total of 566 patients were included in the study. The retained volume of more than 100 ml was associated with more pain (0.0/426 vs 49/140, p < 0.001), a higher incidence of fever (7/426 vs 22/140, p < 0.001), a higher incidence of high-grade complications (G4A 0 vs 4), and a higher incidence of residual stones (11/426 vs 49/140, p < 0.001). Conclusion: The outflow from the access sheath is a crucial factor that can significantly impact the outcome of RIRS. Level of evidence: Not applicable
Perceived stress and anxiety among medical students at Helwan University: A cross-sectional study
Authors: Ebrahim Omnya S , Sayed Hanan Ali , Rabei Samah , Hegazy Nelly 
Published: February 2024

Background: Medical students are prone to high levels of perceived stress and anxiety, which can negatively impact their academic performance, as well as their physical and mental health. This study aimed to assess the main stressors, levels of perceived stress and anxiety, and their predictors among medical students. Design and methods: A structured questionnaire was used to collect data from 1696 medical students at Helwan University. A cross-sectional study was designed to evaluate their perceived stress, stressors, and anxiety using the Perceived Stress Scale, Medical Students Stressor Questionnaire, and Beck Anxiety Inventory, respectively. Results: Approximately 93% of medical students experienced moderate to high levels of stress, while 54.9% of medical students experienced moderate to concerning levels of anxiety. The main stressors were academic, teaching, social, intrapersonal, group activity, and desire-related stressors. Risk factors associated with higher perceived stress included being female, young age, living away from the family, obtaining lower academic percentages, having psychiatric, neurological, or other chronic medical illnesses, and experiencing higher levels of academic, intrapersonal, drive, and group activities-related stressors. Risk factors for higher anxiety included being female, residing in rural areas, having psychiatric, neurological, or other chronic medical illnesses, perceiving a high level of stress, and experiencing higher levels of academic, intrapersonal, and social-related stressors. Conclusions: The findings indicate that a significant proportion of medical students experience various levels of stress and anxiety. These results underscore the urgent need for a stress management program, to help medical students to cope with different stressors.
Prevalence, Performance and Predictors of Electrocardiographic Left Ventricular Hypertrophy in Male Black Athletes: A Retrospective Study
Authors: Ilodibia Tochukwu F. , Odigwe Clement O. , Odili Augustine N. 
Published: February 2024

Introduction QRS voltages for electrocardiographic left ventricular hypertrophy (ECG-LVH) are more prominent in Black athletes than non-Black athletes. The underlying physiological relationships of ECG-LVH in BA remain enigmatic despite their greater predisposition to arterial hypertension. Objectives To determine the frequency of eight eponymous ECG-LVH criteria in male collegiate athletes in Nigeria; To determine the diagnostic performance of the most prevalent criteria; To determine the predictors of ECG-LVH. Methods 34 (thirty-four) athletes and 49 (forty-nine) non-athletic controls with normal electrocardiograms and echocardiograms were retrospectively recruited from an existing pre-participation screening cohort. They were all normotensive, non-obese and normoglycemic, and matched for age and body mass index (BMI). Results The four most frequent criteria were Sokolow-Lyon index (67.6% vs. 36.7%; χ2 = 7.7; p = .006), Romhilt’s criterion (52.9% vs. 8.2%; χ2 = 20.6; p < .001), Peguero-Lo Presti criterion (38.2% vs. 22.4%; χ2 = 2.43; p < .144), and Mazzoleni’s criterion (35.3% vs. 4.1%; χ2 = 13.95; p < .001). The sensitivity, specificity and accuracy of these criteria ranged between 23.8%–57.1%, 38.5%–53.9%, and 32.4%–50.0%, respectively. Athletic activity (OR = 4.49; 95% confidence interval, CI = 1.63–12.36; p = .004) and lower BMI (OR = 0.78; 95% CI = 0.63–0.97; p = .026) were independent predictors of ECG-LVH by the Sokolow-Lyon criterion. Conclusions Voltage ECG-LVH criteria all poorly predict the presence of echocardiographic LVH in young male Black athletes. However, the Sokolow-Lyon criterion seems to be associated with a benign cardio-metabolic profile in such athletes and appears hypothetically superior to other voltage criteria for identifying physiological cardiac remodeling in them. This hypothesis should be tested in future studies.
Phylogeography and phenotypic wing shape variation in a damselfly across populations in Europe
Authors: Yildirim Y. , Kristensson D. , Outomuro D. , Mikolajewski D. , Rödin Mörch P. , Sniegula S. , Johansson F. 
Published: February 2024

