bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early and mid-term outcomes of off-pump versus on-pump coronary artery bypass surgery in patients with triple-vessel coronary artery disease: a randomized controlled trial
Authors: Forouzannia Seyed Mohammad , Forouzannia Seyed Khalil , Yarahmadi Pourya , Alirezaei Mohammad , Shafiee Akbar , Anari Negin Yazdian , Masoudkabir Farzad , Dehghani Zahra , Pashang Mina 
Published: April 2023

Abstract
Background and aim of the study
Several studies have compared early and late outcomes of on-pump coronary artery bypass grafting (CABG) and off-pump CABG. However, there is still an ongoing debate on this matter, especially in patients with triple-vessel coronary artery disease (3VD).

Methods
We randomly assigned 274 consecutive patients with 3VD to two equal groups to undergo on-pump CABG or off-pump CABG. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), including all-cause mortality, acute coronary syndrome, stroke or transient ischemic attack, and the need for repeat revascularization. The secondary outcomes were postoperative infection, ventilation time, ICU admission duration, hospital stay length, and renal failure after surgery.

Results
The median follow-up duration was 31.2 months (range 24.6–35.2 months). The mean age of patients was 61.4 ± 9.3 years (range: 38–86), and 207 (78.7%) were men. There were 15 (11.2%) and 9 (7.0%) MACCE occurrences in on-pump and off-pump groups, respectively (P value = 0.23). MACCE components including all-cause death, non-fatal MI, CVA, and revascularization did not significantly differ between on-pump and off-pump groups. We observed no difference in the occurrence of MACCE between off-pump and on-pump groups in multivariable regression analysis (HR = 0.57; 95% CI 0.24–1.32; P value = 0.192). There were no statistical differences in postoperative outcomes between the off-pump and on-pump CABG groups.

Conclusions
Off-pump CABG is an equal option to on-pump CABG for 3VD patients with similar rates of MACCE and postoperative complications incidence when surgery is performed in the same setting by an expert surgeon in both methods. (IRCT20190120042428N1).
Novel strategies for cancer immunotherapy: counter-immunoediting therapy
Authors: Liu Shaochuan , Sun Qian , Ren Xiubao 
Published: April 2023

AbstractThe advent of immunotherapy has made an indelible mark on the field of cancer therapy, especially the application of immune checkpoint inhibitors in clinical practice. Although immunotherapy has proven its efficacy and safety in some tumors, many patients still have innate or acquired resistance to immunotherapy. The emergence of this phenomenon is closely related to the highly heterogeneous immune microenvironment formed by tumor cells after undergoing cancer immunoediting. The process of cancer immunoediting refers to the cooperative interaction between tumor cells and the immune system that involves three phases: elimination, equilibrium, and escape. During these phases, conflicting interactions between the immune system and tumor cells result in the formation of a complex immune microenvironment, which contributes to the acquisition of different levels of immunotherapy resistance in tumor cells. In this review, we summarize the characteristics of different phases of cancer immunoediting and the corresponding therapeutic tools, and we propose normalized therapeutic strategies based on immunophenotyping. The process of cancer immunoediting is retrograded through targeted interventions in different phases of cancer immunoediting, making immunotherapy in the context of precision therapy the most promising therapy to cure cancer.
Effect of altitude and solvent on Psidium guajava Linn. leaves extracts: phytochemical analysis, antioxidant, cytotoxicity and antimicrobial activity against food spoilage microbes
Authors: Majhi Rita , Maharjan Rukusha , Shrestha Mitesh , Mali Aatish , Basnet Angisha , Baral Manish , Duwal Rabin , Manandhar Rojlina , Rajbhandari Prajwal 
Published: April 2023

Abstract
Background
Guava (Psidium guajava Linn.) has been traditionally used in the treatment of a wide range of diseases due to its rich content of secondary metabolites.

