bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of frailty index with congestive heart failure, all-cause and cardiovascular mortality among individuals with type 2 diabetes: a study from National Health and Nutrition Examination Surveys (NHANES), 1999–2018
Authors: Qin Yu-Nan , Zheng Xiao-Pu 
Published: October 2023

AbstractBackgroundBoth type 2 diabetes mellitus (T2DM) and frailty are strongly associated with congestive heart failure (CHF). Individuals with T2DM and CHF have a high frailty burden. The association of frailty with HF, all-cause, and cardiovascular mortality in patients with T2DM has not been thoroughly explored.MethodsThis study included 2894 adults with T2DM from the National Health and Nutrition Examination Survey (NHANES) database over ten cycles (1999–2018) and followed up for all-cause and cardiovascular mortality through 31 December 2019. The frailty index (FI) was calculated using a 46-item deficit model to assess frailty status. Weighted multivariable logistic regression was performed to explore the relationship between frailty and CHF in patients with T2DM. Weighted restricted cubic splines were used to evaluate the non-linear relationship between FI and outcome. All-cause mortality and cardiovascular mortality association with FI was assessed using the Kaplan–Meier curve and COX proportional hazards regression accounting for sampling weights. Subgroup and sensitivity analyses were performed to evaluate the robustness of the results.ResultsAfter the adjustment of essential confounders, a higher frailty index in T2DM was associated with increased odds of CHF (odds ratio [OR] for per 1-SD increase, 2.02, 95% confidence interval [CI] 1.67–2.45;P < 0.0001). The presence of frailty T2DM (OR, 3.60; 95% CI 2.34–5.54;P < 0.0001) was associated with a significant increase in the prevalence of CHF compared to non-frailty T2DM in a fully adjusted model. During the median follow-up of 6.75 years, per 1-SD increase in FI was associated with a 41% higher risk of all-cause mortality and a 30% higher risk of cardiovascular mortality after being adjusted for all confounders. Similar results were observed when sensitivity analyses were performed. There was also a non-linear relationship between FI and all-cause mortality. In a weighted multivariate COX proportional model adjusted for full confounders, frailty T2DM increased all-cause (HR, 1.86; 95% CI 1.55–2.24;P < 0.0001) and cardiovascular (HR 1.66; 95% CI 1.18–2.33;P = 0.003) mortality and compared to non-frailty T2DM. The positive association of frailty index and all-cause mortality was only in participants without CHF. The positive association of frailty index and cardiovascular mortality was only in non-anti-diabetic drug users.ConclusionsFrailty index in T2DM was positively associated with CHF in linear fashions. The Frailty index was positively correlated with all-cause and cardiovascular death in patients with T2DM. Frailty T2DM was positively associated with CHF, all-cause mortality, and cardiovascular mortality compared to non-frailty T2DM. Promoting frailty measurement and management in T2DM may be beneficial to reduce the burden of CHF and mortality.
Co-designing community-based interventions to tackle antimicrobial resistance (AMR): what to include and why
Authors: Mitchell Jessica , Arjyal Abriti , Baral Sushil , Barrington Dani , Cooke Paul , Fieroze Fariza , Huque Rumana , Hamade Prudence , Hawkings Helen , Jones Nichola , Latham Sophia , Parajuli Ayuska , Saify Md Badruddin , King Rebecca ,   the CE4AMR network
Published: October 2023

AbstractAntimicrobial resistance (AMR) is a social and biological problem. Although resistance to antimicrobials is a natural phenomenon, many human behaviors are increasing the pressure on microbes to develop resistance which is resulting in many commonly used treatments becoming ineffective. These behaviors include unregulated use of antimicrobial medicines, pesticides and agricultural chemicals, the disposal of heavy metals and other pollutants into the environment, and human-induced climatic change. Addressing AMR thus calls for changes in the behaviors which drive resistance. Community engagement for antimicrobial resistance (CE4AMR) is an international and interdisciplinary network focused on tackling behavioural drivers of AMR at community level. Since 2019 this network has worked within Low-Middle Income Countries (LMICs), predominantly within Southeast Asia, to tackle behavioral drivers of AMR can be mitigated through bottom-up solutions championed by local people. This commentary presents seven Key Concepts identified from across the CE4AMR portfolio as integral to tackling AMR. We suggest it be used to guide future interventions aimed at addressing AMR via social, participatory, and behavior-change approaches.
Sex-specific role of galectin-3 in aortic stenosis
Authors: Matilla Lara , Martín-Núñez Ernesto , Garaikoetxea Mattie , Navarro Adela , Tamayo Ibai , Fernández-Celis Amaya , Gainza Alicia , Fernández-Irigoyen Joaquín , Santamaría Enrique , Muntendam Pieter , Álvarez Virginia , Sádaba Rafael , Jover Eva , López-Andrés Natalia 
Published: October 2023

