bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of fatty liver with left ventricular concentric remodeling: Insights from the Corinthia study
Authors: Theofilis P , Mystakidi V C , Goliopoulou A , Papamikroulis G A , Lazaros G , Vogiatzi G , Anastasiou M , Tsalamandris S , Vavuranaki G , Korakas E , Lambadiari V , Siasos G , Oikonomou E , Tousoulis D 
Published: November 2023

Abstract

Introduction
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease, affecting approximately 25% of the population worldwide. In the majority of patients with NAFLD, other metabolic disorders, such as obesity, diabetes mellitus, dyslipidemia, and metabolic syndrome, are usually present.

Purpose
To study how NAFLD and steatosis are associated with left ventricular (LV) concentric remodeling and LV hypertrophy (LVH).

Methods
In this cross-sectional study we examined 1649 participants (997 women) of the Corinthia region, with a mean age of 64±12 years. Several demographic and clinical characteristics were recorded. Echocardiography was performed to all subjects. LV mass was calculated with the method of Devereux et al. LV mass was subsequently indexed for body surface area (BSA), and LVH was defined as left ventricular mass indexed for BSA ≥ 115 g/m2 in men and ≥ 95 g/m2 in women. Hepatic steatosis index (HSI) with the formula (8 × (ALT/AST) + BMI + (2, if diabetes mellitus) + (2, if female)) was used as a predictor of NAFLD. HSI values &gt;36 was used to rule in steatosis.

Results
From the study population, 1353 were included in the steatosis category. Between the steatosis and non-steatosis group, there was a significant difference in age, gender, BMI and BSA and in several cardiovascular risk factors, including hypertension (Table 1). Interestingly, LV mass 155±38 gr vs. 142±31 gr, p&lt;0.001) and LV mass index (82±17 gr/m2 vs. 79±14 gr/m2, p=0.01) were increased in the steatosis compared to non-steatosis group. LVH prevalence was higher in the steatosis compared to non-steatosis group (11% vs. 2%, p&lt;0.001). Since significant confounders may interfere in the association of steatosis with LVH, we proceeded to a logistic regression analysis that confirmed the independent predictive value of steatosis to LVH (Table 2).

Conclusion
These findings highlight the interaction of cardiometabolic risks factors, liver steatosis and NAFLD with left ventricular remodeling and left ventricular hypertrophy independently of other known cardiovascular risk factors.
Machine learning-based prediction of 30-day major adverse cardiac and cerebrovascular events in non-cardiac surgery patients
Authors: Kwun J S , Ahn H , Suh J W , Yoo S Y 
Published: November 2023

Abstract

Background
The number of non-cardiac surgeries performed worldwide has been steadily increasing, presenting a challenge for clinicians to accurately identify patients at high risk of complications and to allocate the appropriate level of perioperative care. Accurate prediction of postoperative mortality is crucial not only for successful patient care, but also for information-based shared decision-making with patients and efficient allocation of medical resources.

Purpose
In this study, we aimed to develop a novel predictive model using machine learning methods applied to electronic health record data. Our objective is to identify the risk factors most likely to lead to 30-day major adverse cardiac and cerebrovascular events after non-cardiac surgery

Methods
We conducted a retrospective analysis of data from a single tertiary care institution that included patients aged 65 years or over who underwent non-cardiac surgery from May 2003 and December 2020. The Observational Medical Outcomes Partnership (OMOP) common data model (CDM) data was used to build predictive models, which allowed for the utilization of demographic data, as well as preoperative characteristics such as diagnosis, lab results, vital signs, medications, and information on operations and procedures from the electronic health records (EHRs) in a standardized way. We employed machine learning models, which were developed and validated using the OHDSI Patient-Level-Prediction framework.

Results
We included a total of 47,915 patients to train (75%) and test (25%) our predictive models. To compare prediction performances, we applied gradient boosting machine (GBM), logistic regression (LR), random forest (RF), AdaBoost (AB), and decision tree (DT). Our results for a test data (Fig 1.) showed that the GBM model had the best performance in terms of the area under the receiver operating characteristic curve (AUROC) (0.903) and the area under the precision-recall curve (AUPRC) (0.395).

