bluuebunny/crossref_metadata_2025_split huggingface dataset:
ILUVIEN® in diabetic macular edema that persists or recurs despite treatment: Results from the Retina.pt® RIVER audit
Authors: Teixeira Carla , Pessoa Bernardete , Ruão Miguel , Sousa João Paulo Castro , Penas Susana , Silva Rufino , Carneiro Ângela , Meireles Angelina 
Published: November 2023

Purpose Persistent diabetic macular edema (DME) remains a problem in clinical practice, with many patients having a suboptimal response to the standard of care (SOC). Evidence supports the long-term efficacy of intravitreal fluocinolone acetonide (FAc) implant (ILUVIEN®) in patients that have responded sub-optimally, although there is still scarce data from real-world Portuguese practices. We aimed to monitor the current SOC in selected Portuguese practices prior to FAc implantation and then assess the long-term effectiveness and safety of the FAc implant. Settings The study included patient data from five Portuguese public hospitals. Design This was a non-interventional, multicenter audit of data collected from Retina.pt registry from patients with persistent or recurrent DME despite treatment. Methods Outcome measures included changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure (IOP). Results were compared at regular times over 36 months. Results This study included 222 eyes from 152 patients. A significant decrease in BCVA (P < 0.001) and a significant increase in CMT (P = 0.013) were observed prior to FAc. A significant increase in BCVA was registered at 6 months after FAc implant administration (P < 0.001), which was maintained during follow-up. No relevant changes in IOP were observed. Treatment burden was reduced as a result of treatment with FAc (P < 0.001 for anti-VEGF, corticosteroids, or both treatments) in the full population. Conclusions In Portuguese practice, data showed that pre-FAc implantation, some patients did not respond to SOC treatment and/or they were undertreated. Following FAc implant administration, there were rapid, sustained, long-term visual and anatomical improvements, and a marked reduction in treatment burden.
Multi-omics Analysis of Prognostic Significance and Immune Infiltration of FASTK Family Members in Kidney Renal Clear Cell Carcinoma
Authors: Zhong Guanghui , Wu Dali , Chen Haiping , Yan Lingfei , Xiang Qi , Liu Yufeng , Wang Tao 
Published: November 2023

Objective: The Fas-activated serine/threonine kinase (FASTK) family of proteins has been recently found to be able to regulate mitochondrial gene expression post-transcriptionally. Nonetheless, there is a paucity of study about the role of the FASTK family in kidney renal clear cell carcinoma (KIRC). This study was conducted to explore the correlation of FASTK family genes with expression, prognosis, and immune infiltration in KIRC. Methods: We collected the data from the UALCAN, GeneMANIA, STRING, CancerSEA, cBioPortal, Kaplan-Meier plotter, GEPIA, TISIDB and TIMER databases to evaluate the genetic alterations, differential expression, prognostic significance, and immune cell infiltration of FASTKs in patients with KIRC. Results: In tumor tissues of KIRC, the mRNA expression level of FASTK and TBRG4 was elevated, whereas that of FASTKD1, FASTKD2, and FASTKD5 was lowered compared with normal tissues ( P < .05). Patients with KIRC and high FASTK and Transforming growth factor β regulator 4 (TBRG4) expression had worse overall survival (OS) and disease specific survival (DFS), while those with lower expression of FASTKD2/3/5 had worse outcomes. FASTK was positively correlated with DNA damage. FASTKD1 was positively related to differentiation. FASTKD2 was inversely related to proliferation and FASTKD5 was inversely related to invasion and EMT in KIRC cells. FASTK expression in KIRC was inversely linked to the presence of several immune cells including Tgd, macrophages, Tcm, and Mast cells ( P < .05). Conclusions: Our research provided fresh insight and in-depth analysis to the selection of prognostic biological markers of FASTK family members in KIRC.
Structural design and experimental study on the axial compression behavior of large-span carbon-fiber-reinforced polymer truss structures
Authors: Li Shiping , Chen Wujun , Hu Jianhui , Zhang Yibei , Mi Xiang , Zhang Daxu 
Published: November 2023