Abstract
Background
Describing geographical variation in morphology of organisms in combination with data on genetic differentiation and biogeography can provide important information on how natural selection shapes such variation. Here we study genetic structure using ddRAD seq and wing shape variation using geometric morphometrics in 14 populations of the damselfly Lestes sponsa along its latitudinal range in Europe.

Results
The genetic analysis showed a significant, yet relatively weak population structure with high genetic heterozygosity and low inbreeding coefficients, indicating that neutral processes contributed very little to the observed wing shape differences. The genetic analysis also showed that some regions of the genome (about 10%) are putatively shaped by selection. The phylogenetic analysis showed that the Spanish and French populations were the ancestral ones with northern Swedish and Finnish populations being the most derived ones.
We found that wing shape differed significantly among populations and showed a significant quadratic (but weak) relationship with latitude. This latitudinal relationship was largely attributed to allometric effects of wing size, but non-allometric variation also explained a portion of this relationship.
However, wing shape showed no phylogenetic signal suggesting that lineage-specific variation did not contribute to the variation along the latitudinal gradient. In contrast, wing size, which is correlated with body size in L. sponsa, had a strong negative correlation with latitude.

Conclusion
Our results suggest a relatively weak population structure among the sampled populations across Europe, but a clear differentiation between south and north populations. The observed geographic phenotypic variation in wing shape may have been affected by different local selection pressures or environmental effects.
Skin single-cell transcriptomics reveals a core of sebaceous gland-relevant genes shared by mice and humans
Authors: Thalheim Torsten , Schneider Marlon R. 
Published: February 2024

Abstract
Background
Single-cell RNA sequencing (scRNA-seq) has been widely applied to dissect cellular heterogeneity in normal and diseased skin. Sebaceous glands, essential skin components with established functions in maintaining skin integrity and emerging roles in systemic energy metabolism, have been largely neglected in scRNA-seq studies.

Methods
Departing from mouse and human skin scRNA-seq datasets, we identified gene sets expressed especially in sebaceous glands with the open-source R-package oposSOM.

Results
The identified gene sets included sebaceous gland-typical genes as Scd3, Mgst1, Cidea, Awat2 and KRT7. Surprisingly, however, there was not a single overlap among the 100 highest, exclusively in sebaceous glands expressed transcripts in mouse and human samples. Notably, both species share a common core of only 25 transcripts, including mitochondrial and peroxisomal genes involved in fatty acid, amino acid, and glucose processing, thus highlighting the intense metabolic rate of this gland.

Conclusions
This study highlights intrinsic differences in sebaceous lipid synthesis between mice and humans, and indicates an important role for peroxisomal processes in this context. Our data also provides attractive starting points for experimentally addressing novel candidates regulating sebaceous gland homeostasis.
Single-cell transcriptome analyses reveal critical regulators of spermatogonial stem cell fate transitions
Authors: Li Shuang , Yan Rong-Ge , Gao Xue , He Zhen , Wu Shi-Xin , Wang Yu-Jun , Zhang Yi-Wen , Tao Hai-Ping , Zhang Xiao-Na , Jia Gong-Xue , Yang Qi-En 
Published: February 2024

