bluuebunny/crossref_metadata_2025_split huggingface dataset:
Do blood flow patterns in the left atriums differ between left upper lobectomy and other lobectomies? A computational study
Authors: Yi Wentao , Otani Tomohiro , Endo Shunsuke , Wada Shigeo 
Published: January 2024

BackgroundLeft atrial (LA) hemodynamics after lung lobectomies with pulmonary vein (PV) resection is widely understood to be a risk factor for LA thrombosis. A recent magnetic resonance imaging study showed that left upper lobectomy (LUL) with left superior pulmonary vein resection tended to cause LA flow patterns distinct from those of other lobectomies, with flow disturbances seen near the PV stump. However, little is known about this flow pattern because of severe image resolution limitations. The present study compared flow patterns in the LA after LUL with the flow patterns of other lobectomies using computational simulations.MethodsThe computational simulations of LA blood flow were conducted on the basis of four-dimensional computed tomography images of four lung cancer patients prior to lobectomies. Four kinds of PV resection cases were constructed by cutting each one of the PVs from the LA of each patient. We performed a total of five cases (pre-resection case and four PV resection cases) in each patient and evaluated global flow patterns formed by the remaining PV inflow, especially in the upper LA region.ResultsLUL tended to enhance the remaining left inferior PV inflow, with impingements seen in the right PV inflows in the upper LA region near the PV stump. These flow alterations induced viscous dissipation and the LUL cases had the highest values compared to other PV resection cases, especially in the LV systole in three patients, and reached three to four times higher than those in pre-resection cases. However, in another patient, these tendencies were weaker when PV inflow was stronger from the right side than from the left side, and the degree of flow dissipation was lower than those in other PV resection cases.ConclusionThese findings suggest marked variations in LA flow patterns among patients after lobectomies and highlights the importance of patient-specific assessment of LA hemodynamics after lobectomies.
Assessing the utility of deep neural networks in detecting superficial surgical site infections from free text electronic health record data
Authors: Bonde Alexander , Lorenzen Stephan , Brixen Gustav , Troelsen Anders , Sillesen Martin 
Published: January 2024

BackgroundHigh-quality outcomes data is crucial for continued surgical quality improvement. Outcomes are generally captured through structured administrative data or through manual curation of unstructured electronic health record (EHR) data. The aim of this study was to apply natural language processing (NLP) to chart notes in the EHR to accurately capture postoperative superficial surgical site infections (SSSIs).MethodsDeep Learning (DL) NLP models were trained on data from 389,865 surgical cases across all 11 hospitals in the Capital Region of Denmark. Surgical cases in the training dataset were performed between January 01st, 2017, and October 30th, 2021. We trained a forward reading and a backward reading universal language model on unlabeled postoperative chart notes recorded within 30 days of a surgical procedure. The two language models were subsequently finetuned on labeled data for the classification of SSSIs. Validation and testing were performed on surgical cases performed during the month of November 2021. We propose two different use cases: a stand-alone machine learning (SAM) pipeline and a human-in-the-loop (HITL) pipeline. Performances of both pipelines were compared to administrative data and to manual curation.ResultsThe models were trained on 3,983,864 unlabeled chart notes and finetuned on 1,231,656 labeled notes. Models had a test area under the receiver operating characteristic curves (ROC AUC) of 0.989 on individual chart notes and 0.980 on an aggregated case level. The SAM pipeline had a sensitivity of 0.604, a specificity of 0.996, a positive predictive value (PPV) of 0.763, and a negative predictive value (NPV) of 0.991. Prior to human review, the HITL pipeline had a sensitivity of 0.854, a specificity of 0.987, a PPV of 0.603, and a NPV of 0.997.ConclusionThe performance of the SAM pipeline was superior to administrative data, and significantly outperformed previously published results. The performance of the HITL pipeline approached that of manual curation.
Student satisfaction in clinical area subjects during the COVID-19 pandemic in a medical school
Authors: Diaz-Lazo Anibal , Alvarez-Risco Aldo , Córdova Rosales Carlo , Cori Rosales Sandra , Ruiz-Aquino Mely , Del-Aguila-Arcentales Shyla , Davies Neal M. , Mejia Christian R. , Yáñez Jaime A. 
Published: January 2024