Herein – with the optimization goals of a lightweight, large-span structure; modularization; and heavy loading – a tapered-section truss module and standard truss module are integrated and assembled, yielding a new design for an all-carbon-fiber-reinforced polymer (CFRP) truss structure. The design structure fully considers the mechanical characteristics of the truss and the requirements of standardized production efficiency, integrating the “fish keel” structural design method to give it a hollow structure style. By fabricating two 1:1 truss structures (A-Truss and B-Truss) with a length of 20.4 m, the conceptual design, modular design method, and integrated assembly technology of the truss structure were effectively verified; further, experimental research on the strength performance of the mold-clave-forming plate-type joint and the axial compression behavior of large-span full CFRP truss structure is carried out. The failure position of the truss structure is determined, and an enhancement measure for the key connection joint between the truss modules is proposed. Based on specific application scenarios, it is clear that the truss meets the design requirements in terms of bearing capacity and deformation, and can be used as the main bearing structure of large aircraft and aerospace assembly platforms.
Dynamic Cerebral Autoregulation After Carotid Endarterectomy
Authors: Shen Zi-Duo , Qu Yang , Zhang Peng , Wang Guibin , Wang You , Yang Yi , Xu Baofeng , Guo Zhen-Ni 
Published: November 2023

Objective: Studies have shown that dynamic cerebral autoregulation (dCA) is impaired in patients with severe internal carotid artery (ICA) stenosis and that carotid endarterectomy (CEA) may improve dCA in these patients. However, the time course of dCA changes in patients after CEA remains unclear. Therefore, this study aimed to investigate the effects of CEA on the dCA in patients with carotid artery stenosis at different time points. Methods: This prospective study enrolled 44 patients (19 symptomatic stenosis patients and 25 asymptomatic stenosis patients) who underwent CEA and 44 age- and sex-matched controls. In the CEA group, the patients underwent dCA measurements at baseline, within 3 days, and 1 month after CEA. Transfer function parameters, phase difference (PD), and gain were used to quantify dCA. Changes in dCA before and after CEA were analyzed in detail. Results: The bilateral PD of the patients before CEA was significantly lower than that of the control group. This damage did not improve within 3 days after surgery. One month after surgery, the PD on the affected side of the patients significantly improved compared with before surgery and reached the level of the control group. The PD of affected side across time points in symptomatic and asymptomatic stenosis patients is consistent with that in all patients. Conclusions: The dCA level did not improve immediately after CEA but significantly improved 1 month after surgery. This suggests that the occurrence of stroke should be considered in the acute period after CEA surgery, and its preventive effect on stroke may be effective after 1 month. Clinical Impact We found the dCA level did not improve immediately after CEA but significantly improved 1 month after surgury. This suggests that the occuttencce of stroke and surgical complications (such as cerebral hyperperfusion syndrome) associated with impaired dCA in the acute phase after CEA surgery should be of particular concern.
A 12-Year Comparison of Alzheimer’s Dementia Patients With Their Informants in Taiwan
Authors: Jhang Kai-Ming , Wang Wen-Fu , Hsu Kuang-Nan , Huang Shang-Chien , Yang Sheng-Hsiang , Huang Ling-Chun , Yang Yuan-Han 
Published: November 2023

Background To update the characteristics of patients with Alzheimer’s disease (AD) and their informants in Taiwan and compare them from 12 years ago. Methods 1218 patients with AD and their informants were recruited from six hospitals in Taiwan. The uniform data set version 3.0 (UDS3, form A1-A3) were administered. Results Compared with the first registration from 2010-2012 (n = 691), the mean clinical dementia rating sum of boxes score was significantly lower, more patients living independently, and more informants not living together with the patients. A total of 11.2%, 4.1%, 12.8%, and 0.5% of the patients had a reported history of cognitive impairment in their mothers, fathers, siblings, and children, respectively. Conclusion Compared with the data from 2010, patients have been diagnosed at a milder disease stage, and their informants used telephone contact more frequently instead of living with the patients. Family histories of cognitive impairment in patients with AD remain frequent.
Minimally Invasive Mitral Valve Surgery With Concomitant Cox Maze Procedure Is as Effective as a Median Sternotomy With Decreased Morbidity
Authors: Yates Tari-Ann , McGilvray Martha , Vinyard Connor , Sinn Laurie , Razo Nicholas , He June , Roberts Harold G. , Schill Matthew R. , Zemlin Christian , Damiano Ralph J. 
Published: November 2023