Conclusions
Our study demonstrates that applying machine learning algorithms to electronic health record data can effectively identify patients at high risk of major adverse cardiac and cerebrovascular events following non-cardiac surgery. This algorithm has the potential to support clinicians in effectively identifying patients at high risk and provide appropriate perioperative care.
Further work is needed to validate and refine the proposed model to ensure its external validity and broader applicability in clinical practice.We plan to validate the proposed model externally by testing it on a cohort of approximately 280,000 patients from other tertiary care institution, and present the results at the 2023 ESC Congress.
Impact of coronary artery calcium on the prognosis of heterozygous familial hypercholesterolemia
Authors: Tada H , Nomura A , Usui S , Sakata K , Takamura M , Kawashiri M 
Published: November 2023

Abstract

Aims
This study was designed to examine the association between coronary artery calcium (CAC) and major adverse cardiac events (MACEs) and to estimate CAC progression in patients with familial hypercholesterolemia (FH) in primary prevention settings.

Methods and results
Data of patients with FH admitted to our university hospital between 2000 and 2020, who underwent CAC measurement and were followed up (N = 622, male = 306), were retrospectively reviewed. Risk factors for MACEs were determined using the Cox proportional hazard model. The median follow-up duration was 13.2 years (interquartile range: 9.8–18.4 years). We observed 132 MACEs during the follow-up period. The event rate per 1,000 person-years for CAC scores of 0 (N = 283 [45.5%]), 1–100 (N = 260 [41.8%]), and &gt;100 (N = 79 [12.7%]) was 1.2, 17.0, and 78.8, respectively. Log (CAC score+1) was a significant predictor of the occurrence of MACEs (hazard ratio: 3.24; 95% confidence interval: 1.68–4.80; p = 5.6×10−5) in the multivariate Cox regression analysis, independent of other factors. The risk discrimination of MACEs was enhanced by adding CAC information to other conventional risk factors (C-statistics: 0.833–0.934; p = 1.4×10−15). The regression equations between age and the CAC score in male and female were Y = 0.074X–1.52 and Y = 0. 087X–3.21, respectively.

Conclusion
CAC score helps in further risk stratification in patients with FH. Furthermore, the average age of CAC onset was 21 years in male and 37 years in females.
The distribution of lipoprotein(a) in Norway: a nationwide population-based study
Authors: Jeevanathan J , Blom S M , Retterstol K , Christensen J J 
Published: November 2023

Abstract

Background
Lipoprotein(a)[Lp(a)] is shown to be a common and important risk factor for atherosclerotic cardiovascular disease (ASCVD) because of its proatherogenic and prothrombotic properties. The concentrations of Lp(a) are mainly determined by genetics, and the median value can differ by up to fourfold between ethnic groups. Nevertheless, the distribution of Lp(a) in the Norwegian population remains unknown.
Aim of study: To investigate the distribution of Lp(a) levels in the Norwegian population in individuals &lt;50 years. To investigate awareness and test frequency of Lp(a) among Norwegian doctors.

Methods
The study material is nationwide clinical laboratory data with ̴ 275 000 Lp(a) measurements from 185 000 unique individuals &lt;50 years of age, measured between 2000 and 2019. The data material is restricted to individuals &lt;50 years because we assume a low use of medication among young adults.

Results
Analyses based on samples from 20 597 individuals measured between 2018-2019, show that 72.3% of the individuals have Lp(a)-levels &lt; 30 mg/dL, 8.7% have Lp(a)-levels 30-50 mg/dL and 18.9% have Lp(a)-levels &gt; 50 mg/dL. The distribution of Lp(a)-levels are similar for men and women &lt; 50 years. There is high consciousness of Lp(a) among cardiologists, but low test frequency among cardiologists in other workplaces than lipid clinics.

Conclusion
This is the first study that shows the distribution of Lp(a) in the Norwegian population, which is similar to other European distributions of Lp(a).
Variability of Vaccine Responsiveness in Young Children
Authors: Pichichero Michael E , Xu Lei , Gonzalez Eduardo , Pham Minh , Kaur Ravinder 
Published: November 2023

Abstract

Background
Variability in vaccine responsiveness among young children is poorly understood.