IntroductionCoronavirus SARS-CoV-2 had an impact on health and education, among other subjects. It caused changes in teaching medicine. The objective of the study was to determine student satisfaction in the subjects of the clinical area in a medical school during the coronavirus SARS-CoV-2 pandemic.MethodsThe current study has an observational, descriptive, and cross-sectional design. The sample consisted of 119 students. Inclusion criteria included being a student enrolled in the 2021–2022 semester, between the VI and XII semesters in a medical school.ResultsIt was found that the median age was 21  years; 68 (57.1%) were men. Overall student satisfaction was 67.1%. High student satisfaction was found in the dimension development of professional skills (84.9%), achievement of student expectations (69.7%), and virtual assistance (67.2%) at a medium level of student satisfaction. Flexibility in learning (64.7%), the use of infrastructure and facilities (61.7%), and the use of educational resources (61.3%) were reported.DiscussionThe students were generally satisfied with the dynamic communication of the teachers, especially concerning promoting student participation (79%).
The maternal hair metabolome is capable of discriminating intrahepatic cholestasis of pregnancy from uncomplicated pregnancy
Authors: Yin Nanlin , Jiang Xiuping , Yu Muhua , Yang Yang , Ge Huisheng , Han Ting-Li , Qi Hongbo 
Published: January 2024

IntroductionIntrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disease associated with elevated bile acids in the blood. Diagnosis typically only occurs after the manifestation of clinical symptoms and the metabolic mechanisms underlying its development remain unclear. The aim of this study was to investigate potential specific metabolites and the underlying metabolic changes occurring during the development of ICP in the maternal plasma and hair metabolomes of women diagnosed with either ICP or having a healthy pregnancy.MethodsA total of 35 Chinese women with ICP and 42 healthy pregnancies were enrolled in our study. Plasma and hair samples, total bile acid levels (TBA), alanine transaminase levels (ALT), aspartate aminotransferase levels (AST), and additional clinical information were collected during the third trimester. Metabolites from maternal plasma and hair segments collected pre-conception and analyzed using gas chromatography–mass spectrometry (GC-MS).ResultsThree plasma metabolites (p &lt; 0.05, q &lt; 0.38) and 21 hair metabolites (p &lt; 0.05, q &lt; 0.05) were significantly different between ICP and healthy pregnancies. A combination of the eight most significant hair metabolites in a multivariate receiver operating characteristic curve model showed the best area under the curve (AUC) was 0.885, whereas the highest AUC using metabolites from plasma samples was only 0.74. Metabolic pathway analysis revealed 32 pathways were significantly (p and q values &lt; 0.05) affected in the hair samples of patients with ICP. Pathways associated with glutathione metabolism and ABC transporters were affected. No metabolic pathways were significantly affected in plasma.DiscussionOverall, this study showed that the hair metabolome could be more useful than the plasma metabolome for distinguishing ICP from normal pregnancy.
Placenta-derived exosomes exacerbate beta cell dysfunction in gestational diabetes mellitus through delivery of miR-320b
Authors: Wang Yanmei , Yuan Yue , Shen Shanmei , Ge Zhijuan , Zhu Dalong , Bi Yan 
Published: January 2024

Recent studies have shown placenta-derived exosome (pdE) acts as an important mediator of organ-to-organ interplay regulating maternal metabolic alterations, however, the function and mechanisms of placental exosomes on pancreatic β-cell maladaptation in gestational diabetes mellitus (GDM) remain unclear. The purpose of this investigation was to ascertain how placental exosomes affected the β-cell dysfunction associated with the onset of GDM. Exosomes were isolated from chorionic villi explants of pregnant mice and humans with normal glucose tolerance (NGT) and GDM. The effects of pdE from GDM on glucose tolerance in vivo and islets function in vitro were determined. Isolated islets from mice fed on the chow diet displayed an increase in apoptosis and observed their glucose-stimulated insulin secretion (GSIS) greatly diminished by PdE from GDM mice. Mice that accepted PdE from mice with GDM possessed glucose intolerance.Based on miRNA microarray assay and bioinformatics analysis from human placental exosomes, we identified miR-320b selectively enriched in PdE secreted in GDM compared with NGT. Importantly, the level of placental miR-320b was positively correlated with the 1h-glucose and 2-h glucose of a 75 g oral glucose tolerance test (OGTT) during human pregnancies. Furthermore, miR-320 overexpression attributed to impaired insulin secretion and increased apoptosis in MIN6 cells and islets obtained from mice with normal insulin sensitivity. This study firstly proposed that altered miRNAs in pdE contribute to defective adaptation of β cells during pregnancy, which expands the knowledge of GDM pathogenesis. Exosomes from the placenta may be an emerging therapeutic target for GDM.
Causal association between obesity and hypothyroidism: a two-sample bidirectional Mendelian randomization study
Authors: Qiu Yingkun , Liu Qinyu , Luo Yinghua , Chen Jiadi , Zheng Qingzhu , Xie Yuping , Cao Yingping 
Published: January 2024

