bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anteromedial cannulated screw fixation for Hawkins II/III talus fractures in children: a retrospective study
Authors: Huang Xincheng , Ruan Siyuan , Lei Zhuolin , Cao Hong 
Published: October 2023

Abstract
Objective
To investigate the clinical effect of the anteromedial cannulated screw approach in the treatment of Hawkins II/III talus fractures in children.

Methods
A retrospective study was conducted on 20 children with talar fractures admitted to Renmin Hospital from September 2018 to February 2022. The fracture healing and functional recovery of the affected limb were strictly followed up after the operation. There were 14 males and 6 females. The average age was 9 years (range 6–12 years). According to the Hawkins classification, there were 12 cases of talar neck fracture type II and 8 cases of type III. All patients were fixed with cannulated compression screws via an anteromedial approach. According to the American Orthopedic Foot and Ankle Society ankle and hindfoot function scoring system, limb function was evaluated before and after the operation. A visual analog scale was used to evaluate the degree of postoperative pain.

Results
All 20 children were followed up for 12 months to 30 months, with an average of 15 months. We found that there was no significant difference in the excellent and good rate (76.9%) and necrosis rate (30.8%) between male children and female children (71.4%) and necrosis rate (28.6%) (P > 0.05). The excellent and good rates (92.9%) of children younger than 9 years old at the time of injury were higher than those of children older than 9 years old (33.3%), and the incidence of avascular necrosis of the talus was lower. The differences between the two groups were statistically significant (P < 0.05). The average prognosis score of children who underwent surgery within 5 days after injury was 89.2 ± 6.4, which was significantly higher than that of children who underwent surgery after 5 days (72.9 ± 13.1), and the difference was statistically significant (P < 0.05). There was no significant difference between patients who underwent surgery within 5 days after injury (15.4%) and those who underwent surgery after 5 days (51.7%) (P > 0.05). The excellent and good rates of talar neck fracture type II and talar neck fracture type III were 90.1% and 55.6%, respectively.

Conclusion
The anteromedial approach combined with cannulated compression screws for the treatment of Hawkins II/III talus fractures in children not only has a clear surgical field, but the fracture can also be reduced and fixed under direct vision using this technique. It does not affect the stability of the ankle joint and is conducive to the recovery of ankle function. It can be used as a surgical scheme for the treatment of talar fractures in children.
Primary unifocal thymic Rosai-Dorfman disease: an extremely rare challenge in diagnostic practice
Authors: Liu Qian , Liao Fengxiang , Liu Yong , Cheng Yang , Qi Chubo 
Published: October 2023

AbstractRosai-Dorfman disease (RDD) is currently considered a group of neoplastic diseases of unknown etiology, with monoclonal proliferation of histiocytes, showing unique histopathologic features and varying clinical presentation. Primary thymic RDD is an extremely rare extranodal form of this disorder. In this study, we describe the case of an otherwise healthy 64-year-old Chinese man who presented with an isolated, asymptomatic soft tissue density lesion in the anterior mediastinum detected by computed tomography. Histology of the surgical specimen revealed infiltration of thymic tissue by sheets of large histiocytes with mixed lymphocytes and plasma cells, and background fibrosis. Immunohistochemical staining of the histiocytes was positive for S100, CD68, CD163, OCT2 and cyclin D1, but negative for CD1a and BrafV600E expression, thus supporting a diagnosis of RDD. Primary thymic RDD is extremely rare and may be a diagnostic challenge when presenting as mediastinal lesion.
N-terminal pro-B-type natriuretic peptide is associated with clinical outcomes after transcatheter aortic valve replacement
Authors: Yu Jun , Wang Wei 
Published: October 2023

Abstract
Background
Limited data on the prognostic value of periprocedural changes of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) after transcatheter aortic valve replacement (TAVR).

Methods
Data of plasma NT-proBNP were retrospectively collected in 357 patients before TAVR procedure and at discharge from January 1, 2018 to December 31, 2021 in our single center. Patients were grouped as responders and non-responders according to the NT-proBNP ratio (postprocedural NT-proBNP at discharge/ preprocedural NT-proBNP). Responders were defined as NT-proBNP ratio < 1 and non-responders were defined as NT-proBNP ratio ≥ 1. Outcomes were defined according to the Valve Academy Research Consortium (VARC)-3 criteria.