Aim
This study was aimed to evaluate the effect of altitude and solvent systems on guava leaves crude extract’s phenolics and flavonoid content, antioxidant, antimicrobial, and toxicity nature.

Methods
Guava leaves were collected from three different geographical locations in Nepal while solvents with an increasing polarity index were used for extraction. The yield percentage of extracts was calculated. Total Phenolic Content, Total Flavonoid Content, and antioxidant activity were determined by the Folin-Ciocalteu method, Aluminium chloride colorimetric method, and DPPH (2,2′-Diphenyl-1-picrylhydrazyl) assay respectively. The quantification of fisetin and quercetin was performed using the HPLC with method validation. The antimicrobial activity of the extracts was tested against bacteria and fungus isolated from spoiled fruits and vegetables and identified through 16s and 18s rRNA sequencing. Finally, Brine Shrimp Lethality Assay (BSLA) was used for testing the toxicity of the extracts.

Results
The phenolic and total flavonoid content was found to be higher in ethanol extract (331.84 mg GAE/g dry extract) and methanol extract (95.53 mg QE/g dry extract) from Kuleshwor respectively. Water extract of guava leaves from Kuleshwor (WGK) did not show significantly different antioxidant activity when compared to methanol and ethanol extracts. Fisetin and quercetin were higher in WGK (1.176 mg/100 g) and (10.967 mg/100 g) dry extract weight respectively. Antibacterial activity against food spoilage bacteria was dose-dependent and found to be highest for all the extracts from different solvents and altitudes at higher concentrations (80 mg/ml). Similarly, methanol and ethanol guava extracts from all locations showed antifungal activity against Geotrichum candidum RIBB-SCM43 and Geotrichum candidum RIBB-SCM44. WGK was found to be non-toxic.

Conclusion
Our study concludes that the antioxidant and antimicrobial activity of WGK was found to be similar statistically to that of methanol and ethanol extracts of Bishnupur Katti and Mahajidiya. These results suggest the possibility of using water as a sustainable solvent to extract natural antioxidant and antimicrobial compounds which can further be used as natural preservatives to extend the shelf life of fruits and vegetables.
Perceptions, facilitators, and barriers regarding use of the injury prevention exercise programme Knee Control among players and coaches in youth floorball: a cross-sectional survey study
Authors: Åkerlund Ida , Sonesson Sofi , Lindblom Hanna , Waldén Markus , Hägglund Martin 
Published: April 2023

Abstract
Background
Youth participation in team ball sports is associated with a risk of both acute and gradual onset injuries but today there are several efficacious injury prevention exercise programmes (IPEPs). However, there is limited research about how to implement those programmes and the perceived barriers and facilitators among end-users.

Objective
To investigate perceptions of the IPEP Knee Control and facilitators and barriers to programme use among coaches and youth floorball players, and explore factors associated with planned maintenance of Knee Control.

Methods
This cross-sectional study is a sub-analysis of data from the intervention group of a cluster randomised controlled trial. Perceptions about Knee Control and facilitators and barriers to programme use were evaluated with surveys pre-intervention and post-season. 246 youth floorball players aged 12–17 years, and 35 coaches that reported no use of IPEPs during the preceding year were included. Descriptive statistics and univariate and multivariate ordinal logistic regression models were undertaken with the dependent variables: coaches’ planned maintenance and players’ opinions of maintenance of Knee Control. Independent variables were perceptions, facilitators and barriers regarding use of Knee Control and other potential influencing factors.

Results
88% of the players believed that Knee Control can reduce injury risk. Common facilitators to Knee Control use among coaches were support, education and high player motivation, and common barriers were that injury prevention training was time-consuming, lack of space to execute the exercises and lack of player motivation. Players who planned to maintain use of Knee Control had higher outcome expectancies and belief in one’s ability to use Knee Control (action self-efficacy). Coaches who planned to maintain Knee Control had higher action self-efficacy and to a lesser extent considered that Knee Control takes too much time.