AbstractBackgroundAortic stenosis (AS) is characterized by inflammation, fibrosis, osteogenesis and angiogenesis. Men and women develop these mechanisms differently. Galectin-3 (Gal-3) is a pro-inflammatory and pro-osteogenic lectin in AS. In this work, we aim to analyse a potential sex-differential role of Gal-3 in AS.Methods226 patients (61.50% men) with severe AS undergoing surgical aortic valve (AV) replacement were recruited. In AVs, Gal-3 expression and its relationship with inflammatory, osteogenic and angiogenic markers was assessed. Valve interstitial cells (VICs) were primary cultured to perform in vitro experiments.ResultsProteomic analysis revealed that intracellular Gal-3 was over-expressed in VICs of male AS patients. Gal-3 secretion was also higher in men’s VICs as compared to women’s. In human AVs, Gal-3 protein levels were significantly higher in men, with stronger immunostaining in VICs with myofibroblastic phenotype and valve endothelial cells. Gal-3 levels in AVs were positively correlated with inflammatory markers in both sexes. Gal-3 expression was also positively correlated with osteogenic markers mainly in men AVs, and with angiogenic molecules only in this sex. In vitro,Gal-3 treatment induced expression of inflammatory, osteogenic and angiogenic markers in male’s VICs, while it only upregulated inflammatory and osteogenic molecules in women-derived cells. Gal-3 blockade with pharmacological inhibitors (modified citrus pectin and G3P-01) prevented the upregulation of inflammatory, osteogenic and angiogenic molecules.ConclusionsGal-3 plays a sex-differential role in the setting of AS, and it could be a new sex-specific therapeutic target controlling pathological features of AS in VICs.Graphical Abstract
Predictors of cervical tumour size for outpatients with cervical cancer at the University of Gondar referral hospital: a retrospective study design
Authors: Gashu Chalachew , Aguade Aragaw Eshetie 
Published: October 2023

Abstract
Background
Cervical cancer is one of the most serious threats to women's lives. Modelling the change in tumour size over time for outpatients with cervical cancer was the study's main goal.

Methods
A hospital conducted a retrospective cohort study with outpatients who had cervical cancer. The information about the tumour size was taken from the patient's chart and all patient data records between May 20, 2017, and May 20, 2021. The data cover 322 cervical cancer outpatients' basic demographic and medical information. When analysing longitudinal data, the linear mixed effect model and the connection between tumour sizes in outpatients were taken into consideration. A linear mixed model, a random intercept model, and a slope model were used to fit the data.

Result
A sample of 322 cervical cancer outpatients was examined, and 148 (or 46% of the outpatients) tested positive for HIV. The linear mixed model with a first-order autoregressive covariance structure revealed that a change in time of one month led to a 0.009 cm2 reduction in tumour size. For every kilogramme more in weight, the tumour size change in cervical cancer patients decreased considerably by 0.0098 cm2. The tumour size change in the cervical cancer patient who was HIV-positive was 0.4360 cm squared greater than that in the HIV-negative outpatients.

Conclusion
As a consequence, there was a significant association between the longitudinal change in tumour size and the predictor variables visit time, therapy, patient weight, cancer stage, HIV, oral contraceptive use, history of abortion, and smoking status.
Two murine models of sepsis: immunopathological differences between the sexes—possible role of TGFβ1 in female resistance to endotoxemia
Authors: Bojalil Rafael , Ruíz-Hernández Armando , Villanueva-Arias Arturo , Amezcua-Guerra Luis Manuel , Cásarez-Alvarado Sergio , Hernández-Dueñas Ana María , Rodríguez-Galicia Verónica , Pavón Lenin , Marquina Brenda , Becerril-Villanueva Enrique , Hernández-Pando Rogelio , Márquez-Velasco Ricardo 
Published: October 2023

