bluuebunny/crossref_metadata_2025_split huggingface dataset:
ABC-AF-Stroke score predicts thromboembolism in non-anticoagulated patients following successful atrial fibrillation ablation: a report from the Chinese Atrial Fibrillation Registry
Authors: Wang Yufeng , Jiang Chao , He Liu , Du Xin , Guo Xueyuan , Tang Ribo , Sang Caihua , Long Deyong , Dong Jianzeng , Hijazi Ziad , Lip Gregory Y.H. , Ma Changsheng 
Published: October 2023

Abstract

Background:
The age, biomarkers, and clinical history (ABC)-atrial fibrillation (AF)-Stroke score have been proposed to refine stroke risk stratification, beyond what clinical risk scores such as the CHA2DS2-VASc score can offer. This study aimed to identify risk factors associated with thromboembolism and evaluate the performance of the ABC-AF-Stroke score in predicting thromboembolism in non-anticoagulated AF patients following successful ablations.

Methods:
A total of 2692 patients who underwent successful ablations with discontinued anticoagulation after a 3-month blanking period in the Chinese Atrial Fibrillation Registry (CAFR) between 2013 and 2019 were included. Cox regression analysis was conducted to present the association of risk factors with thromboembolism risk. The ABC-AF-Stroke score was evaluated in terms of discrimination, including concordance index (C-index), net reclassification improvement (NRI) and integrated discrimination improvement (IDI), clinical utilization by decision curve analysis (DCA), and calibration by comparing the predicted risk with the observed annualized event rate.

Results:
After a median follow-up of 3.5 years, 64 patients experienced thromboembolism events. Age, prior history of stroke/transient ischemic attack (TIA), high-sensitivity cardiac troponin T (cTnT-hs), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were independently associated with thromboembolism risk. The ABC-AF-Stroke score performed statistically significantly better than the CHA2DS2-VASc score in terms of C-index (0.67, 95% confidence interval [CI]: 0.59–0.74 vs. 0.60, 95% CI: 0.52–0.67, P = 0.030) and reclassification capacity. The DCA implied that the ABC-AF-Stroke score could identify more thromboembolism events without increasing the false positive rate compared to the CHA2DS2-VASc score. The calibration curve showed that the ABC-AF-Stroke score was well calibrated in this population.

Conclusions:
In this real-world study enrolling non-anticoagulated AF patients following successful ablations, age, prior history of stroke/TIA, level of NT-proBNP, and cTnT-hs were independently associated with an increased risk of thromboembolism. The ABC-AF-Stroke score was well-calibrated and statistically significantly outperformed the CHA2DS2-VASc score in predicting thromboembolism risk.
Mechanisms of Immune Tolerance and Inflammation via Gonadal Steroid Hormones in Preterm Birth
Authors: Shen Yongmei , Li Yaqi , Cao Jiasong , Li Wen , Lin Qimei , Wang Jianxi , Wei Zhuo , Chang Ying 
Published: October 2023

Abstract
In 2019, preterm births (PTB) accounted for approximately 0.66 million deaths globally. PTB is also associated with a significantly higher risk of mortality and long-term complications for newborns. Long-term studies associated several factors, including disruption of immune tolerance and inflammation, with PTB. However, the pathogenesis of PTB remains unclear. Gonadal steroid hormones are critical for pregnancy maintenance and regulation of immune and inflammatory responses. However, it is not clear how unbalanced gonadal steroid hormones, such as imbalanced estrogen/androgen or estrogen/progesterone contribute to PTB. In this review, we discuss how gonadal steroid hormones mediate dysfunction in immune tolerance and inflammatory responses, which are known to promote the occurrence of PTB, and provide insight into PTB prediction.
Factors of Fetal Origin in the Regulation of Labor Initiation and Preterm Birth
Authors: Ding Longkun , Gao Lu 
Published: October 2023