Conclusions
Support, education, and high player motivation are key facilitators, while lack of time and space for injury prevention training and boring exercises are key barriers for coaches and players to use Knee Control. High action self-efficacy among coaches and players seems to be a prerequisite for maintained use of IPEPs.
A test battery for evaluation of muscle strength, balance and functional performance in subjects with chronic ankle instability: a cross-sectional study
Authors: Ryman Augustsson Sofia , Sjöstedt Erik 
Published: April 2023

Abstract
Background
Studies investigating ankle condition in subjects with chronic ankle instability (CAI) using an on-the-field test battery are scarce. Understanding which tests that are most challenging for these subjects has the potential to set realistic goals in rehabilitation and return-to-sports criteria. Thus, the primary aim of this study was to investigate CAI subjects regarding strength, balance and functional performance with an easily used test battery that required minimal equipment.

Methods
This study was conducted with a cross-sectional design. A total of 20 CAI subjects, engaged in sports, and 15 healthy subjects serving as a control group, were tested for assessment of strength, balance and functional performance. A test battery was developed accordingly; isometric strength in inversion and eversion, the single leg stance test (SLS), single leg hop for distance (SLHD) and side hop test. The limb symmetry index was calculated to determine whether a side-to-side lower limb difference could be classified as normal or abnormal. The sensitivity of the test battery was also calculated.

Results
The subjects were 20% weaker on the injured side compared with the non-injured side in eversion (p < 0.01) and 16% weaker in inversion (p < 0.01) (Table 2). For the SLS test, the mean score of the injured side was 8 points (67%) higher (more foot lifts) compared to the non-injured side (p < 0.01). The mean distance of the SLHD was 10 cm (9%) shorter for the injured side compare to the non-injured side (p = 0.03). The mean number of side hop was 11 repetitions (29%) fewer for the injured side compare to the non-injured side (p < 0.01). Six of the 20 subjects obtained abnormal LSI values in all five tests whereas none obtained normal values in all tests. The sensitivity of the test battery was 100%.

Conclusion
Deficits in muscle strength, balance and functional performance appear to be present in CAI subjects with the largest impairments in balance and side hop performance, which stresses the need for return to sport criteria for this group of subjects.

Trial registration
Registered retrospectively on 24/01/2023. NCT05732168.
Mucosal healing assessment in Crohn’s disease with normalized iodine concentration from dual-energy CT enterography: comparison with endoscopy
Authors: Zhu Chao , Hu Jing , Rong Chang , Zhou Jianhua , Zhang Bo , Gao Yankun , Li Cuiping , Li Jianying , Wu Xingwang 
Published: April 2023

AbstractObjectivesMucosal healing (MH) is an important goal in the treatment of patients with Crohn’s disease (CD). Noninvasive assessment of MH with normalized iodine concentration (NIC) is unknown.MethodsIn this retrospective study, 94 patients with diagnosed CD underwent endoscopy and dual-energy CT enterography (DECTE) at the post-infliximab treatment review. Two radiologists reviewed DECTE images by consensus for assessing diseased bowel segments of the colon or terminal ileum, and the NIC was measured. Patients were divided into transmural healing (TH), MH and non-MH groups. The diagnostic performance of the MH and non-MH groups with clinical factors and NIC was assessed utilizing receiver operating characteristic (ROC) curve analysis.ResultsOf the 94 patients included in our study, 8 patients achieved TH, 34 patients achieved MH, and 52 patients did not achieve MH at the post-IFX treatment review. The area under the ROC curve (AUC), sensitivity, specificity, and accuracy values were 0.929 (95% confidence interval [CI] 0.883–0.967), 0.853, 0.827, and 0.837, respectively, for differentiating MHs from non-MHs, and the optimal NIC threshold was 0.448. The AUC of the combined model for distinguishing MHs from non-MHs in CD patients, which was based on the NIC and calprotectin, was 0.964 (95% CI 0.935–0.987).ConclusionsThe normalized iodine concentration measurement in DECTE has good performance in assessment MH in patients with CD. Iodine concentration from DECTE can be used as a radiologic marker for MH.
A thrombophilic allele of clotting Factor VII/VIIa promoting recurrent pulmonary emboli, clinical details, and a structural model of the altered protein: a case report
Authors: Newman Kenneth , Daldal Fevzi , Dancis Andrew 
Published: April 2023