AbstractEndotoxic shock (ExSh) and cecal ligature and puncture (CLP) are models that induce sepsis. In this work, we investigated early immunologic and histopathologic changes induced by ExSh or CLP models in female and male mice. Remarkable results showed that females supported twice the LD100 of LPS for males, CLP survival and CFU counts were similar between genders, high circulating LPS levels in ExSh mice and low levels of IgM anti-LPS in males. In the serum of ExSh males, TNF and IL-6 increased in the first 6 h, in CLP males at 12 h. In the liver of ExSh mice, TNF increased at 1.5 and 12 h, IL-1 at 6 h. TGFβ1 increased in females throughout the study and at 12 h in males. In CLP mice, IL-6 decreased at 12 h, TGFβ1 increased at 6–12 h in males and at 12 h in females. In the lungs of ExSh males, IL-1β increased at 1.5-6 h and TGFβ1 at 12 h; in females, TNF decrease at 6 h and TGFβ1 increased from 6 h; in CLP females, TNF and IL-1β decreased at 12 h and 1.5 h, respectively, and TGFβ1 increased from 6 h; in males, TGFβ1 increased at 12 h. In the livers of ExSh mice, signs of inflammation were more common in males; in the CLP groups, inflammation was similar but less pronounced. ExSh females had leucocytes with TGFβ1. The lungs of ExSh males showed patches of hyaline membranes and some areas of inflammatory cells, similar but fewer and smaller lesions were seen in male mice with CLP. In ExSh females, injuries were less extent than in males, similar pulmonary lesions were seen in female mice with CLP. ExSh males had lower levels of TGFβ1 than females, and even lower levels were seen in CLP males. We conclude that the ExSh was the most lethal model in males, associated with high levels of free LPS, low IgM anti-LPS, exacerbated inflammation and target organ injury, while females showed early TGFβ1 production in the lungs and less tissue damage. We didn't see any differences between CLP mice.
Exploration of phyllosphere microbiomes in wheat varieties with differing aphid resistance
Authors: Li Xinan , Wang Chao , Zhu Xun , Ntoukakis Vardis , Cernava Tomislav , Jin Decai 
Published: October 2023

Abstract
Background
Leaf-associated microbes play an important role in plant development and response to exogenous stress. Insect herbivores are known to alter the phyllosphere microbiome. However, whether the host plant’s defense against insects is related to the phyllosphere microbiome remains mostly elusive. Here, we investigated bacterial communities in the phyllosphere and endosphere of eight wheat cultivars with differing aphid resistance, grown in the same farmland.

Results
The bacterial community in both the phyllosphere and endosphere showed significant differences among most wheat cultivars. The phyllosphere was connected to more complex and stable microbial networks than the endosphere in most wheat cultivars. Moreover, the genera Pantoea, Massilia, and Pseudomonas were found to play a major role in shaping the microbial community in the wheat phyllosphere. Additionally, wheat plants showed phenotype-specific associations with the genera Massilia and Pseudomonas. The abundance of the genus Exiguobacterium in the phyllosphere exhibited a significant negative correlation with the aphid hazard grade in the wheat plants.

Conclusion
Communities of leaf-associated microbes in wheat plants were mainly driven by the host genotype. Members of the genus Exiguobacterium may have adverse effects on wheat aphids. Our findings provide new clues supporting the development of aphid control strategies based on phyllosphere microbiome engineering.
Diagnostic performance of short noncontrast biparametric 3-T MRI for tonsillar infections: comparison with a full protocol including contrast-enhanced sequences
Authors: Vierula Jari-Pekka , Nurminen Janne , Jussila Ville , Nyman Mikko , Heikkinen Jaakko , Pape Bernd , Sorvettula Kaarlo , Mattila Kimmo , Hirvonen Jussi 
Published: October 2023

Abstract
Background
We investigated whether a short, 5-min magnetic resonance imaging (MRI) protocol consisting of only axial T2-weighted and diffusion-weighted imaging (DWI) sequences can discriminate between tonsillar infections, peritonsillar abscesses and deeply extending abscesses in a retrospective, blinded, multireader setting.

Methods
We included patients sent by emergency physicians with suspected pharyngotonsillar infections who underwent emergency neck 3-T MRI from April 1 2013 to December 31 2018. Three radiologists (with 10−16 years of experience) reviewed the images for abscesses and their extension into deep neck spaces. Data were reviewed first using only axial T2-weighted Dixon images and DWI (short protocol) and second including other sequences and contrast-enhanced T1-weighted Dixon images (full protocol). Diagnostic accuracy, interobserver agreement, and reader confidence were measured. Surgical findings and clinical course served as standard of reference.

