bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of S-ketamine and midazolam for intravenous preoperative sedative and anxiolytic effects in preschool children: study protocol for a randomized controlled clinical trial
Authors: Zhang Meng-Qiu , Xu Ming-Zhe , He Yi , Su Yong-Wei , Ma Jun , Zuo Yun-Xia 
Published: November 2023

Abstract
Background
Preoperative anxiety management is gaining particular attention in paediatric anaesthesia. Pharmacological and non-pharmacological resorts can be implemented to address this special issue. Despite the various approaches currently used for preoperative sedation in children, the different sedative and anti-anxiety effects between the newly marketed anaesthetic, S-ketamine, and the traditional sedative, midazolam, are still unclear.

Methods
This is a patient- and assessor-blinded randomized controlled clinical trial. Participants (n = 110) will receive S-ketamine (0.5 mg/kg) or midazolam (0.08 mg/kg) intravenously administrated at a ratio of 1:1 in the anaesthesia holding area. The primary outcome of this study is the sedative effect evaluated via the change in the modified Yale preoperative anxiety scale. It will be performed at two timepoints: in the pre-anaesthetic holding area before premedication (baseline, marked as T0) and about 5 min after premedication in the operating room without the existence of their guardians (marked as T1). Our secondary objectives include the parent separation anxiety score, postoperative agitation, caregivers’ and anaesthesia care providers’ satisfaction, and mask compliance.

Discussion
This randomized controlled trial is the first study to compare the anti-anxiety effect of intravenous S-ketamine and midazolam. We will provide a new approach for the clinical management of preoperative anxiety in preschool children posted for elective surgery.

Trial registration
ChiCTR2300069998. Registered on 30 March 2023.
Divergent brain regional atrophy and associated fiber disruption in amnestic and non-amnestic MCI
Authors: Du Chao , Dang Mingxi , Chen Kewei , Chen Yaojing , Zhang Zhanjun 
Published: November 2023

Abstract
Background
Understanding the pathological characteristics of various mild cognitive impairment (MCI) subtypes is crucial for the differential diagnosis of dementia. The purpose of this study was to feature divergent symptom-deficit profiles in amnestic MCI (aMCI) and non-amnestic MCI (naMCI).

Methods
T1 and DTI MRI data from a total of 158 older adults with 50 normal controls, 56 aMCI, and 52 naMCI were included. The voxel-wise gray matter volumes and the number of seed-based white matter fiber bundles were compared among these three groups. Furthermore, correlation and mediation analyses between the neuroimaging indices and cognitive measures were performed.

Results
The aMCI with specific memory abnormalities was characterized by volumetric atrophy of the left hippocampus but not by damage in the linked white matter fiber bundles. Conversely, naMCI was characterized by both the altered volume of the right inferior frontal gyrus and the significant damage to fiber bundles traversing the region in all three directions, not only affecting fibers around the atrophied area but also distant fibers. Mediation analyses of gray matter-white matter-cognition showed that gray matter atrophy affects the number of fiber bundles and further affects attention and executive function. Meanwhile, fiber bundle damage also affects gray matter volume, which further affects visual processing and language.

Conclusions
The divergent structural damage patterns of the MCI subtypes and cognitive dysfunctions highlight the importance of detailed differential diagnoses in the early stages of pathological neurodegenerative diseases to deepen the understanding of dementia subtypes and inform targeted early clinical interventions.
Evaluation of imaging findings in gastrointestinal anisakiasis in emergency CT and ultrasound
Authors: Fornell-Perez Roberto , Urizar-Gorosarri Maite , Martinez-Urabayen Uxue , Perez-Bea Marta 
Published: November 2023

Abstract
Background
To assess the frequency of appearance of various signs (isolated and grouped) in emergency imaging tests in patients with anisakiasis, according to the location of gastrointestinal tract involvement.

Methods
Retrospective review by two experienced radiologists of emergency ultrasounds and CTs performed on patients admitted in the Emergency Department of our hospital with later confirmed anisakiasis (2010–2021), assessing the presence of signs suggesting anisakiasis. Calculation of the frequency of appearance according to the gastric or intestinal location, as well as the most common grouped signs.