Abstract
Preterm birth is the leading cause of mortality and morbidity in newborns and children under 5 years-of-age. In order to improve the survival rate and quality of preterm infants, there is critical need to identify the specific mechanisms underlying the initiation of labor. Pregnancy represents a period of constant interactive dialog between mother and fetus. A disturbance in the pattern of maternal-fetal communication can induce physiological or pathological labor. Although a number of studies have investigated the contributions of maternal factors to the initiation of labor, the concept that fetal organ development and maternal adaptation are coordinated has emerged over recent years, thus emphasizing that factors of fetal origin may serve as hormonal signals for the initiation of labor. In this review, we summarize and discuss several specific mechanisms by which factors of fetal origin may influence parturition during term or preterm labor, including the specific regulation of fetal organs, including the lungs and accessory organs during pregnancy. Future research may focus on the specific pathways by which signals from the fetal lungs and other fetal organs interact with the maternal system to initiate eventual labor.
Using the Delphi Technique to Achieve Consensus on Prevention and Treatment of Preterm Single Birth in China
Authors: Li Taishun , Liu Zhe , Yang Huixia , Hu Yali 
Published: October 2023

Abstract

Objective
This study aimed to reach a consensus among obstetric experts on the prevention and treatment of preterm single births in China.

Methods
Based on the scoping literature review and the 2014 edition of preterm birth of Clinical Diagnosis and Treatment guidelines, we generated the Delphi survey statements with five evaluation dimensions, including the definition of preterm birth, exclusion of risk factors for preterm birth, prevention, and prediction of preterm birth, treatment of preterm birth, and evaluation of intervention outcomes of preterm birth. Obstetric experts from the Obstetrics and Gynecology Branch of the Chinese Medical Association formed the expert group for this survey. All the obstetric experts participated two-round modified Delphi survey via an anonymous online survey and an online panel. Mean scores, rank sum, full score ratio, and the lowest score ratio were calculated to reflect the concentration of expert opinions. The coefficient of variation and Kendall W coefficient were used to reflect the expert opinion coordination degree of the survey statement.

Results
The expert response rate for both rounds of surveys was 100% (41/41). Experts reached an agreement on 36 statements in five dimensions of preterm birth prevention and treatment in the first round of the survey and reached a consensus on the remaining 13 statements in the second round. A total of 49 statements (mean scores ≥3, full score ratio ≥20%, coefficient of variation ≤0.3) were explicitly included in this guideline to form recommendations, while the remaining three clinical issues that did not reach a consensus require further determination based on evidence quality. The Kendall W coefficient in the two rounds of the Delphi survey were 0.20 (P < 0.001) and 0.29 (P < 0.001).

Conclusion
The five dimensions and 49 statements, agreed upon through a two-round Delphi study, determined the recommended statements to be included in the updated guidelines for the prevention and treatment of preterm birth in China. The defined lower limit is set at ≥28 gestational weeks; however, an update has been made to the definition of premature birth, specifying that “with the consent of the mother and her family, treatment is not abandoned for viable infants ≥26 gestational weeks.”
Predicting the Risk of Preterm Birth Throughout Pregnancy Based on a Novel Transcriptomic Signature
Authors: Ran Yuxin , Huang Dongni , Yin Nanlin , Wen Yanqing , Jiang Yan , Liu Yamin , Qi Hongbo 
Published: October 2023

Abstract

Objective
This study focused on the prediction of preterm birth (PTB). It aimed to identify the transcriptomic signature essential for the occurrence of PTB and evaluate its predictive value in early, mid, and late pregnancy and in women with threatened preterm labor (TPTL).

Methods
Blood transcriptome data of pregnant women were obtained from the Gene Expression Omnibus database. The activity of biological signatures was assessed using gene set enrichment analysis and single-sample gene set enrichment analysis. The correlation among molecules in the interleukin 6 (IL6) signature and between IL6 signaling activity and the gestational week of delivery and latent period were evaluated by Pearson correlation analysis. The effects of molecules associated with the IL6 signature were fitted using logistic regression analysis; the predictive value of both the IL6 signature and IL6 alone were evaluated using receiver operating characteristic curves and pregnancy maintenance probability was assessed using Kaplan-Meier analysis. Differential analysis was performed using the DEseq2 and limma algorithms.