Objective: A right minithoracotomy (RMT) is a minimally invasive surgical approach that has been increasingly performed for the concomitant Cox maze IV procedure (CMP) and mitral valve surgery (MVS). Little is known regarding whether long-term rhythm and survival outcomes are affected by the RMT as compared with the traditional median sternotomy (MS) approach. Methods: Between April 2004 and April 2021, 377 patients underwent the concomitant CMP and MVS, of whom 38% had RMT. Propensity score matching yielded 116 pairs. Freedom from atrial tachyarrhythmias (ATA) was assessed with prolonged monitoring annually for 8 years. Survival, rhythm, and perioperative outcomes were compared. Results: The unmatched RMT cohort had a greater freedom from ATA recurrence at 1 year (99% vs 90%, P = 0.001) and 3 years (94% vs 86%, P = 0.045). The matched RMT cohort had longer cardiopulmonary bypass (median: 215 [199 to 253] vs 170 [136 to 198] min, P < 0.001) and aortic cross-clamp (110 [98 to 124] vs 86 [71 to 102] min, P < 0.001) times but shorter intensive care time (48 [24 to 95] vs 71 [26 to 144] h, P = 0.001) and length of stay (8 [6 to 11] vs 10 [7 to 14] h, P < 0.001). More pacemakers (18% vs 4%, P < 0.001) and postoperative transfusions (57% vs 41%, P = 0.014) occurred in the MS cohort. The 30-day mortality ( P = 0.651) and 8-year survival ( P = 0.072) was not significantly different between the cohorts. Conclusions: Early 1-year and 3-year freedom from ATA recurrence was better in the RMT cohort compared with the MS cohort. Despite longer operative times, the RMT cohort had shorter lengths of stay, fewer postoperative transfusions, and fewer pacemakers placed.
Treatment Trends in Pediatric Trigger Thumb Among Hand Surgeons, Pediatric Orthopedic Surgeons, and Pediatric Hand Surgeons
Authors: MacConnell Ashley E. , Schoenfeldt Theodore L. , Bowman Christine A. , January Alicia M. , Fishman Felicity G. 
Published: November 2023

Background: The appropriate initial management of pediatric trigger thumb (PTT) remains controversial. Some providers advocate for prolonged nonoperative management, whereas others may offer surgical release to provide a reliable and expedient resolution. The goal of this study was to elucidate the practice patterns of surgeons with different fellowship training who treat patients with PTT. We hypothesized that an association between surgeon specialty training and treatment algorithm would be identified. Methods: A cross-sectional survey was sent to mailing lists of 3 professional organizations whose members represent most providers caring for pediatric hand patients. Respondents were asked their training background and treatment recommendations for several clinical scenarios. Responses were compared across subspecialties. Results: Of the respondents, 444 completed a fellowship in hand surgery, 167 completed a pediatric orthopedic fellowship, and 155 completed an additional congenital hand fellowship. Providers with hand fellowship training were more likely to offer surgical intervention as a first-line treatment for a 3-year-old patient with a flexible trigger thumb than those who completed a pediatric orthopedic fellowship ( P = .001), and more likely to offer surgical intervention to a 3-year-old patient with an intermittent ( P = .007), painful ( P = .015), or locked ( P = .012) trigger thumb than those providers who completed additional training in congenital hand surgery. No statistically significant differences in practice patterns were appreciated for children aged 6 and 18 months. Conclusion: Variability was appreciated in practice patterns for initial treatment recommendation for a patient presenting with PTT. Subspecialty training does appear to affect treatment recommendations for clinical scenarios involving a 3-year-old patient with PTT, although this trend is not observed when treating younger patients.
The South West Clinical School model: an initiative to transform clinical academic career pathways
Authors: Underwood Frazer , Kent Bridie , Rae Pamela , O’Keeffe Kim , Shawe Jill 
Published: November 2023