Methods
Nasopharyngeal secretions were collected in the first weeks of life for measurement of cytokines/chemokines seeking a biomarker, and blood samples were collected at age 1 year to identify vaccine responsiveness status, defined as low vaccine responder (LVR), normal vaccine responder (NVR), and high vaccine responder (HVR), to test for vaccine antigen–induced immune memory and for antigen-presenting cell (APC) function.

Results
Significantly lower specific cytokine/chemokine levels as biosignatures, measurable in nasopharyngeal secretions at infant age 1–3 weeks, predicted LVR status compared to NVR and HVR children. Antibiotic exposures were correlated with increased occurrence of LVR. At age 1 year, LVRs had fewer CD4+ T-helper 1 and T-helper 2 memory cells responsive to specific vaccine antigens. APC responses observed among LVRs, both at rest and in response to Toll-like receptor 7/8 stimulation by R848, were suboptimal, suggesting that altered innate immunity may contribute to immune deficiency in LVRs.

Conclusions
Cytokine biosignatures in the first weeks of life may predict vaccine responsiveness in children during the first year of life. Antibiotic exposure is associated with LVR in children. CD4+ T-cell memory induction and APC deficiencies occur in LVR children.
Dancing on a Flaming World: Du Bois’s Religiously Inflected Poetry and Creative Fiction
Authors: Cladis Mark 
Published: November 2023

Abstract
In religious studies, W. E. B Du Bois is familiar as a sociologist of religion and as a Black intellectual and activist. He is less known as a poet and speculative fiction author and certainly not at all as a Romantic author. I present Du Bois as a radical Romantic poet and speculative fiction author who employs religious forms and motifs to reveal and combat anti-Black racism among other forms of oppression. This portrait of Du Bois will no doubt surprise many. Romanticism is usually understood as a specific, delimited period of artistic and intellectual history—a period that Du Bois does not belong to chronologically nor (as most would assume) ideologically. But by bringing attention to Du Bois the radical Romantic, we see religious thought employed as a vehicle to depict the pain, humiliation, and cruelty of racist oppression in North America as well as the possibilities of social change.
Emergence of multiple fluconazole-resistant Candida parapsilosis sensu stricto clones with persistence and transmission in China
Authors: Ning Ya-Ting , Sun Tian-Shu , Dai Rong-Chen , Luo Zheng-Yu , Yu Shu-Ying , Zhang Ge , Mei Ya-Ning , Lin Yu-Lan , Hasi Chao-Lu , Chen Sharon C A , Kong Fan-Rong , Xiao Meng , Xu Ying-Chun , Zhang Li 
Published: November 2023

Abstract

Objectives
We explored the epidemiological and molecular characteristics of Candida parapsilosis sensu stricto isolates in China, and their mechanisms of azole resistance.

Methods
Azole susceptibilities of 2318 non-duplicate isolates were determined using CLSI broth microdilution. Isolates were genotyped by a microsatellite typing method. Molecular resistance mechanisms were also studied and functionally validated by CRISPR/Cas9-based genetic alterations.

Results
Fluconazole resistance occurred in 2.4% (n = 56) of isolates, and these isolates showed a higher frequency of distribution in ICU inpatients compared with susceptible isolates (48.2%, n = 27/56 versus 27.8%, 613/2208; P = 0.019). Microsatellite-genotyping analysis yielded 29 genotypes among 56 fluconazole-resistant isolates, of which 10 genotypes, including 37 isolates, belonged to clusters, persisting and transmitting in Chinese hospitals for 1–29 months. Clusters harbouring Erg11Y132F (5/10; 50%) were predominant in China. Among these, the second most dominant cluster MT07, including seven isolates, characteristically harbouring Erg11Y132F and Mrr1Q625K, lent its carriage to being one of the strongest associations with cross-resistance and high MICs of fluconazole (&gt;256 mg/L) and voriconazole (2–8 mg/L), causing transmission across two hospitals. Among mutations tested, Mrr1Q625K led to the highest-level increase of fluconazole MIC (32-fold), while mutations located within or near the predicted transcription factor domain of Tac1 (D440Y, T492M and L518F) conferred cross-resistance to azoles.