Results
A total of 234 patients (65.5%) and 123 patients (34.5%) were grouped as the responders and the non-responders, respectively. Responders and non-responders were significantly different in both median preprocedural (2103.5 vs. 421.0 pg/ml, p < 0.001) and postprocedural (707.6 vs. 1009.0, p < 0.001) NT-proBNP levels. Patients in the non-responder group were more inclined to have comorbidities of hypertension (73.2% vs. 51.7%, p < 0.001), hyperlipidaemia (46.3% vs. 34.6%, p = 0.031), peripheral vascular disease (20.3% vs. 8.5%, p = 0.001) and pure aortic insufficiency (15.4% vs. 4.3%, p < 0.001). In the contrast, patients in the responder group had higher prevalence of maximum transvalvular velocity (4.6 vs. 4.2 m/s, p < 0.001), reduced left ventricular ejection fraction (58.0% vs. 63.0%, p < 0.001), heart failure (9.4% vs. 2.4%, p = 0.014), mitral regurgitation ≥ moderate (13.7% vs. 4.9%, p = 0.010), tricuspid regurgitation ≥ moderate (12.0% vs. 2.4%, p = 0.002), and pulmonary hypertension (32.9% vs. 13.0%, p < 0.001). Patients in the non-responder group were moderately longer than the responder group in total hospitalization length (14 vs. 12 days, p < 0.001). The non-responder group were significantly associated with cumulative all-cause mortality (p = 0.009) and cardiac mortality (p < 0.001) during the follow-up period.

Conclusions
Periprocedural changes of NT-proBNP is clinically useful for the risk stratification of survival in patients after TAVR.
Isoforskolin modulates AQP4-SPP1-PIK3C3 related pathway for chronic obstructive pulmonary disease via cAMP signaling
Authors: Lin Haochang , Cheng Sha , Yang Songye , Zhang Qian , Wang Lueli , Li Jiangya , Zhang Xinyue , Liang Liju , Zhou Xiaoqian , Yang Furong , Song Jingfeng , Cao Xue , Yang Weimin , Weng Zhiying 
Published: October 2023

Abstract
Background
Cyclic adenosine monophosphate (cAMP) levels are directly activated by adenylate cyclase (AC) and play an anti-inflammatory role in chronic obstructive pulmonary disease (COPD). Previously, we have shown that isoforskolin (ISOF) can effectively activate AC1 and AC2 in vitro, improve pulmonary ventilation and reduce the inflammatory response in COPD model rats, supporting that ISOF may be a potential drug for the prevention and treatment of COPD, but the mechanism has not been explored in detail.

Methods
The potential pharmacological mechanisms of ISOF against COPD were analyzed by network pharmacology and multi-omics based on pharmacodynamic study. To use specific agonists, inhibitors and/or SiRNA for gene regulation function studies, combined qPCR, WB were applied to detect changes in mRNA and protein expression of important targets PIK3C3, AKT, mTOR, SPP1 and AQP4 which related to ISOF effect on COPD. And the key inflammatory factors detected by ELISA.

Results
Bioinformatics suggested that the anti-COPD pharmacological mechanism of ISOF was related to PI3K-AKT signaling pathway, and suggested target protein like PIK3C3, AQP4, SPP1, AKT, mTOR. Using the AQP4 inhibitor,or inhibiting SPP1 expression by siRNA-SPP1 could block the PIK3C3-AKT-mTOR pathway and ameliorate chronic inflammation. ISOF showed cAMP-promoting effect then suppressed AQP4 expression, together with decreased level of IL-1β, IL-6, and IL-8.

Conclusions
These findings demonstrate ISOF controlled the cAMP-regulated PIK3C3-AKT-mTOR pathway, thereby alleviating inflammatory development in COPD. The cAMP/AQP4/PIK3C3 axis also modulate Th17/Treg differentiation, revealed potential therapeutic targets for this disease.
Kruppel-like factor 13 acts as a tumor suppressor in thyroid carcinoma by downregulating IFIT1
Authors: Liu Yang , Song Yixuan , He Yuqin , Kong Ziren , Li Han , Zhu Yiming , Liu Shaoyan 
Published: October 2023

Abstract
Background
Kruppel-like factor 13 (KLF13) is a transcription factor and plays an important role in carcinogenesis. However, the significance of KLF13 in thyroid carcinoma (THCA) is underdetermined. In this study, we aimed to explore the clinical relevance and function of KLF13 in the progress of THCA.