AbstractBackgroundSpermatogonial stem cells (SSCs) are the foundation cells for continual spermatogenesis and germline regeneration in mammals. SSC activities reside in the undifferentiated spermatogonial population, and currently, the molecular identities of SSCs and their committed progenitors remain unclear.ResultsWe performed single-cell transcriptome analysis on isolated undifferentiated spermatogonia from mice to decipher the molecular signatures of SSC fate transitions. Through comprehensive analysis, we delineated the developmental trajectory and identified candidate transcription factors (TFs) involved in the fate transitions of SSCs and their progenitors in distinct states. Specifically, we characterized the Asinglespermatogonial subtype marked by the expression ofEomes. Eomes+cells contained enriched transplantable SSCs, and more than 90% of the cells remained in the quiescent state. Conditional deletion ofEomesin the germline did not impact steady-state spermatogenesis but enhanced SSC regeneration. Forced expression ofEomesin spermatogenic cells disrupted spermatogenesis mainly by affecting the cell cycle progression of undifferentiated spermatogonia. After injury, Eomes+cells re-enter the cell cycle and divide to expand the SSC pool. Eomes+cells consisted of 7 different subsets of cells at single-cell resolution, and genes enriched in glycolysis/gluconeogenesis and the PI3/Akt signaling pathway participated in the SSC regeneration process.ConclusionsIn this study, we explored the molecular characteristics and critical regulators of subpopulations of undifferentiated spermatogonia. The findings of the present study described a quiescent SSC subpopulation, Eomes+spermatogonia, and provided a dynamic transcriptional map of SSC fate determination.
Physiological and molecular changes of onion (Allium cepa L.) seeds under different aging conditions
Authors: Kamaei Reza , Kafi Mohammad , Afshari Reza Tavakkol , Shafaroudi Saeid Malekzadeh , Nabati Jafar 
Published: February 2024

Abstract
Background
Onion seeds have limited storage capacity compared to other vegetable seeds. It is crucial to identify the mechanisms that induce tolerance to storage conditions and reduce seed deterioration. To address this goal, an experiment was conducted to evaluate changes in germination, biochemical, physiological, and molecular characteristics of onion seed landraces (Horand, Kazerun landraces and Zargan cultivar) at different aging levels (control, three-days and six-days accelerated aging, and natural aging for one year).

Results
The findings suggest that there was an increase in glucose, fructose, total sugar, and electrolyte leakage in the Horand (HOR), Kazerun (KAZ) landraces, and Zarghan (ZAR) cultivar, with Kazerun exhibiting the greatest increase. The percentage and rate of germination of Kazerun decreased by 54% and 33%, respectively, in six-day accelerated aging compared to the control, while it decreased by 12% and 14%, respectively, in Horand. Protein content decreased with increasing levels of aging, with a decrease of 26% in Kazerun landrace at six days of aging, while it was 16% in Horand landrace. The antioxidant activities of catalase, superoxide dismutase, and glutathione peroxidase decreased more intensively in Kazerun. The expression of AMY1, BMY1, CTR1, and NPR1 genes were lower in Kazerun landraces than in Horand and Zargan at different aging levels.

Conclusions
The AMY1, BMY1, CTR1, and NPR1 genes play a pivotal role in onion seed germination, and their downregulation under stressful conditions has been shown to decrease germination rates. In addition, the activity of CAT, SOD, and GPx enzymes decreased by seed aging, and the amount of glucose, fructose, total sugar and electrolyte leakage increased, which ultimately led to seed deterioration. Based on the results of this experiment, it is recommended to conduct further studies into the molecular aspects involved in onion seed deterioration. More research on the genes related to this process is suggested, as well as investigating the impact of different priming treatments on the genes expression involved in the onion seed aging process.
The effect of haloperidol’s perioperative application on postoperative delirium in elderly patients: a systematic review and meta-analysis
Authors: Liu Meinv , Su Jie , Wang Bei , Yu Dongdong , Li Jianli , Cao Xinyu 
Published: February 2024

Abstract
Objectives
To systematically review the evidence about the effect of haloperidol on postoperative delirium in elderly patients.

Methods
PubMed, Embase, the Cochrane Library and China National Knowledge Infrastructure were used to find concerned studies for meta-analysis. The main outcome was the incidence of postoperative delirium, and the secondary outcomes were side effects of haloperidol and the length of hospital stay. The meta-analyses were conducted using the Review Manager Version 5.1. This study was conducted based on the PRISMA statement.