Conclusions
This study is the first Chinese report of persistence and transmissions of multiple fluconazole-resistant C. parapsilosis sensu stricto clones harbouring Erg11Y132F, and the first demonstration of the mutations Erg11G307A, Mrr1Q625K, Tac1L263S, Tac1D440Y and Tac1T492M as conferring resistance to azoles.
Rapamycin and caspofungin show synergistic antifungal effects in caspofungin-susceptible and caspofungin-resistant Candida strains in vitro
Authors: Lefranc Maxime , Accoceberry Isabelle , Fitton-Ouhabi Valérie , Biteau Nicolas , Noël Thierry 
Published: November 2023

Abstract

Objectives
Caspofungin is an echinocandin antifungal agent that inhibits synthesis of glucan required for the fungal cell wall. Resistance is mediated by mutation of Fks1 glucan synthase, among which S645P is the most common resistance-associated polymorphism. Rapamycin is a macrolide that inhibits the mechanistic target of rapamycin (mTOR) protein kinase activity. This study investigated the interaction between rapamycin and caspofungin in inhibiting the growth of WT Candida albicans and Fks1 S645P mutant clinical isolate, and WT Candida lusitaniae and genetically engineered isogenic strain with Fks1 S645P mutation at equivalent position.

Methods
Interactions between caspofungin and rapamycin were evaluated using the microdilution chequerboard method in liquid medium. The results were analysed using the Loewe additivity model (FIC index, FICI) and the Bliss independence model (response surface, RS, analysis).

Results
Synergy between rapamycin and caspofungin was shown for C. albicans and C. lusitaniae strains by RS analysis of the chequerboard tests. Synergy was observed in strains susceptible and resistant to caspofungin. Weak subinhibitory concentrations of rapamycin were sufficient to restore caspofungin susceptibility.

Conclusions
We report here, for the first time, synergy between caspofungin and rapamycin in Candida species. Synergy was shown for strains susceptible and resistant to caspofungin. This study highlights the possible implication of the TOR pathway in sensing antifungal-mediated cell wall stress and in modulating the cellular response to echinocandins in Candida yeasts.
High survival simultaneous occurrence of papillary thyroid carcinoma and ectopic thyroid with medullary thyroid carcinoma; case report and literature review
Authors: Alshehri Saad , Alsarrani Faisal , Almanea Leenah , Alharbi Alanood 
Published: November 2023

Abstract
Thyroid cancer is usually treated with surgical intervention followed by ablative radiotherapy if indicated to eliminate any metastases. Five-year survival rates are 99% for papillary thyroid carcinoma (PTC) and 82% for medullary thyroid carcinoma (MTC). The chances of survival decrease significantly with two simultaneous types of cancers and with male gender. PTC and MTC present as different entities. The coexistence of different types of thyroid carcinoma in a patient is a rare event. We report the case of a 45-year-old Saudi male with a rare synchronous occurrence of PTC in the thyroid gland, along with ectopic MTC with a unique prognosis over the years. Our case adds data to the literature supporting the coincidental coexistence of PTC and MTC.
Novel application of Roux-en-Y for diversion of a cutaneous fistula from an irresectable mesenteric root mature teratoma: a case report
Authors: Field Xavier , Welsh Fraser 
Published: November 2023

Abstract
Reconfiguration of the alimentary tract with the Roux-en-Y has been utilized in a wide variety of contexts since its first description by Swiss physician César Roux. We present a novel and unique application of the Roux-en-Y whereby a chronically discharging cutaneous fistula originating at a retroperitoneal mature teratoma within the root of the mesentery was diverted enterically via a cystojejunostomy and the fistula tract excised, providing a resolution of symptoms. The location of the tumour in the root of the mesentery and the involvement of major mesenteric vessels made a radical resection of the tumour technically impossible but due to the distressing symptoms caused by the fistula made diversion of the fistula an excellent treatment option.
Mucinous non neoplastic cyst of the pancreas: a case report
Authors: Elahabadi Ismail , Rahnama Amir , Bazmandegan Gholamreza , Kamiab Zahra 
Published: November 2023

Abstract
The aim of this study was to introduce a patient with mucinous nonneoplastic cyst (MNNC) at an unusual age. MNNCs of the pancreas are uncommon primary tumors, which affect middle-aged women in their fifth decade of life and have significant malignant potential. Therefore, it is important to accurately diagnose and remove them. This case is a 28-year-old woman patient who presented with a pain in the right and upper abdomen from 3 months ago and worsened at night. A cystic lesion was observed near the upper bridge of the left kidney in abdominal ultrasonography. Contrast-enhanced abdominal computed tomography (CT) scan showed a cystic lesion in the trunk and umbilical cord of the pancreas. The patient underwent surgery and the mass was removed and the MNNC was diagnosed.
War, Women, and Sex Work in Occupied Istanbul, 1918–1923
Authors: MacArthur-Seal Daniel-Joseph 
Published: November 2023