Background: The Clinical School Model connects professorial staff from the university directly to practitioners in the National Health Service to promote evidence informed practice and develop clinical academic careers. These are promoted widely, but strategic adoption into organisational culture and workforce plans are challenging to overcome. Aims: To describe the development of the Clinical School Model in Cornwall and explore how it generates impact through staff engagement activities to support clinical academic career pathways. Structure, process and outcomes developments over the last 3-years are reported. Methods: Donabedian’s framework (structure, process and outcome) was used to report on the development and impact of the Clinical School Model. Results: Structural and process activities are reported, illustrating strong foundations to embed clinical academic career pathway opportunities. In the absence of empirical reporting standards for such developments, quantitative and qualitative outcomes are reported against the Clinical School’s 5-year strategic plan. Conclusions: This paper responds to the lack of reported evidence on developing organisational infrastructure to address the clinical academics aspirations of nurses and their employers. This important contribution leads a call for more organisations to report to the evidence base, enabling shared learning and shaping future research.
Impacts of Free-Ranging Dogs on a Community of Vertebrate Scavengers in a High Andean Ecosystem
Authors: Monar-Barragán Henry Paul , Araujo Evelyn Edith , Restrepo-Cardona Juan Sebastián , Kohn Sebastián , Paredes-Bracho Andrea , Vargas Félix Hernán 
Published: November 2023

Background and Research Aims Native vertebrate scavenger communities may be affected by free-ranging dogs ( Canis lupus familiaris), but little information is available on this subject. We aimed to evaluate the influence of free-ranging dogs on a community of native vertebrate scavengers and to propose management and conservation actions. Methods Between November 2014 and June 2016, we systematically monitored 37 ungulate carcasses in the buffer zone of Antisana National Park, Andes of Ecuador at an elevation range between 3000 and 4150 m asl. We monitored carcasses with camera traps operating 24 hours per day. Results We obtained 1010 independent events and recorded seven vertebrate scavenger species. Free-ranging dogs were present at carcasses for 40.39% of the total activity time, but the most frequently recorded species were the Andean fox ( Lycalopex culpaeus) and the Carunculated Caracara ( Phalcoboenus carunculatus). The scavenging birds were diurnal, the Andean fox was mostly nocturnal, and the free-ranging dogs were active in all periods of the day. Native scavenger species changed their peak of activity to times when the free-ranging dogs were less active, probably to avoid agonistic encounters. The presence of free-ranging dogs negatively influenced the number of independent events of the native species. Conclusion The presence of free-ranging dogs showed a negative relationship with the residence time and the number of independent events of native scavenging species. Furthermore, their presence modified the hour of the peak in the activity patterns of the scavenger community. Implications for Conservation The presence of free-ranging dogs may have important implications for the conservation of the Vulnerable Andean Condor ( Vultur gryphus) in Ecuador. To achieve the conservation goals of native vertebrate scavengers, particularly of Andean Condors, it is necessary to develop environmental education programs, provide technical training in responsible dog ownership, and conduct campaigns to sterilize and control dogs.
Educational Technology to Promote Social Entrepreneurship Education in the COVID Pandemic Era
Authors: Hazarika Nibedita , Dagar Kriti 
Published: November 2023

The objective of this study was to assess the literature, on the intersection of technology and social entrepreneurship. It involved conducting analyses by interviewing five entrepreneurs and analyzing the narratives of five governmental organizations that cater to educational needs in Delhi NCR. Through these interviews the study delved into how technology and entrepreneurship impact the access to education for marginalized communities. To analyze both literature and real-life examples from entrepreneurs the ATLAS.ti coding program was employed. Codes and concepts were generated from the data in a manner for analyzing the literature. These codes and concepts were then used deductively to analyze the instances of entrepreneurs using an approach that helps us interpret data and gain new insights. The study filled a gap in knowledge by examining how new technologies can be utilized to create business models that benefit populations. By highlighting the importance of technology among communities for social and economic progress it contributes to the understanding of social innovation and entrepreneurship. Additionally, it provided considerations for technology innovation within contexts. The findings from this research highlighted challenges faced by both social entrepreneurs and organizations working with disadvantaged populations. One major obstacle identified was access to technology. Insufficient financial resources and ineffective resource utilization are also seen as hindrances. Lastly enhancing skills, among groups is emphasized as crucial for effectively promoting education.
Synthetic CRISPR/dCas9-KRAB system driven by specific PSA promoter suppresses malignant biological behavior of prostate cancer cells through negative feedback inhibition of PSA expression
Authors: Yang Yi , Mei Hongbing , Han Xiaohong , Zhang Xintao , Cheng Jianli , Zhang Zhongfu , Wang Han , Xu Haixia 
Published: November 2023