Results
Out of 231 total patients with anisakiasis, imaging studies were performed in 144: abdominopelvic ultrasound in 43 cases and CT in 111 (both techniques in 31). In cases with gastric occurrence (34), in CT the wall stratification (100%), wall thickening (97%), fat stranding (91%) and ascitic fluid (82%) were predominant. In the intestinal cases (105), in CT (95) the wall thickening (100%), fat stranding (92%) and mesenteric vessel engorgement (83%) were usual; in ultrasound (40), ascitic fluid and wall thickening (70% in both cases) were frequently observed. The frequency of grouped appearance of the mentioned signs was 82% in gastric cases, 80% in intestinal cases and 50% in ultrasounds. Multisegment involvement in CT reached 28% (gastric + intestinal) and 11% (only intestinal) of cases.

Conclusions
The most frequent CT findings in patients with gastric anisakiasis are wall stratification and thickening, fat stranding and ascitic fluid. In the intestinal cases, wall thickening, fat oedema and vessel engorgement are the most often observed findings.

Critical relevance statement
The presence of different radiological signs makes it advisable to include anisakiasis in the differential diagnosis of acute abdomen. Intestinal and multifocal involvement rates are greater than previously reported.

Key points
• In gastric anisakiasis, CT frequently shows wall stratification and thickening, fat stranding and ascitic fluid.
• In intestinal anisakiasis, CT often presents wall thickening, fat stranding and vessel engorgement.
• In intestinal anisakiasis, ultrasounds most frequently show ascitic fluid and wall thickening.

Graphical Abstract
Inhibition of exosome biogenesis affects cell motility in heterogeneous sub-populations of paediatric-type diffuse high-grade gliomas
Authors: Pericoli Giulia , Galardi Angela , Paolini Alessandro , Petrilli Lucia Lisa , Pepe Gerardo , Palma Alessandro , Colletti Marta , Ferretti Roberta , Giorda Ezio , Levi Mortera Stefano , Burford Anna , Carai Andrea , Mastronuzzi Angela , Mackay Alan , Putignani Lorenza , Jones Chris , Pascucci Luisa , Peinado Hector , Helmer-Citterich Manuela , de Billy Emmanuel , Masotti Andrea , Locatelli Franco , Di Giannatale Angela , Vinci Maria 
Published: November 2023

Abstract
Background
Paediatric-type diffuse High-Grade Gliomas (PDHGG) are highly heterogeneous tumours which include distinct cell sub-populations co-existing within the same tumour mass. We have previously shown that primary patient-derived and optical barcoded single-cell-derived clones function as interconnected networks. Here, we investigated the role of exosomes as a route for inter-clonal communication mediating PDHGG migration and invasion.

Results
A comprehensive characterisation of seven optical barcoded single-cell-derived clones obtained from two patient-derived cell lines was performed. These analyses highlighted extensive intra-tumour heterogeneity in terms of genetic and transcriptional profiles between clones as well as marked phenotypic differences including distinctive motility patterns. Live single-cell tracking analysis of 3D migration and invasion assays showed that the single-cell-derived clones display a higher speed and longer travelled distance when in co-culture compared to mono-culture conditions. To determine the role of exosomes in PDHGG inter-clonal cross-talks, we isolated exosomes released by different clones and characterised them in terms of marker expression, size and concentration. We demonstrated that exosomes are actively internalized by the cells and that the inhibition of their biogenesis, using the phospholipase inhibitor GW4689, significantly reduced the cell motility in mono-culture and more prominently when the cells from the clones were in co-culture. Analysis of the exosomal miRNAs, performed with a miRNome PCR panel, identified clone-specific miRNAs and a set of miRNA target genes involved in the regulation of cell motility/invasion/migration. These genes were found differentially expressed in co-culture versus mono-culture conditions and their expression levels were significantly modulated upon inhibition of exosome biogenesis.