Abstract
The occupation of Istanbul by British, French, and Italian forces and the broader political upheavals between 1918 and 1923 radically altered the lives of women selling sex in the Ottoman capital. Increased demand brought by Allied soldiers and increases in supply as waves of migration brought new and financially precarious women to the city led to an expansion in the scale of the sex trade, which soon became a major concern of Allied and Ottoman authorities, servicemen, and the wider public. British, French, and Italian soldiers not only visited brothels as paying customers, but also enforced new regulations on prostitution, making women sex workers particularly vulnerable to violence perpetrated by them. The end of occupation in 1923 posed further challenges, as shifts in the political and judicial framework and reductions in clientele instigated new outward flows of sex workers from the city, emigrations that were complicated by financial and legal restrictions. The article uses French, British, Turkish, and League of Nations sources to uncover the challenges that women faced while working in Istanbul’s brothels in this period and the ways in which they navigated occupation. In doing so, it hopes to contribute to the investigation of the occupation’s impact on subaltern Istanbulites, something that has been hitherto neglected in research centered on the political contest between imperialist, Ottoman, and Turkish nationalist cadres during these years.
A CRISPR/Cas9-based vector system enables the fast breeding of selection-marker-free canola with Rcr1-rendered clubroot resistance
Authors: Hu Hao , Zhang Yan , Yu Fengqun 
Published: November 2023

Abstract
Breeding for disease resistance in major crops is of crucial importance for global food security and sustainability. However, common biotechnologies such as traditional transgenesis or genome editing do not provide an ideal solution, whereas transgenic crops free of selection markers such as cisgenic/intragenic crops might be suitable. In this study, after cloning and functional verification of the Rcr1 gene for resistance to clubroot (Plasmodiophora brassicae), we confirmed that the genes Rcr1, Rcr2, Rcr4, and CRa from Brassica rapa crops and the resistance gene from B. napus oilseed rape cv. ‘Mendel’ on chromosome A03 were identical in their coding regions. We also determined that Rcr1 has a wide distribution in Brassica breeding materials and renders potent resistance against multiple representative clubroot strains in Canada. We then modified a CRISPR/Cas9-based cisgenic vector system and found that it enabled the fast breeding of selection-marker-free transgenic crops with add-on traits, with selection-marker-free canola (B. napus) germplasms with Rcr1-rendered stable resistance to clubroot disease being successfully developed within 2 years. In the B. napus background, the intragenic vector system was able to remove unwanted residue sequences from the final product with high editing efficiency, and off-target mutations were not detected. Our study demonstrates the potential of applying this breeding strategy to other crops that can be transformed by Agrobacterium. Following the streamlined working procedure, intragenic germplasms can be developed within two generations, which could significantly reduce the breeding time and labor compared to traditional introgression whilst still achieving comparable or even better breeding results.
Renovation sets and their applications in higher-order argumentation frameworks
Authors: Wu Jiachao , Li Hengfei 
Published: November 2023

Abstract
The acceptability of attacks plays a key role in defining semantics of higher-order argumentation frameworks (HO-AF). Several approaches have been put forward to describe the recursive acceptability of attacks. The diversity, on the one hand, leads to the variety of HO-AF semantics. However, on the other hand, it also brings difficulties in the formal examination of the relationship among these distinct semantics and the exploration of new semantics. This work aims at exploring the underlying commons in existing HO-AF semantics and examining the role of such commons in the study of HO-AF semantics. To this end, we introduce novel notion of renovation sets to represent the acceptability of attacks, and identify several types of renovation sets for different kinds of acceptability. We then use renovation sets to represent and compare HO-AF semantics built in four different approaches. The proposal of renovation sets provides a general tool for the study of HO-AFs. The representation demonstrates a method of using renovation sets to establish HO-AF semantics. The comparison shows the feasibility of investigating the relationship between different HO-AF semantics with the help of renovation sets.