Results
Circulatory IL6 signaling activity increased significantly in cases with preterm labor than in those with term pregnancies (normalized enrichment score (NES) = 1.857, P = 0.001). The IL6 signature (on which IL6 signaling is based) was subsequently considered as the candidate biomarker for PTB. The area under the curve (AUC) values for PTB prediction (using the IL6 signature) in early, mid, and late pregnancy were 0.810, 0.695, and 0.779, respectively; these values were considerably higher than those for IL6 alone. In addition, the pregnancy curves of women with abnormal IL6 signature differed significantly from those with normal signature. In pregnant women who eventually had preterm deliveries, circulatory IL6 signaling activity was lower in early pregnancy (NES = −1.420, P = 0.031) and higher than normal in mid (NES = 1.671, P = 0.002) and late pregnancy (NES = 2.350, P < 0.001). In women with TPTL, the AUC values for PTB prediction (or PTB within 7 days and 48 hours) using the IL6 signature were 0.761, 0.829, and 0.836, respectively; the up-regulation of IL6 signaling activity and its correlation with the gestational week of delivery (r = −0.260, P = 0.001) and latency period (r = −0.203, P = 0.012) were more significant than in other women.

Conclusion
Our findings suggest that the IL6 signature may predict PTB, even in early pregnancy (although the predictive power is relatively weak in mid pregnancy) and is particularly effective in symptomatic women. These findings may contribute to the development of an effective predictive and monitoring system for PTB, thereby reducing maternal and fetal risk.
Clinical Parameters in the First 5 Minutes after Birth Have a Predictive Value for Survival of Extremely Preterm Infants
Authors: Torrejón-Rodríguez Laura , Solaz-García Álvaro , Lara-Cantón Inmaculada , Pinilla-González Alejandro , Aguar Marta , Vento Máximo 
Published: October 2023

Abstract
Extreme preterm infants (<28 weeks' gestation) often require positive pressure ventilation with oxygen during postnatal stabilization in the delivery room. To date, optimal inspired fraction of oxygen (FiO2) still represents a conundrum in newborn care oscillating between higher (>60%) and lower (<30%) initial FiO2. Recent evidence and meta-analyses have underscored the predictive value for survival and/or relevant clinical outcomes of the Apgar score and the achievement of arterial oxygen saturation measured by pulse oximetry ≥85% at 5 minutes after birth. New clinical trials comparing higher versus lower initial FiO2 have been launched aiming to optimize postnatal stabilization of extreme preterm while avoiding adverse effects of hypoxemia or hyperoxemia.
Validation of AGA clinical care pathway and AASLD practice guidance for nonalcoholic fatty liver disease in a prospective cohort of patients with type 2 diabetes
Authors: Ajmera Veeral , Tesfai Kaleb , Sandoval Erick , Lopez Scarlett , Cervantes Vanessa , Madamba Egbert , Bettencourt Ricki , Manousou Pinelopi , Richards Lisa , Loomba Rohit 
Published: October 2023

Background and Aims:Recently, the American Gastroenterological Association and the American Association for the Study of Liver Diseases developed clinical pathways to evaluate populations at high risk for NAFLD. We assessed the diagnostic performance of the new guidance in a well-phenotyped cohort of patients with Type 2 diabetes mellitus (T2DM).Approach and Results:This prospective study enrolled patients age ≥50 years with T2DM. Participants underwent a standardized clinical research visit with MRI and ultrasound-based assessment of liver fat and stiffness and Enhanced Liver Fibrosis (ELF) testing. Of 417 participants (36% men) with T2DM with FIB-4 and MRE data, the prevalence of NAFLD was 64% and 12% had advanced fibrosis (MRE≥3.63 kPa). Applying the American Gastroenterological Association pathway of FIB-4 and vibration-controlled transient elastography, the false negative rate was 3.3% and 18% would qualify for specialty referral. Applying the FIB-4 + ELF American Association for the Study of Liver Diseases pathway, the false negative rate was 4.5%, but 50% would qualify for specialty referral. Applying higher ELF cut points improved the pathway, yielding a similar false negative rate of 4.9% but decreased specialty referral to 27%.Conclusion:Validation of the American Gastroenterological Association clinical pathway in a prospectively recruited cohort with T2DM revealed a low false negative rate and avoided specialty referral in a large percentage of patients. The American Association for the Study of Liver Diseases pathway with FIB-4 + ELF resulted in a high rate of specialty referral, which improved with the utilization of higher ELF cut points and may serve as an alternative for primary care and endocrinology clinics without access to vibration-controlled transient elastography.
Exploratory Data Analysis of the Groundwater Contaminants at the Former Panna Maria Uranium Recovery Facility
Authors: Harvey Mark C. , Glenn Griesinger Nancy L. 
Published: October 2023