AbstractPSA is a type of proto-oncogene that is specifically and highly expressed in embryonic and prostate cancer cells, but not expressed in normal prostate tissue cells. The specific expression of prostate-specific antigen (PSA) is found to be related with the conditional transcriptional regulation of its promoter. Clustered regularly interspaced short palindromic repeats (CRISPR)-dCas9-KRAB is a newly developed transcriptional regulatory system that inhibits gene expression by interupting the DNA transcription process. Induction of CRISPR-dCas9-KRAB expression through the PSA promoter may help feedback inhibition of cellular PSA gene expression via single guide RNA (sgRNA), thereby monitoring and suppressing the malignant state of tumor cells. In this study, we examined the transcriptional activity of the PSA promoter in different prostate cancer cells and normal prostate epithelial cells and determined that it is indeed a prostate cancer cell-specific promoter.Then we constructed the CRISPR-dCas9-KRAB system driven by the PSA promoter, which can inhibit PSA gene expression in the prostate cancer cells at the transcriptional level, and therefore supress the malignant growth and migration of prostate cancer cells and promote their apoptosis in vitro. This study provides a potentially effective anti-cancer strategy for gene therapy of prostate cancer.
A machine learning one-class logistic regression model to predict stemness for single cell transcriptomics and spatial omics
Authors: Dezem Felipe Segato , Marção Maycon , Ben-Cheikh Bassem , Nikulina Nadya , Omotoso Ayodele , Burnett Destiny , Coelho Priscila , Hurley Judith , Gomez Carmen , Phan-Everson Tien , Ong Giang , Martelotto Luciano , Lewis Zachary R. , George Sophia , Braubach Oliver , Malta Tathiane M. , Plummer Jasmine 
Published: November 2023

AbstractCell annotation is a crucial methodological component to interpreting single cell and spatial omics data. These approaches were developed for single cell analysis but are often biased, manually curated and yet unproven in spatial omics. Here we apply a stemness model for assessing oncogenic states to single cell and spatial omic cancer datasets. This one-class logistic regression machine learning algorithm is used to extract transcriptomic features from non-transformed stem cells to identify dedifferentiated cell states in tumors. We found this method identifies single cell states in metastatic tumor cell populations without the requirement of cell annotation. This machine learning model identified stem-like cell populations not identified in single cell or spatial transcriptomic analysis using existing methods. For the first time, we demonstrate the application of a ML tool across five emerging spatial transcriptomic and proteomic technologies to identify oncogenic stem-like cell types in the tumor microenvironment.
Association of gastrointestinal symptoms and skipping breakfast with anxiety and depressive symptoms in quarantined Chinese college students during the Shanghai 2022 lockdown: a cross sectional survey
Authors: Qiao Tingting , Gao Dingwei , Lu Gaixia , Yi Wanwan , Lv Zhongwei 
Published: November 2023

Abstract
Background
This study aimed to evaluate the prevalence of anxiety and depressive symptoms among quarantined college students at school in Shanghai 2022 lockdown during the COVID-19 pandemic and investigate the association of gastrointestinal discomfort related-factors and skipping breakfast with anxiety and depressive symptoms.

Methods
384 quarantined college students in Shanghai China were recruited in this cross-sectional study from April 5th to May 29th, 2022. Generalized Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were used to assess anxiety and depressive symptoms, respectively.

Results
The prevalence of anxiety and depressive symptoms were 56.8% and 62.8%, respectively. Longer quarantine duration, higher education level, skipping breakfast, stomachache or abdominal pain, and nausea or dyspepsia were significantly associated with anxiety symptoms. Moreover, longer quarantine duration, being woman, skipping breakfast, stomachache or abdominal pain, and nausea or dyspepsia were markedly related to depressive symptoms. Notably, regularly physical exercising and taking positive attitude towards COVID-19 were negatively correlated with anxiety and depressive symptoms.

Conclusions
More attention should be paid to anxiety and depressive symptoms of quarantined college students and universities should provide timely psychological monitoring and intervention services to mitigate the impact of negative emotions on students. Effectively relieving gastrointestinal symptoms, insisting on eat breakfast, regularly exercising, and taking a positive attitude towards to COVID-19 might contribute to preventing the anxiety and depressive symptoms for those college students experiencing a long-term quarantine.