Results
Eight RCTs (1569 patients) were included in the meta-analysis. There was a significant difference in the incidence of postoperative delirium between haloperidol and control groups (OR = 0.62, 95%CI 0.48–0.80, P = 0.0002, I2 = 20%). In addition, side effects of haloperidol and the duration of hospitalization were comparable (OR = 0.58, 95%CI 0.25–1.35, P = 0.21, I2 = 0%; MD =-0.01, 95%CI -0.16-0.15, P = 0.92, I2 = 28%). Subgroup analysis implied the effect of haloperidol on postoperative delirium might vary with the dose (5 mg daily: OR = 0.40, 95%CI 0.22–0.71, P = 0.002, I2 = 0%; <5 mg daily: OR = 0.72, 95%CI 0.42–1.23, P = 0.23, I2 = 0%).

Conclusions
The meta-analysis revealed perioperative application of haloperidol could decrease the occurrence of postoperative delirium without obvious side effects in elderly people, and high-dose haloperidol (5 mg daily) possessed a greater positive effect.
Long-term outcomes of left atrial appendage closure with or without concomitant pulmonary vein isolation:a propensity score matching analysis based on CLACBAC study
Authors: Li Xiang , Feng Shiyu , Ren Zhongyuan , Wu Jiayu , Zhou Lili , Yang Haotian , Zheng Yixing , Meng Weilun , Zhang Jun , Su Yang , Jiang Yan , Xu Jun , Sun Hui , Xu Yawei , Zhao Dongdong , Yin Xiaobing 
Published: February 2024

Abstract
Background
The combined procedure of left atrial appendage closure (LAAC) with concomitant pulmonary vein isolation (PVI) has demonstrated its efficacy and safety. However, there is still a lack of comparative investigations regarding the long-term benefits of the combined procedure when compared to LAAC alone. Our study aims to assess the long-term outcomes of combined procedure of LAAC with concomitant PVI in comparison with a propensity matched LAAC alone group.

Methods
Propensity score matching (PSM) was employed to rectify covariate imbalances, resulting in the inclusion of 153 comparable patients from the initial cohort of 333 non-valvular atrial fibrillation (AF) patients. Clinical outcomes, encompassing thrombotic events, major cardiocerebrovascular adverse events (MACCE), re-hospitalization due to cardiovascular disease (CVD), and atrial tachycardia (AT), were juxtaposed between the two groups. Bleeding events and peri-device complications, such as residual flow, device-related thrombus, and device replacement, were also compared. Additionally, a patients group underwent PVI alone was included for comparing AF recurrence rates between the PVI alone group and the combined group.

Results
Following PSM, 153 patients (mean age 70.3 ± 8.9, 62.7% men) were included, with 102 undergoing the combined procedure and 51 undergoing LAAC alone. No significant differences were found in baseline characteristics between the two groups. The mean follow-up time was 37.6 ± 7.9 months, and two patients were lost to follow-up in the combined procedure group. Thrombotic events were observed in 4 (7.8%) patients in the LAAC alone group and 4 (4.0%) in the combined group (Log-rank p = 0.301). The proportion of patients experiencing MACCE, re-hospitalization due to CVD, and AT between the two groups was comparable, as were bleeding events and peri-device complications. Among patients from the combined procedure group without AF recurrence, a significant difference was noted in prior-procedure left ventricular ejection fraction (LVEF) and LVEF at the 12th month after the procedure (57.2% ± 7.1% vs. 60.5% ± 6.5%, p = 0.002).

Conclusion
The concomitant PVI and LAAC procedure did not increase procedure-related complications, nor did it confer significant benefits in preventing thrombotic events or reducing other cardiovascular events. However, the combined procedure improved heart function, suggesting potential long-term benefits.
Shock index creatinine: a new predictor of mortality in acute coronary syndrome patients
Authors: Shariefuddin Widuri Wita Andriati , Pramudyo Miftah , Martha Januar Wibawa 
Published: February 2024

Abstract
Background
The Shock Index Creatinine (SIC) scoring is a recently developed tool for risk stratification patients. These updated scoring was already used in ST-Elevation Myocardial Infarction (STEMI) patients. However its utility in predicting outcomes for patients with Acute Coronary Syndrome (ACS) remains unclear. This study aims to evaluate and update the current SIC score to predict in-hospital mortality among patients with ACS.