Methods
The expression of KLF13 in thyroid carcinoma and normal tissue was investigated by qPCR and IHC assay. The expression of KLF13 and IFIT1 in cell samples was investigated with Western blot assay. Cell proliferation ability was detected with CCK8 and colony formation assay. Cell growth in vivo with or without KLF13 overexpression was evaluated on a xenograft model. Cell migration ability was measured with Transwell assay. Cell cycle was detected with flow cytometer. The downstream genes of KLF13 were screened using RNA-seq assay. Luciferase activity was employed to assess the transcriptional regulation of KLF13 on IFIT1 promoter.

Results
KLF13 expression was downregulated in THCA samples. KLF13 knockdown and overexpression promoted and inhibited the proliferation and migration of THCA cells, respectively. The RNA-seq, RT-qPCR and immunoblotting data showed that KLF13 knockdown significantly potentiated IFIT1 expression at both mRNA and protein levels. Luciferase assays showed that KLF13 suppressed the transcription activity of IFIT1 promoter. Besides, IFIT1 upregulation was critical for the proliferation and migration of THCA cell lines. Lastly, silencing of IFIT1 greatly reversed the proliferation and migration induced by KLF13 knockdown.

Conclusions
In conclusion, KLF13 may function as an anti-tumor protein in THCA by regulating the expression of IFIT1 and offer a theoretical foundation for treating thyroid carcinoma.
Doxapram versus placebo in preterm newborns: a study protocol for an international double blinded multicentre randomized controlled trial (DOXA-trial)
Authors: Poppe Jarinda A. , Flint Robert B. , Smits Anne , Willemsen Sten P. , Storm Kelly K. , Nuytemans Debbie H. , Onland Wes , Poley Marten J. , de Boode Willem P. , Carkeek Katherine , Cassart Vincent , Cornette Luc , Dijk Peter H. , Hemels Marieke A. C. , Hermans Isabelle , Hütten Matthias C. , Kelen Dorottya , de Kort Ellen H. M. , Kroon André A. , Lefevere Julie , Plaskie Katleen , Stewart Breanne , Voeten Michiel , van Weissenbruch Mirjam M. , Williams Olivia , Zonnenberg Inge A. , Lacaze-Masmonteil Thierry , Pas Arjan B.te , Reiss Irwin K. M. , van Kaam Anton H. , Allegaert Karel , Hutten G. Jeroen , Simons Sinno H. P. 
Published: October 2023

Abstract
Background
Apnoea of prematurity (AOP) is one of the most common diagnoses among preterm infants. AOP often leads to hypoxemia and bradycardia which are associated with an increased risk of death or disability. In addition to caffeine therapy and non-invasive respiratory support, doxapram might be used to reduce hypoxemic episodes and the need for invasive mechanical ventilation in preterm infants, thereby possibly improving their long-term outcome. However, high-quality trials on doxapram are lacking. The DOXA-trial therefore aims to investigate the safety and efficacy of doxapram compared to placebo in reducing the composite outcome of death or severe disability at 18 to 24 months corrected age.

Methods
The DOXA-trial is a double blinded, multicentre, randomized, placebo-controlled trial conducted in the Netherlands, Belgium and Canada. A total of 396 preterm infants with a gestational age below 29 weeks, suffering from AOP unresponsive to non-invasive respiratory support and caffeine will be randomized to receive doxapram therapy or placebo. The primary outcome is death or severe disability, defined as cognitive delay, cerebral palsy, severe hearing loss, or bilateral blindness, at 18–24 months corrected age. Secondary outcomes are short-term neonatal morbidity, including duration of mechanical ventilation, bronchopulmonary dysplasia and necrotising enterocolitis, hospital mortality, adverse effects, pharmacokinetics and cost-effectiveness. Analysis will be on an intention-to-treat principle.

Discussion
Doxapram has the potential to improve neonatal outcomes by improving respiration, but the safety concerns need to be weighed against the potential risks of invasive mechanical ventilation. It is unknown if the use of doxapram improves the long-term outcome. This forms the clinical equipoise of the current trial. This international, multicentre trial will provide the needed high-quality evidence on the efficacy and safety of doxapram in the treatment of AOP in preterm infants.

Trial registration
ClinicalTrials.gov NCT04430790 and EUDRACT 2019-003666-41. Prospectively registered on respectively June and January 2020.
Single-cell RNA sequencing reveals a peripheral landscape of immune cells in Schistosomiasis japonica
Authors: Li Junhui , Zhang Yu , Li Hao , Jiang Jie , Guo Chen , Zhou Zhaoqin , Luo Yulin , Zhou Chen , Ming Yingzi 
Published: October 2023

Abstract
Background
Schistosomiasis, also known as bilharzia, is a devastating parasitic disease. This progressive and debilitating helminth disease is often associated with poverty and can lead to chronic poor health. Despite ongoing research, there is currently no effective vaccine for schistosomiasis, and praziquantel remains the only available treatment option. According to the progression of schistosomiasis, infections caused by schistosomes are classified into three distinct clinical phases: acute, chronic and advanced schistosomiasis. However, the underlying immune mechanism involved in the progression of schistosomiasis remains poorly understood.