Conclusions
In conclusion, our study highlights for the first time a key role for exosomes in the inter-clonal communication in PDHGG and suggests that interfering with the exosome biogenesis pathway may be a valuable strategy to inhibit cell motility and dissemination for these specific diseases.
Use of airway pressure-based indices to detect high and low inspiratory effort during pressure support ventilation: a diagnostic accuracy study
Authors: Yang Yan-Lin , Liu Yang , Gao Ran , Song De-Jing , Zhou Yi-Min , Miao Ming-Yue , Chen Wei , Wang Shu-Peng , Wang Yue-Fu , Zhang Linlin , Zhou Jian-Xin 
Published: November 2023

Abstract
Background
Assessment of the patient’s respiratory effort is essential during assisted ventilation. We aimed to evaluate the accuracy of airway pressure (Paw)-based indices to detect potential injurious inspiratory effort during pressure support (PS) ventilation.

Methods
In this prospective diagnostic accuracy study conducted in four ICUs in two academic hospitals, 28 adult acute respiratory failure patients undergoing PS ventilation were enrolled. A downward PS titration was conducted from 20 cmH2O to 2 cmH2O at a 2 cmH2O interval. By performing an end-expiratory airway occlusion maneuver, the negative Paw generated during the first 100 ms (P0.1) and the maximal negative swing of Paw (∆Pocc) were measured. After an end-inspiratory airway occlusion, Paw reached a plateau, and the magnitude of change in plateau from peak Paw was measured as pressure muscle index (PMI). Esophageal pressure was monitored and inspiratory muscle pressure (Pmus) and Pmus–time product per minute (PTPmus/min) were used as the reference standard for the patient’s effort. High and low effort was defined as Pmus > 10 and < 5 cmH2O, or PTPmus/min > 200 and < 50 cmH2O s min−1, respectively.

Results
A total of 246 levels of PS were tested. The low inspiratory effort was diagnosed in 145 (59.0%) and 136 (55.3%) PS levels using respective Pmus and PTPmus/min criterion. The receiver operating characteristic area of the three Paw-based indices by the respective two criteria ranged from 0.87 to 0.95, and balanced sensitivity (0.83–0.96), specificity (0.74–0.88), and positive (0.80–0.91) and negative predictive values (0.78–0.94) were obtained. The high effort was diagnosed in 34 (13.8%) and 17 (6.9%) support levels using Pmus and PTPmus/min criterion, respectively. High receiver operating characteristic areas of the three Paw-based indices by the two criteria were found (0.93–0.95). A high sensitivity (0.80–1.00) and negative predictive value (0.97–1.00) were found with a low positive predictive value (0.23–0.64).

Conclusions
By performing simple airway occlusion maneuvers, the Paw-based indices could be reliably used to detect low inspiratory efforts. Non-invasive and easily accessible characteristics support their potential bedside use for avoiding over-assistance. More evaluation of their performance is required in cohorts with high effort.
Title-plus-abstract versus title-only first-level screening approach: a case study using a systematic review of dietary patterns and sarcopenia risk to compare screening performance
Authors: Teo Lynn , Van Elswyk Mary E. , Lau Clara S. , Shanahan Christopher J. 
Published: November 2023

Abstract
Background
Conducting a systematic review is a time- and resource-intensive multi-step process. Enhancing efficiency without sacrificing accuracy and rigor during the screening phase of a systematic review is of interest among the scientific community.

Methods
This case study compares the screening performance of a title-only (Ti/O) screening approach to the more conventional title-plus-abstract (Ti + Ab) screening approach. Both Ti/O and Ti + Ab screening approaches were performed simultaneously during first-level screening of a systematic review investigating the relationship between dietary patterns and risk factors and incidence of sarcopenia. The qualitative and quantitative performance of each screening approach was compared against the final results of studies included in the systematic review, published elsewhere, which used the standard Ti + Ab approach. A statistical analysis was conducted, and contingency tables were used to compare each screening approach in terms of false inclusions and false exclusions and subsequent sensitivity, specificity, accuracy, and positive predictive power.