IntroductionPrevious observational studies have reported a positive correlation between obesity and susceptibility to hypothyroidism; however, there is limited evidence from alternative methodologies to establish a causal link.MethodsWe investigated the causal relationship between obesity and hypothyroidism using a two-sample bidirectional Mendelian randomization (MR) analysis. Single-nucleotide polymorphisms (SNPs) associated with obesity-related traits were extracted from a published genome-wide association study (GWAS) of European individuals. Summarized diagnostic data of hypothyroidism were obtained from the UK Biobank. Primary analyses were conducted using the inverse variance-weighted (IVW) method with a random-effects model as well as three complementary approaches. Sensitivity analyses were performed to ascertain the correlation between obesity and hypothyroidism.ResultsMR analyses of the IVW method and the analyses of hypothyroidism/myxedema indicated that body mass index (BMI) and waist circumference (WC) were significantly associated with higher odds and risk of hypothyroidism. Reverse MR analysis demonstrated that a genetic predisposition to hypothyroidism was associated with an increased risk of elevated BMI and WC, which was not observed between WC adjusted for BMI (WCadjBMI) and hypothyroidism.DiscussionOur current study indicates that obesity is a risk factor for hypothyroidism, suggesting that individuals with higher BMI/WC have an increased risk of developing hypothyroidism and indicating the importance of weight loss in reducing the risk of hypothyroidism.
Efficacy and safety of adjuvant radiation therapy in localized adrenocortical carcinoma
Authors: Wu Luming , Chen Jiayi , Su Tingwei , Jiang Lei , Han Yimin , Zhang Cui , Zhou Weiwei , Jiang Yiran , Zhong Xu , Wang Weiqing 
Published: January 2024

ContextAdrenocortical carcinoma (ACC) is rare and have high rates of recurrence and mortality. The role of adjuvant radiation therapy (RT) in localized ACC was controversial.MethodsWe conducted a retrospective study in our center between 2015 and 2021 to evaluate the efficacy and safety of adjuvant RT in localized ACC. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method. Cox proportional hazards regression models were used to estimate the independent risk factors. Adverse events associated with RT were documented according to the toxicity criteria of the radiation therapy oncology group (RTOG) and the common terminology criteria for adverse events (CTCAE v5.0).ResultsOf 105 patients with localized ACC, 46 (43.8%) received adjuvant RT after surgery. The median radiation dose was 45.0Gy (range:30.0-50.4) and median follow up time was 36.5 (IQR: 19.7-51.8) months. In comparison to the no adjuvant RT group, patients with adjuvant RT had better 3-year OS (87.9% vs 79.5%, P=0.039), especially for patients with ENSAT I/II stage (P=0.004). Adjuvant RT also improved the median DFS time from 16.5months (95%CI, 12.0-20.9) to 34.6months (95%CI, 16.1-53.0). Toxicity of RT was generally mild and moderate with six grade 3 events.ConclusionsPostoperative adjuvant RT significantly improved OS and DFS compared with the use of surgery alone in resected ACC patients. Although this retrospective study on RT in localized ACC indicates that RT is effective in ACC, its findings need to be prospectively confirmed.
Potential causal association between aspirin use and erectile dysfunction in European population: a Mendelian randomization study
Authors: Li Rongkang , Peng Lei , Deng Dashi , Li Guangzhi , Wu Song 
Published: January 2024