Methods
We employed single-cell RNA sequencing (scRNA-seq) to profile the immune landscape of Schistosomiasis japonica infection based on peripheral blood mononuclear cells (PBMCs) from a healthy control group (n = 4), chronic schistosomiasis group (n = 4) and advanced schistosomiasis group (n = 2).

Results
Of 89,896 cells, 24 major cell clusters were ultimately included in our analysis. Neutrophils and NK/T cells accounted for the major proportion in the chronic group and the healthy group, and monocytes dominated in the advanced group. A preliminary study showed that NKT cells were increased in patients with schistosomiasis and that CXCR2 + NKT cells were proinflammatory cells. Plasma cells also accounted for a large proportion of B cells in the advanced group. MHC molecules in monocytes were notably lower in the advanced group than in the chronic group or the healthy control group. However, monocytes in the advanced group exhibited high expression of FOLR3 and CCR2.

Conclusions
Overall, this study enhances our understanding of the immune mechanisms involved in schistosomiasis. It provides a transcriptional atlas of peripheral immune cells that may contribute to elimination of the disease. This preliminary study suggests that the increased presence of CCR2 + monocyte and CXCR2 + NKT cells might participate in the progression of schistosomiasis.

Graphical Abstract
Design and development of multiband PIFA antenna for vehicular LTE/5G and V2X communication
Authors: Nikam Amruta A. , Patil Rupali B. 
Published: October 2023

AbstractThis paper aims to introduce a custom-designed multiband planar inverted-F antenna (PIFA) suitable for automotive applications in LTE/5G schemes operating under 6 GHz, as well as Vehicle-to-Everything (V2X) communications. The PIFA antenna has a broad bandwidth capability, resonating from 950 MHz to 6 GHz. The proposed PIFA antenna is divided into three parts: the top, front, and back, resulting in a unique and effective antenna structure. The antenna is fabricated using a substrate made of FR4 material with a dielectric constant of 4.4. The whole measurements of the antenna are 54 × 38 × 25 mm3.The proposed PIFA antenna has been tested and has achieved a voltage standing wave ratio (VSWR) of less than 2 across the entire frequency range of 950 MHz to 6 GHz. Additionally, the maximum gain achieved by the antenna is 7.08 dBi at a frequency of 5.5 GHz, 6.81 dBi at 5.2 GHz, and 6.65 dBi at 5.9 GHz. The antenna also achieved a gain of 6.67 dBi at 3.8 GHz and a gain of 3.31 dBi at 1.7 GHz. Overall, this paper presents a well-designed and effective multiband PIFA antenna that is appropriate for use in vehicular applications. The antenna ability to cover a wide range of bandwidth and achieve high gain makes it an excellent candidate for use in LTE/5G systems and V2X communications.
Determinants of behavioral intention toward telemedicine services among Indonesian Gen-Z and Millenials: a PLS–SEM study on Alodokter application
Authors: Pramudita Eka , Achmadi Hendra , Nurhaida Hansa 
Published: October 2023

AbstractTelemedicine has become increasingly important in healthcare, especially with the COVID-19 pandemic. Despite, Younger generations are more fluent in using technology, previous study shows that older generations (Gen-X) are more satisfied in using telemedicine compared to younger generations. This study aims to identify the factors influencing user satisfaction and behavioral intention toward Alodokter's telemedicine service application usage among Millennials and Gen-Z in Indonesia. A quantitative cross-sectional study was conducted using a purposive sampling technique. A total of 160 Millenials and Gen-Z respondents who had used the Alodokter telehealth application within the past year were chosen in this study. The data were collected by means of an online questionnaire that was distributed through widely used social media platforms. The questionnaire consisted of 30 questions that assessed variables, such as performance expectancy, effort expectancy, social influence, price value, customer satisfaction, and behavioral intention. Data were analyzed using Partial Least Square–Structural Equation Modeling (PLS–SEM) with SmartPLS software version 3.2.9. The findings reveal that customer satisfaction positively affects behavioral intention. Performance expectancy, effort expectancy, price value, and social influence positively impact customer satisfaction. Price value was shown to have the most positive influence on behavioral intention. This study provides insights into the factors influencing user satisfaction and behavioral intention toward telemedicine service application usage among younger generations in Indonesia. The results can be used to improve telemedicine services and enhance the experience of users, particularly Millennials and Gen-Z.
Association between ferritin to albumin ratio and 28-day mortality in patients with sepsis: a retrospective cohort study
Authors: Liu Feng , Liu Zhengting 
Published: October 2023