Results
Thirty-eight citations were included in the final analysis, published elsewhere. The current case study found that the Ti/O first-level screening approach correctly identified 22 citations and falsely excluded 16 citations, most often due to titles lacking a clear indicator of study design or outcomes relevant to the systematic review eligibility criteria. The Ti + Ab approach correctly identified 36 citations and falsely excluded 2 citations due to limited population and intervention descriptions in the abstract. Our analysis revealed that the performance of the Ti + Ab first-level screening was statistically different compared to the average performance of both approaches (Chi-squared: 5.21, p value 0.0225) while the Ti/O approach was not (chi-squared: 2.92, p value 0.0874). The predictive power of the first-level screening was 14.3% and 25.5% for the Ti/O and Ti + Ab approaches, respectively. In terms of sensitivity, 57.9% of studies were correctly identified at the first-level screening stage using the Ti/O approach versus 94.7% by the Ti + Ab approach.

Conclusions
In the current case study comparing two screening approaches, the Ti + Ab screening approach captured more relevant studies compared to the Ti/O approach by including a higher number of accurately eligible citations. Ti/O screening may increase the likelihood of missing evidence leading to evidence selection bias.

Systematic review registration
PROSPERO Protocol Number: CRD42020172655.
Experimental and Analytical Investigation of Fracture Characteristics of Steel Fiber-Reinforced Recycled Aggregate Concrete
Authors: Maglad Ahmed M. , Mansour Walid , Tayeh Bassam A. , Elmasry Mohamed , Yosri Ahmed M. , Fayed Sabry 
Published: November 2023

AbstractFracture parameters of fiber concrete (FC) are currently a hot research area. Fracture mechanics is the field of solid mechanics that helps to study the type and propagation of cracks in materials. It uses methods of calculating the driving force on a crack and characterizes the material's resistance to fracture. Behavioral characteristics are determined by crack mouth opening displacement and the load–deflection method. This research identifies the fracture parameters of 33 notched simply supported beams made by recycled aggregate cement concrete with steel fiber. The recycled aggregate ratio in concrete has been altered to determine the effect on the mechanical and fracture properties. For determining fracture parameters, a 3-point bending single-edge notched fracture test was used. The results indicated that the steel fiber-reinforced concrete made with recycled aggregate showed similar performance and fracture characteristics compared to normal concrete. Thus, adding steel fibers to various concrete mixes considerably improved the fracture characteristics, while the brittleness was reduced with increased steel fiber content. Linear regression analysis also showed the accuracy of mechanical strength results as the value of R-square was close to unity. Displacement, ultimate load, brittleness (B), fracture toughness (KIC), crack mouth opening displacement (CMOD), fracture energy (GF), modulus of elasticity (E), and characteristic length (lch), were determined for both conventional and recycled aggregate specimens. The “work of fracture"—by definition the formula—is the most reliable to calculate the fracture energy as the nonlinearity is related to the performance of FC.
Maternal microbiota communicates with the fetus through microbiota-derived extracellular vesicles
Authors: Kaisanlahti Anna , Turunen Jenni , Byts Nadiya , Samoylenko Anatoliy , Bart Genevieve , Virtanen Nikke , Tejesvi Mysore V. , Zhyvolozhnyi Artem , Sarfraz Sonia , Kumpula Sohvi , Hekkala Jenni , Salmi Sonja , Will Olga , Korvala Johanna , Paalanne Niko , Erawijantari Pande Putu , Suokas Marko , Medina Tuula Peñate , Vainio Seppo , Medina Oula Peñate , Lahti Leo , Tapiainen Terhi , Reunanen Justus 
Published: November 2023

Abstract
Background
Reports regarding the presence of bacteria in the fetal environment remain limited and controversial. Recently, extracellular vesicles secreted by the human gut microbiota have emerged as a novel mechanism for host-microbiota interaction. We aimed to investigate the presence of bacterial extracellular vesicles in the fetal environment during healthy pregnancies and determine whether extracellular vesicles derived from the gut microbiota can cross biological barriers to reach the fetus.

Results
Bacterial extracellular vesicles were detectable in the amniotic fluid of healthy pregnant women, exhibiting similarities to extracellular vesicles found in the maternal gut microbiota. In pregnant mice, extracellular vesicles derived from human maternal gut microbiota were found to reach the intra-amniotic space.