Patients and methods
A retrospective cohort, Single-centered study enrolled 1349 ACS patients aged ≥ 18 years old diagnosed with ACS was conducted between January 2018 to January 2022 who met for inclusion and exclusion criteria. Study subjects were analyzed for in-hospital mortality and evaluated using binary linear regression analysis. The area under the curve (AUC) of SIC score was obtain to predict the sensitivity and specificity.

Results
Multivariate analysis showed that SIC score was significantly associated with in-hospital mortality. High SIC score (SIC ≥ 25) had significantly higher in-hospital mortality (p < 0.001) with odds ratio for (95% CIs) were 2.655 (1.6–4.31). Receiver operating characteristics (ROC) curve analysis determine the predictive power of SIC score for in-hospital mortality. SIC had an acceptable predictive value for in-hospital mortality (AUC = 0.789, 95% CI: 0.748–0.831, p < 0.001). The SIC score for sensitivity and specificity were, respectively, 71.5% and 74.4%, with optimal cutoff of SIC ≥ 25.

Conclusion
SIC had acceptable predictive value for in-hospital mortality in patients with all ACS spectrums. SIC was a useful parameter for predicting in-hospital mortality, particularly with a score ≥ 25. This is the first study to evaluate SIC in all spectrums of ACS.
Comparison of the efficacy and tolerability of elobixibat plus sodium picosulfate with magnesium citrate and split-dose 2-L polyethylene glycol with ascorbic acid for bowel preparation before outpatient colonoscopy: a study protocol for the multicentre, randomised, controlled E-PLUS trial
Authors: Hotta Kinichi , Otake Yosuke , Yamaguchi Daisuke , Shimodate Yuichi , Hanabata Norihiro , Ikematsu Hiroaki , Yabuuchi Yohei , Sano Yasushi , Shimoda Ryo , Sugimoto Shinya , Oba Mari , Takamaru Hiroyuki , Kimura Kouichiro , Kishida Yoshihiro , Takada Kazunori , Ito Sayo , Imai Kenichiro , Hosotani Kazuya , Murano Tatsuro , Yamada Masayoshi , Shinmura Kensuke , Takezawa Rio , Tomonaga Michito , Saito Yutaka 
Published: February 2024

Abstract
Background
Sodium picosulfate (SP)/magnesium citrate (MC) and polyethylene glycol (PEG) plus ascorbic acid are recommended by Western guidelines as laxative solutions for bowel preparation. Clinically, SP/MC has a slower post-dose defaecation response than PEG and is perceived as less cleansing; therefore, it is not currently used for major bowel cancer screening preparation. The standard formulation for bowel preparation is PEG; however, a large dose is required, and it has a distinctive flavour that is considered unpleasant. SP/MC requires a small dose and ensures fluid intake because it is administered in another beverage. Therefore, clinical trials have shown that SP/MC is superior to PEG in terms of acceptability. We aim to compare the novel bowel cleansing method (test group) comprising SP/MC with elobixibat hydrate and the standard bowel cleansing method comprising PEG plus ascorbic acid (standard group) for patients preparing for outpatient colonoscopy.

Methods
This phase III, multicentre, single-blind, noninferiority, randomised, controlled, trial has not yet been completed. Patients aged 40–69 years will be included as participants. Patients with a history of abdominal or pelvic surgery, constipation, inflammatory bowel disease, or severe organ dysfunction will be excluded. The target number of research participants is 540 (standard group, 270 cases; test group, 270 cases). The primary endpoint is the degree of bowel cleansing (Boston Bowel Preparation Scale [BBPS] score ≥ 6). The secondary endpoints are patient acceptability, adverse events, polyp/adenoma detection rate, number of polyps/adenomas detected, degree of bowel cleansing according to the BBPS (BBPS score ≥ 8), degree of bowel cleansing according to the Aronchik scale, and bowel cleansing time.

Discussion
This trial aims to develop a “patient-first” colon cleansing regimen without the risk of inadequate bowel preparation by using both elobixibat hydrate and SP/MC.

Trial registration
Japan Registry of Clinical Trials (jRCT; no. s041210067; 9 September 2021; https://jrct.niph.go.jp/), protocol version 1.5 (May 1, 2023).