BackgroundAspirin, as one of the most commonly used drugs, possesses a broad spectrum of therapeutic applications. Presently, the potential association between aspirin usage and the risk elevation of erectile dysfunction (ED) remains inconclusive. The objective of this study employing two-sample Mendelian randomization (MR) was to clarify the causal impact of aspirin use on the risk of ED.MethodsThis study incorporated two sets of Genome-Wide Association Study (GWAS) summary statistics, one for aspirin use (46,946 cases and 286,635 controls) and another for ED (6,175 cases and 217,630 controls) in individuals of European ancestry. The inverse-variance weighted (IVW) method was employed as the primary approach, supplemented by MR-Egger, weighted median, weighted mode, and simple mode to estimate the causal effect of aspirin usage on the risk of ED development. To assess pleiotropy, the MR-PRESSO global test and MR-Egger regression were used. Cochran’s Q test was adopted to check heterogeneity, and the leave-one-out analysis was performed to confirm the robustness and reliability of the results.ResultsThe causal association between genetically inferred aspirin use and ED was found by using inverse variance weighted (OR = 20.896, 95% confidence interval = 2.077-2.102E+2, P = 0.010). The sensitivity analysis showed that no pleiotropy and heterogeneity was observed. Furthermore, the leave-one-out analysis demonstrated that the findings were not significantly affected by any instrumental variables.ConclusionThe results of this study highlighted the significance of aspirin use as a predisposing factor for ED and provided further evidence supporting the causal association between aspirin utilization and ED within European populations.
Discriminating early-stage diabetic retinopathy with subjective and objective perimetry
Authors: Sabeti Faran , van Kleef Joshua P. , Iyer Rakesh M. , Carle Corinne F. , Nolan Christopher J. , Chia Rong Hui , Maddess Ted 
Published: January 2024

IntroductionTo prevent progression of early-stage diabetic retinopathy, we need functional tests that can distinguish multiple levels of neural damage before classical vasculopathy. To that end, we compared multifocal pupillographic objective perimetry (mfPOP), and two types of subjective automated perimetry (SAP), in persons with type 2 diabetes (PwT2D) with either no retinopathy (noDR) or mild to-moderate non-proliferative retinopathy (mmDR).MethodsBoth eyes were assessed by two mfPOP test methods that present stimuli within either the central ±15° (OFA15) or ±30° (OFA30), each producing per-region sensitivities and response delays. The SAP tests were 24-2 Short Wavelength Automated Perimetry and 24-2 Matrix perimetry.ResultsFive of eight mfPOP global indices were significantly different between noDR and mmDR eyes, but none of the equivalent measures differed for SAP. Per-region mfPOP identified significant hypersensitivity and longer delays in the peripheral visual field, verifying earlier findings. Diagnostic power for discrimination of noDR vs. mmDR, and normal controls vs. PwT2D, was much higher for mfPOP than SAP. The mfPOP per-region delays provided the best discrimination. The presence of localized rather than global changes in delay ruled out iris neuropathy as a major factor.DiscussionmfPOP response delays may provide new surrogate endpoints for studies of interventions for early-stage diabetic eye damage.
Adrenal incidentalomas, cortisol secretion and cancer: is there a real crosstalk?
Authors: Herrera-Martínez Aura D. , Román Ángel Rebollo , Corrales Eider Pascual , Idrobo Cindy , Ramírez Paola Parra , Rojas Patricia Martín , Lázaro Cristina Robles , Araujo-Castro Marta 
Published: January 2024

BackgroundCortisol has immunomodulatory effects that increase the risk and evolution of several diseases. Cancer is characterized by a proinflammatory state in which cells exert impaired function and proliferation. The relation between cortisol secretion and increased risk of malignant neoplasm, or their behavior, has not been fully elucidated.AimTo determine the relation between cortisol secretion and the prevalence and clinical outcome of malignant neoplasms in patients with adrenal incidentalomas (AIs).MethodsMulticenter retrospective study that included 935 patients with AIs. Cortisol secretion was defined by a cortisol post-dexamethasone suppression test &gt; 1.8 µg/dL, and nonfunctioning AIs (NFAIs) as a value ≤ 1.8 µg/dL.ResultsCortisol secretion was evident in 30.8% of the patients and cancer in 23.6% (especially breast, colorectal, prostate and thyroid cancer). No differences in the cancer prevalence were found between patients with cortisol secretion and NFAIs (63.6% vs. 63.4%, p=0.10). After adjusting by age, cortisol secretion was not associated with the presence of cancer (OR 1.29, CI 0.93–1.78). However, cortisol secretion was significantly associated with stage IV of cancer at diagnosis (OR 2.68, CI 1.19– 6.00) and mortality (OR 3.2, CI 1.28- 7.97). Patients with NFAI and breast cancer required treatment with chemo- and radio-therapy more frequently that patients with cortisol secreting AI (90% vs 10% and 92.9% vs 7.1% respectively, p&lt;0.05), similarly patients with prostate cancer required radiotherapy more frequently (90.9% vs 9.1%, p=0.05); also, patients with colorectal cancer and NFAI, tended to require chemotherapy more frequently(76.5% vs 23.5%, p=0.06).ConclusionCortisol secretion does not increase the risk of malignant neoplasm, but it affects its clinical course, treatment requirements and mortality, leading to a worst prognosis and higher mortality when compared with patients with NFAIs.
A robust investment decision to deploy bioenergy carbon capture and storage—exploring the case of Stockholm Exergi
Authors: Stenström Oscar , Khatiwada Dilip , Levihn Fabian , Usher Will , Rydén Magnus 
Published: January 2024