Conclusions
Our findings reveal maternal microbiota-derived extracellular vesicles as an interaction mechanism between the maternal microbiota and fetus, potentially playing a pivotal role in priming the prenatal immune system for gut colonization after birth.
Autofluorescence imaging of endogenous metabolic cofactors in response to cytokine stimulation of classically activated macrophages
Authors: Bess Shelby N. , Igoe Matthew J. , Denison Abby C. , Muldoon Timothy J. 
Published: November 2023

Abstract
Background
Macrophages are one of the most prevalent subsets of immune cells within the tumor microenvironment and perform a range of functions depending on the cytokines and chemokines released by surrounding cells and tissues. Recent research has revealed that macrophages can exhibit a spectrum of phenotypes, making them highly plastic due to their ability to alter their physiology in response to environmental cues. Recent advances in examining heterogeneous macrophage populations include optical metabolic imaging, such as fluorescence lifetime imaging (FLIM), and multiphoton microscopy. However, the method of detection for these systems is reliant upon the coenzymes NAD(P)H and FAD, which can be affected by factors other than cytoplasmic metabolic changes. In this study, we seek to validate these optical measures of metabolism by comparing optical results to more standard methods of evaluating cellular metabolism, such as extracellular flux assays and the presence of metabolic intermediates.

Methods
Here, we used autofluorescence imaging of endogenous metabolic co-factors via multiphoton microscopy and FLIM in conjunction with oxygen consumption rate and extracellular acidification rate through Seahorse extracellular flux assays to detect changes in cellular metabolism in quiescent and classically activated macrophages in response to cytokine stimulation.

Results
Based on our Seahorse XFP flux analysis, M0 and M1 macrophages exhibit comparable trends in oxygen consumption rate (OCR) and extracellular acidification rate (ECAR). Autofluorescence imaging of M0 and M1 macrophages was not only able to show acute changes in the optical redox ratio from pre-differentiation (0 hours) to 72 hours post-cytokine differentiation (M0: 0.320 to 0.258 and M1: 0.316 to 0.386), mean NADH lifetime (M0: 1.272 ns to 1.379 ns and M1: 1.265 ns to 1.206 ns), and A1/A2 ratio (M0: 3.452 to ~ 4 and M1: 3.537 to 4.529) but could also detect heterogeneity within each macrophage population.

Conclusions
Overall, the findings of this study suggest that autofluorescence metabolic imaging could be a reliable technique for longitudinal tracking of immune cell metabolism during activation post-cytokine stimulation.
Turning the tide: understanding estuarine detection range variability via structural equation models
Authors: Bruneel Stijn , Goossens Jolien , Reubens Jan , Pauwels Ine , Moens Tom , Goethals Peter , Verhelst Pieterjan 
Published: November 2023

AbstractInsight into the detection range of acoustic telemetry systems is crucial for both sampling design and data interpretation. The detection range is highly dependent on the environmental conditions and can consequently be substantially different among aquatic systems. Also within systems, temporal variability can be significant. The number of studies to assess the detection range in different systems has been growing, though there remains a knowledge gap in estuarine habitats. In this study, a 2-month experimental set-up was used to assess the detection range variability and affecting environmental factors of an estuary. Given the expected complex interplay of different factors and the difficulties it entails for interpretation, a structural equation modelling (pSEM) approach is proposed. The detection range of this estuarine study was relatively low and variable (average 50% detectability of 106 m and ranging between 72 and 229 m) compared to studies of riverine and marine systems. The structural equation models revealed a clear, yet complex, tidal pattern in detection range variability which was mainly affected by water speed (via ambient noise and tilt of the receivers), water depth and wind speed. The negative effect of ambient noise and positive effect of water depth became more pronounced at larger distances. Ambient noise was not only affected by water speed, but also by water depth, precipitation, tilt angle and wind speed. Although the tilt was affected by water speed, water depth and wind speed, most of the variability in tilt could be traced back to the receiver locations. Similarly, the receiver locations seemed to explain a considerable portion of the detection range variability. Retrospective power analyses indicated that for most factors only a minor gain in explanatory power was achieved after more than two days of data collecting. Redirecting some of the sampling effort towards more spatially extensive measurements seems to be a relevant manner to improve the insights in the performance of telemetry systems in estuarine environments. Since the low and variable detection range in estuaries can seriously hamper ecological inferences, range tests with sound sampling designs and appropriate modelling techniques are paramount.