Abstract
Objectives
The ratio of ferritin to albumin (FAR) has been proposed as a novel prognostic indicator for COVID-19. However, the role of FAR in predicting the all-cause mortality rate in patients with sepsis has not been evaluated. Therefore, the aim of this study is to elucidate the correlation between FAR and the 28-day all-cause mortality rate in patients with sepsis.

Methods
This study used data from the Medical Information Mart for Intensive Care IV database (v2.0) for a retrospective cohort analysis. The study focused on adult patients with sepsis who were admitted to the intensive care unit. The primary objective was to assess the predictive capability of FAR in determining the 28-day all-cause mortality rate among patients with sepsis.

Results
The study involved 1553 sepsis patients in total. Based on the survival status of sepsis patients within 28 days, they were divided into two groups: a survival group consisting of 973 patients, and a death group consisting of 580 patients. The results revealed a 28-day mortality rate of 37.35% among sepsis patients. The multivariable Cox regression analysis revealed that FAR was an independent predictor of the 28-day all-cause mortality rate in patients with sepsis (hazard ratio [HR]: 1.17–1.19; 95% confidence interval 1.11–1.26; P < 0.001). The FAR demonstrated a higher area under the curve (AUC) of 61.01% (95% confidence interval 58.07–63.96%), compared to serum ferritin (60.48%), serum albumin (55.56%), and SOFA score (56.97%). Receiver operating characteristic curve (ROC) analysis determined the optimal cutoff value for FAR as 364.2215. Kaplan–Meier analysis revealed a significant difference in the 28-day all-cause mortality rate between patients with FAR ≥ 364.2215 and those with FAR < 364.2215 (P < 0.001). Furthermore, subgroup analysis showed no significant interaction between FAR and each subgroup.

Conclusions
This study revealed a significant correlation between FAR and the 28-day mortality rate in patients with sepsis. Higher FAR values were strongly associated with increased mortality rates within 28 days.
Multi-faceted attributes of salivary cell-free DNA as liquid biopsy biomarkers for gastric cancer detection
Authors: Swarup Neeti , Cheng Jordan , Choi Irene , Heo You Jeong , Kordi Misagh , Aziz Mohammad , Arora Akanksha , Li Feng , Chia David , Wei Fang , Elashoff David , Zhang Liying , Kim Sung , Kim Yong , Wong David T.W. 
Published: October 2023

Abstract
Background
Recent advances in circulating cell-free DNA (cfDNA) analysis from biofluids have opened new avenues for liquid biopsy (LB). However, current cfDNA LB assays are limited by the availability of existing information on established genotypes associated with tumor tissues. Certain cancers present with a limited list of established mutated cfDNA biomarkers, and thus, nonmutated cfDNA characteristics along with alternative biofluids are needed to broaden the available cfDNA targets for cancer detection. Saliva is an intriguing and accessible biofluid that has yet to be fully explored for its clinical utility for cancer detection.

Methods
In this report, we employed a low-coverage single stranded (ss) library NGS pipeline “Broad-Range cell-free DNA-Seq” (BRcfDNA-Seq) using saliva to comprehensively investigate the characteristics of salivary cfDNA (ScfDNA). The identification of cfDNA features has been made possible by applying novel cfDNA processing techniques that permit the incorporation of ultrashort, ss, and jagged DNA fragments. As a proof of concept using 10 gastric cancer (GC) and 10 noncancer samples, we examined whether ScfDNA characteristics, including fragmentomics, end motif profiles, microbial contribution, and human chromosomal mapping, could differentiate between these two groups.

Results
Individual and integrative analysis of these ScfDNA features demonstrated significant differences between the two cohorts, suggesting that disease state may affect the ScfDNA population by altering nuclear cleavage or the profile of contributory organism cfDNA to total ScfDNA. We report that principal component analysis integration of several aspects of salivary cell-free DNA fragmentomic profiles, genomic element profiles, end-motif sequence patterns, and distinct oral microbiome populations can differentiate the two populations with a p value of < 0.0001 (PC1).

Conclusion
These novel features of ScfDNA characteristics could be clinically useful for improving saliva-based LB detection and the eventual monitoring of local or systemic diseases.