The upscaling of novel carbon dioxide removal, such as bioenergy carbon capture and storage (BECCS), to gigatonne scales is an urgent priority if global warming is to be limited to well below 2 °C. But political, economic, social, technological, environmental and regulatory uncertainty permeates BECCS projects and deters investors. To address this, we explore options to improve the robustness of BECCS deployment strategies in the face of multi-dimensional uncertainties. We apply Dynamic Adaptive Planning (DAP) through expert interviews and Robust Decision Making (RDM) through exploratory modelling, two decision making under deep uncertainty methods, to the case of Stockholm Exergi, an early mover aiming to deploy BECCS at a combined heat and power plant in the capital of Sweden. The main contributions of the research are to 1) illustrate how a quantification of robustness against uncertainty can support an investment decision to deploy BECCS 2) comprehensively cover uncertain vulnerabilities and opportunities of deploying BECCS, and 3) identify critical scenarios and adaptations to manage these uncertainties. The main conclusions are: investing in BECCS is relatively robust if assessing performance across many scenarios and if comparing the worst-cases of either investing, or not doing so. Not investing could miss out on up to € 3.8 billion in terms of net present value. The critical uncertainties of BECCS can be managed by strengthening biomass sustainability strategies and by gaining support for negative emission trading regulation on carbon markets, e.g., voluntary or Paris Agreement Article 6. Even in vulnerable scenarios of average electricity prices above 82 €/MWh, if trading regulation is implemented before 2030 and if negative emission prices exceed 151 €/CO2, investing in BECCS performs better than not doing so in 96% of cases. We suggest that facility-level parameters and cost-reductions are of little importance for BECCS investments and upscaling. It is regulatory certainty of operating revenues, e.g., through negative emission markets, that needs to be provided by policymakers.
Characteristics of nitrogen and phosphorus contents in soil and water in an agricultural catchment of the three Gorges reservoir area
Authors: Chen Chenglong , Deng Hua , Xin Guixin , Zhou Youwen 
Published: January 2024

To explore the impact of different land use modes on the contents of nitrogen and phosphorus in soil and water in the agricultural basin of the Three Gorges Reservoir, the differences in the nitrogen and phosphorus contents in soil and shallow groundwater under different land use modes were studied by using sample data collected in the field. The typical agricultural small watershed at the heart of the reservoir area was selected as the research object. The differences in the nitrogen and phosphorus loss concentrations during the rainfall process and in the daily surface runoff of the two subcatchments with different land use compositions and spatial layouts were compared. The results show that under the five land use modes, the average total nitrogen (TN) content of the paddy soil (1.51 g/kg) was the highest and was significantly higher than that of the other four land use modes (p &lt; 0.05); the average nitrate nitrogen (NO3−-N) content of the terraced soil in dry land (30.05 mg/kg) was the highest, and the dispersion degree was the greatest; and the total phosphorus (TP) content of the three types of sloping farmland was higher than that of terraced farmland, among which the total phosphorus content of the dryland sloping farmland (1.37 g/kg) was the highest and was significantly greater than that of the other types (p &lt; 0.05); moreover, the available phosphorus (AP) content in the soil of the closely planted mulberry garden was the highest, with an average of 36.85 mg/kg. Under the different land use modes, the concentrations of TN and NO3−-N in the shallow groundwater varied greatly, while there were no obvious differences in the TP concentrations. Influenced by fertilization, the concentrations of TN and NO3−-N in the shallow groundwater clearly increased after fertilization in spring and autumn. The concentration of TP increased slightly, and the concentration was the highest when the rainfall was concentrated in summer. A comparison of the two subcatchments revealed that the interplanted mulberry and paddy fields at the bottom of the basin effectively reduced TN and TP outputs of surface runoff in the subcatchment.