Abstract
The former Panna Maria mill was a uranium recovery facility that operated from 1979 to December 1992. Sulfuric acid leach was used to process several tons of ore daily. Therefore, the groundwater was sampled at the site to monitor the concentration of background chemical pollutants. The purpose of this study was to perform exploratory data analysis to evaluate whether the arsenic, nickel, selenium, sulfate, and uranium concentrations were in accord with state-regulated groundwater drinking standards at the site. To accomplish this, a substitution method was used to replace concentration values that were below measurable ranges of well monitoring units. Additionally, random forest regression was employed to account for missing not-at-random values in the dataset. Groundwater samples collected in wells before the facility began operations were used to determine an upper bound on background pollutants consistent with US Environmental Protection Agency Standards. The upper tolerance limit comprising 90% of the groundwater sample at a confidence coefficient of 95% was used to establish alternate concentration limits for each chemical based on well data from the National Uranium Resource Hydrogeochemical and Stream Sediment Reconnaissance program. Results obtained in this analysis establish a baseline on the chemical concentrations in the background groundwater at the former Panna Maria mill.
CLOSURE OF A CHRONIC TRAUMATIC MACULAR HOLE AFTER PHACOEMULSIFICATION SURGERY
Authors: Bonnell Alyssa C. , Ohan Masis A. , Feng Shu 
Published: October 2023

Purpose:
To report a case of chronic traumatic macular hole closure after an uncomplicated phacoemulsification surgery.

Methods:
Retrospective chart review with optical coherence tomography imaging.

Results:
Forty-two-year-old woman with a 20-year history of a traumatic macular hole and cataract in the right eye underwent an uncomplicated phacoemulsification surgery. After surgery, the patient was prescribed prednisolone acetate 1% four times per day, which was tapered off by postoperative month 1. By postoperative month 1, the full-thickness macular hole had closed.

Conclusion:
This unique case illustrates the closure of a full-thickness macular hole after cataract surgery. We hypothesize that the closure of the macular hole was aided by the use of topical steroids in the postoperative period, allowing for resolution of the cystic intraretinal fluid and hole closure.
Sex as a biological variable in acute kidney injury
Authors: Dahiya Anita , Pannu Neesh , Soranno Danielle E. 
Published: October 2023

Purpose of review
The purpose of this review is to provide an overview of the preclinical and clinical studies investigating sex as a biological variable, as well as the impact of gender, on the development of and progression of acute kidney injury (AKI).

Recent findings
Despite a matched degree of ischemia-reperfusion AKI based on measured glomerular filtration rates, male and female mice demonstrated important sex biases in cardiorenal outcomes (1). Although the 2012 Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guideline for AKI reported that female sex is associated with increased rates of hospital acquired AKI, subsequent meta-analyses do not show increased risk of AKI in women. Recent large scale, multicenter epidemiologic studies suggest males have higher rates of hospital acquired AKI. However, women have been consistently shown to have worse renal outcomes after AKI. There may be also be gender-based differences in presentation to care and management.

Summary
Sex is an important biological variable in animal models of acute kidney injury. The impact of sex on AKI likely varies based on the etiology of AKI. Preclinical studies demonstrate the nuances of sex chromosomes, sex hormones and epigenetic factors on AKI, however these have not been well studied in humans. Gender may also impact processes of care, treatment and clinical outcomes related to AKI. The scientific rigor and reproducibility of translational studies benefit from the consideration of sex and gender.
Adults are just big kids: pediatric considerations for adult critical care nephrology
Authors: Starr Michelle C. , Gilley Stephanie P. , See Emily J. , Slagle Cara , Soranno Danielle E. 
Published: October 2023

Purpose of review
In recent years, there has been growing attention to pediatric kidney health, especially pediatric acute kidney injury (AKI). However, there has been limited focus on the role of pediatric AKI on adult kidney health, specifically considerations for the critical care physician.