Results
The final sample consisted of 52 patients: 13 acute tonsillitis with no abscesses, 19 peritonsillar abscesses, and 20 deeply extending abscesses. Using the short protocol, diagnostic accuracy for abscesses across all readers was good-to-excellent: sensitivity 0.93 (95% confidence interval 0.87−0.97), specificity 0.85 (0.70−0.93), accuracy 0.91 (0.85−0.95). Using the full protocol, respective values were 0.98 (0.93−1.00), 0.85 (0.70−0.93), and 0.95 (0.90−0.97), not significantly different compared with the short protocol. Similar trends were seen with detecting deep extension. Interobserver agreement was similar between protocols. However, readers had higher confidence in diagnosing abscesses using the full protocol.

Conclusions
Short MRI protocol showed good-to-excellent accuracy for tonsillar abscesses. Contrast-enhanced images improved reader confidence but did not affect diagnostic accuracy or interobserver agreement.

Relevance statement
Short protocol consisting only of T2-weighted Dixon and DWI sequences can accurately image tonsillar abscesses, which may improve feasibility of emergency neck MRI.

Key points
• The short 3-T MRI protocol (T2-weighted images and DWI) was faster (5 min) than the full protocol including T1-weighted contrast-enhanced images (24 min).
• The short 3-T MRI protocol showed good diagnostic accuracy for pharyngotonsillar abscesses.
• Contrast-enhanced sequences improved reader confidence but did not impact diagnostic accuracy or interobserver agreement.

Graphical Abstract
Changes in the profile of Coronavirus disease (COVID-19) and related neuroimaging findings during the first and second waves: a South Indian perspective
Authors: Monachen Matthew , Jasper Anitha , Mannam Pavithra , Aaron Sanjith , Sivadasan Ajith , Prabhakar A. T. , Vanjare Harshad , Selvi Bernice T. 
Published: October 2023

Abstract
Background
The spectrum of COVID-19 infection-related neurological imaging findings in East Asian and Western populations has been well documented. In the Indian subcontinent, certain extracranial neurological imaging manifestations such as acute invasive fungal sinusitis were noted to occur with increasing frequency when compared to that reported in literature. This anomaly was more evident during the second wave of infection and since there is a paucity of literature documenting this change, we undertook this retrospective observational study.

Results
Patients with COVID-19 who underwent brain or spine imaging between 1st March 2020 and 31st May 2021 were assessed for inclusion. We considered cases with imaging done in 2020 as the 1st wave, and cases with imaging done in 2021 as the 2nd wave. In the first wave, the most common neuroimaging findings were ischemic stroke (82, 26.5%), acute invasive fungal sinusitis (34, 11%), dural venous sinus thrombosis (15, 4.9%), and brain hemorrhages (15, 4.9%). In the second wave, the most common were acute invasive fungal sinusitis (44, 21.9%), ischemic stroke (39, 19.4%), and noninvasive sinusitis (30, 14.9%). The second wave had significantly more cases of acute invasive fungal sinusitis (44, 21.9% vs. 34, 11%; p-value .001), noninvasive sinusitis, and orbital cellulitis when compared to the first wave.

Conclusions
While we had ischemic stroke, followed by acute invasive fungal sinusitis, dural venous sinus thrombosis, and brain hemorrhages as the most common neuroimaging findings in the first wave, the second wave was dominated by the extracranial complications of Mucormycosis, namely acute invasive fungal sinusitis.
The application of dual-phase enhanced CT scan in distinguishing adrenal ganglioneuromas from adrenal lipid-poor adenomas
Authors: Yu Huajun , Wang Jian , Niu Zhongfeng , Shao Meihua 
Published: October 2023

Abstract
Background
The utility of dual-phase enhanced computerized tomography (CT) scan in distinguishing adrenal ganglioneuromas from lipid-poor adenomas has not been reported. We aimed to retrospectively compare dual-phase enhanced CT findings which were helpful in distinguishing adrenal ganglioneuromas from adrenal lipid-poor adenomas.

Methods
We estimated the dual-phase enhanced CT findings of 258 adrenal masses (42 ganglioneuromas, 216 lipid-poor adenomas) in 258 patients from July 2008 to July 2020 with ganglioneuromas and July 2016 to July 2020 with lipid-poor adenomas. The CT features between ganglioneuromas and lipid-poor adenomas were compared using independent two-sample t test, Mann–Whitney test, and ROC analysis.