Abstract
Background
The clotting or hemostasis system is a meticulously regulated set of enzymatic reactions that occur in the blood and culminate in formation of a fibrin clot. The precisely calibrated signaling system that prevents or initiates clotting originates with the activated Factor Seven (FVIIa) complexed with tissue factor (TF) formed in the endothelium. Here we describe a rare inherited mutation in the FVII gene which is associated with pathological clotting.

Case presentation
The 52-year-old patient, with European, Cherokee and African American origins, FS was identified as having low FVII (10%) prior to elective surgery for an umbilical hernia. He was given low doses of NovoSeven (therapeutic Factor VIIa) and had no unusual bleeding or clotting during the surgery. In fact, during his entire clinical course he had no unprovoked bleeding. Bleeding instances occurred with hemostatic stresses such as gastritis, kidney calculus, orthopedic surgery, or tooth extraction, and these were handled without factor replacement. On the other hand, FS sustained two unprovoked and life-threatening instances of pulmonary emboli, although he was not treated with NovoSeven at any time close to the events. Since 2020, he has been placed on a DOAC (Direct Oral Anticoagulant, producing Factor Xa inhibition) and has sustained no further clots.

Possible mechanism of (unauthorized) FVII activation
FS has a congenitally mutated FVII/FVIIa gene, which carries a R315W missense mutation in one allele and a mutated start codon (ATG to ACG) in the other allele, thus rendering the patient effectively homozygous for the missense FVII. Structure based comparisons with known crystal structures of TF-VIIa indicate that the patient's missense mutation is predicted to induce a conformational shift of the C170's loop due to crowding of the bulky tryptophan to a distorted "out" position (Fig. 1). This mobile loop likely forms new interactions with activation loop 3, stabilizing a more active conformation of the FVII and FVIIa protein. The mutant form of FVIIa may be better able to interact with TF, displaying a modified serine protease active site with enhanced activity for downstream substrates such as Factor X.

Conclusions
Factor VII can be considered the gatekeeper of the coagulation system. Here we describe an inherited mutation in which the gatekeeper function is altered. Instead of the expected bleeding manifestations resulting from a clotting factor deficiency, the patient FS suffered clotting episodes. The efficacy of the DOAC in treating and preventing clots in this unusual situation is due to its target site of inhibition (anti-Xa), which lies downstream of the site of action of FVIIa/TF.
Resource allocation and network pricing based on double auction in mobile edge computing
Authors: Zheng Xiao , Shah Syed Bilal Hussian , Usman Saeeda , Mahfoudh Saoucene , Shemim KS Fathima , Kumar Shukla Piyush 
Published: April 2023

AbstractBy transferring power-hungry huge data centers to lightweight Internet of Things (IoT) mobile devices, mobile edge computing (MEC) has completely changed the IoT. For MEC, to optimize economic gains and motivate profit-oriented entities, the joint resource allocation and network economics problem must be solved, and the joint issue is limited by local constraints, namely, the edge server only serves multiple nearby mobile devices, which is restricted by its available energy. The article studies the jointly issue of network economics and energy allocation in MEC, where mobile device apply for offloading at a purported bid and an edge server supplies its restricted serving at an asking price. In particular, this paper puts forward two dynamic pricing double auction strategies in the MEC system, i.e., a double auction according to the break-even mechanism (DABM) and a more practical double auction based on dynamic pricing mechanism (DADPM) to decide the matching between mobile devices and edge servers, and the pricing strategy for high-priced economic profit in the case of local restricts. Theoretical analysis shows that the proposed two algorithms have properties such as budget balance, individual rationality, economic benefit, authenticity. Extensive simulation experiments evaluate the efficiency of the system, and results verify that the proposed two schemes will greatly make better the economic benefits of MEC.
Design thinking as an effective method for problem-setting and needfinding for entrepreneurial teams addressing wicked problems
Authors: Bender-Salazar Rahmin 
Published: April 2023