Recent findings
We summarize what is known in the field of pediatric AKI to inform adult medical care including factors throughout the early life course, including perinatal, neonatal, and pediatric exposures that impact survivor care later in adulthood.

Summary
The number of pediatric AKI survivors continues to increase, leading to a higher burden of chronic kidney disease and other long-term co-morbidities later in life. Adult medical providers should consider pediatric history and illnesses to inform the care they provide. Such knowledge may help internists, nephrologists, and intensivists alike to improve risk stratification, including a lower threshold for monitoring for AKI and kidney dysfunction in their patients.
Automated external defibrillators and the link to first responder systems
Authors: Jonsson Martin , Berglund Ellinor , Müller Michael P. 
Published: October 2023

Purpose of review
Automated external defibrillators are a very effective treatment to convert ventricular fibrillation (VF) in out-of-hospital cardiac arrest. The purpose of this paper is to review recent publications related to automated external defibrillators (AEDs).

Recent findings
Much of the recent research focus on ways to utilize publicly available AEDs included in different national/regional registers. More and more research present positive associations between engaging volunteers to increase the use of AEDs. There are only a few recent studies focusing on professional first responders such as fire fighters/police with mixed results. The use of unmanned aerial vehicles (drones) lacks clinical data and is therefore difficult to evaluate. On-site use of AED shows high survival rates but suffers from low incidence of out-of-hospital cardiac arrest (OHCA).

Summary
The use of public AEDs in OHCA are still low. Systems focusing on engaging volunteers in the cardiac arrest response have shown to be associated with higher AED usage. Dispatching drones equipped with AEDs is promising, but research lacks clinical data. On-site defibrillation is associated with high survival rates but is not available for most cardiac arrests.
Efficacy of acupuncture or moxibustion in treating senile insomnia compared with a control group: A systematic review and meta-analysis
Authors: Hu Wenjiao , Zhou Hao , Zeng Yue , Zeng Qian , Huang Zubo , Wang Chao 
Published: October 2023

Introduction:
This systematic review and meta-analysis aimed to assess the efficacy of acupuncture or moxibustion therapy in senile insomnia patients.

Methods:
A comprehensive literature search was conducted using 7 electronic databases to identify randomized controlled trials reported on the use of acupuncture or moxibustion therapy in insomnia. The time frame was set from database establishment to March 11, 2023. The RevMan (version 5.3) and STATA (version 17.0) software were used to evaluate the quality of the included randomized controlled trials and perform a meta-analysis. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. Subgroup analysis was performed based on different intervention methods. The I2 statistic was used to assess heterogeneity among studies.

Results:
A total of 20 studies conducted between 2007 and 2022 were included, involving 1677 patients with senile insomnia. In terms of efficacy, acupuncture or moxibustion alone was significantly better than western drugs (RR = 1.12; 95% CI, 1.06–1.20), acupuncture combined with drugs was better than drugs alone (RR = 1.20; 95% CI, 1.12–1.29), and acupuncture combined with cognitive behavior therapy intervention (CBT-I) was significantly better than CBT-I alone (RR = 1.52; 95% CI, 1.07–2.17). In terms of Pittsburgh Sleep Quality Index scores, acupuncture or moxibustion alone was more effective than western drugs (MD = −1.82; 95% CI, −2.37 to −1.26), acupuncture combined with drugs was more effective than drugs alone (MD = −3.10; 95% CI, −4.25 to −1.95), and acupuncture was significantly more effective than sham acupuncture (MD = −4.18; 95% CI, −5.85 to −2.51) and psychological intervention (MD = −3.54; 95% CI, −4.33 to −2.75) in improving sleep quality.

Conclusions:
This meta-analysis revealed that acupuncture or moxibustion alone or combination with other therapies(drugs, CBT-I or psychological intervention) has high clinical efficacy and can improve the sleep quality of patients with senile insomnia. However, further well-designed studies are warranted to verify these findings.