Results
Significant differences were detected in CT value of unenhanced (CTU), CT value of arterial phase (CTA), CT value of venous phase (CTV), degree of enhancement in arterial phase, degree of enhancement in portal venous phase, age, tumor size [longest dimension, shortest dimension, mean dimension], shape, calcification between the ganglioneuroma and lipid-poor adenoma groups (P < 0.05). The results of receiver operating characteristics (ROC) analyses showed that areas under ROC curves of CTU, CTA and CTV were 0.713, 0.878, and 0.914, respectively. When the cut-off values were set at 22.5 HU, 51.5 HU, and 53.5 HU for CTU, CTA, and CTV, respectively, the three parameters had a sensitivity of 46.8%, 67.6%, and 88.0% and a specificity of 100%, 100%, and 88.1% in distinguishing ganglioneuromas from lipid-poor adenomas.

Conclusions
Dual-phase enhanced abdominal CT can exhibit some of the primary imaging characteristics of ganglioneuromas and lipid-poor adenomas used to distinguish between these two entities.
Multi-phasic magnetic resonance imaging of hemodynamic interchanges in hepatocarcinogenesis
Authors: Elzeneini Ahmed Mahmoud , Abdelmohsen Mohsen Ahmed , Yousef Mohamed Ibrahim 
Published: October 2023

Abstract
Background
Liver cirrhosis and hepatocellular cancer deem a substantial global health burden and are the end result of a variety of chronic liver diseases. Guidelines have been introduced to secure standardized approaches in the diagnosis and management of hepatocellular carcinoma (HCC). Established guidelines agree upon the distinctive dynamic enhancement findings of HCC, characterized by arterial phase wash-in and venous or delayed phase washout. The indeterminate focal hepatic lesions constitute a diagnostic dilemma. The aim of the study was quantification of hepatic vascular parameters using dynamic contrast-enhanced (DCE)-MRI to study liver hemodynamic disturbances that can differentiate between focal hepatic lesions during hepatocellular carcinogenesis.

Results
The study was conducted on 95 patients with comparing perfusion abnormalities across different liver cirrhosis pathologies, and the comparison revealed the correlation of hemodynamics with hepatocarcinogenesis and grades of cirrhosis. Relative enhancement curves were graphed to illustrate the different enhancement patterns across the spectrum of hepatonodular lesions of cirrhosis and among types of de novo and recurrent HCC. Statistical significance was highest between dysplastic nodules (DNs) and HCCs (maximal relative enhancement (MRE) 0.88, wash-in ratio (WIR) 0.84, washout ratio (WOR) 0.78, time to peak (TTP) 0.74, area under curve (AUC 0.73, T0 0.70), compared to those between cirrhotic liver and DNs (MRE 0.74, To 0.62). Least significances were between de novo and recurrent HCCs (TTP 0.66, r AUC 0.66, MRE 0.63). Performances between non-cirrhotic and cirrhotic liver [WOR 0.81, time to peak (TTP) 0.80, r AUC 0.63] surpassed those among different grades of cirrhosis (the highest was between non-tumoral and tumoral cirrhosis: TTP 0.74, MRE 0.68, WIR 0.65, WOR 0.65).

Conclusions
Dynamic contrast-enhanced magnetic resonance imaging hemodynamic metrics promise potential usefulness as non-invasive biomarkers in assessment of liver cirrhosis, characterization of cirrhotic nodules, and evaluation of multistep hepatocarcinogenesis.
The museum method of reusing Shanghai waterfront industrial heritage: continuation and reconstruction of urban memory
Authors: Luo Lan , Cao Yongkang 
Published: October 2023

AbstractIn the context of transforming traditional labour-intensive industries into the service economy in China, the reuse of industrial heritage as museums has become a trend, for example, along Shanghai waterfronts, gradually fuelling the continuation of urban memory, reshaping urban cultural identity and promoting the development of the waterfront economy. Additionally, the connotation of a museum is continually being expanded from an institution to a method, and the major function is gradually shifting from collection to display. Previous studies on Shanghai waterfront industrial heritage have mostly referred to cultural factors, but these factors are still mainly included in macroscale large waterfront projects or microscale single practical project analyses. Mesoscale typology discussions between the two are rare. Therefore, this paper examines eleven industrial heritage sites that have been repurposed as museums along Shanghai waterfronts to analyse the urban memory elements of industrial heritage and summarise three classes of memory interpretation strategies: translating memory information, renovating memory carriers, and relating memory clues. Finally, the advantages and disadvantages of the study cases are discussed separately, and the following corresponding recommendations are made: 1) further enrich and balance memory interpretation strategies; 2) enhance the rationality, service, and tolerance of the “exhibition + ” mode; and 3) improve local laws and regulations related to the protection and utilisation of industrial heritage to provide references for similar reuse designs.