AbstractOrganizations in a wide array of fields and disciplines are increasingly using design thinking as an innovative process to create products or services that address wicked problems in their industries. Design thinking, a method of creative and collaborative problem solving originating in the tactics of designers, is a product design and development process that is, more and more, being used as a tool to move innovation forward and structure creation processes in diverse disciplines, from product development to food creation to social science research. Increasingly design thinking has become popular beyond the confines of creative and design disciplines and into the realm of wicked problems in social and ecological systems. While design thinking has many forms and applications, this study uses a refined version built upon the key themes of inspiration, ideation, and implementation as defined by Tim Brown, CEO of IDEO (2009), and situates it within the social science discipline—namely, systems thinking, organizational learning, and action research. Through a distilled design structure this flexible methodology combines insights from organizational development, social psychology, systems theory, and design research. By embedding learning and reflective practices into the structure of design thinking, a hybrid model of design thinking emerges that is a more effective tool for framing, setting in context, and solving these types of problems within teams.
X-ray crystal structure, UV–Vis and NMR spectroscopic, and molecular docking studies of pyribencarb isomers
Authors: Park Eunyoung , Lee Jiho , Kim Jeong-Han , Moon Joon-Kwan 
Published: April 2023

AbstractThe crystal structures of the pyribencarb E and Z stereoisomers were determined using single-crystal X-ray crystallography. The isomers were confirmed a single data respectively by crystal analysis, LC-UVD mass spectrometry, and NMR spectroscopy. Pyribencarb E crystallizes in triclinic P − 1 and the Z isomer in monoclinic P21/c, with the crystal structures showing comparable packing motifs. Moreover, molecular docking was carried out with cytochrome bc1, revealing binding energies in the ranges of − 24.9 to − 17.6 and − 21.6 to − 14.7 kcal/mol for the E and Z isomers, respectively. Through a combined experimental and theoretical approach, this study contributes to our understanding of pesticides.
Graphical Abstract
Climate variability, agricultural technologies adoption, and productivity in rural Nigeria: a plot-level analysis
Authors: Amankwah Akuffo 
Published: April 2023

Abstract
Background
Increasing agricultural productivity has long been touted as the main avenue to lifting the rural poor out of poverty and ensuring their sustainable development. The adoption of sustainable agricultural practices (SAPs) is vital for spurring agricultural productivity in a changing climate environment. This paper examines the factors (including long-term climate variability) influencing the adoption of multiple SAPs (improved seeds, organic and inorganic fertilizers, and legume intercropping) and their impact on crop productivity.

Methodology
This study uses a nationally representative, geo-referenced plot-level data from a household survey in Nigeria. A multistage sampling technique was used to select households for the survey. The multivariate and ordered probit models were employed to estimate the adoption and intensity of adoption respectively, while the instrumental variables approach was used to examine the impact of the technologies on productivity.

Results
The results provide evidence of interdependences between the SAPs, and that the factors that determine the initial adoption decisions are not necessarily the same factors that influence the intensity of use of the technologies. Climate risks in terms of high variability in temperature and rainfall affect SAPs adoption and their intensity of use. Access to agricultural extension, years of education and off-farm activities of the plot manager, and household wealth influence the use of improved seeds and inorganic fertilizer. Organic fertilizers are used mainly by households with large livestock units and those that live in areas with low soil nutrients and greenness index. In general, the intensity of SAPs adoption is influenced by wage and off-farm activities, and access to agricultural extension services. On the productivity side, inorganic fertilizer is positively correlated with plot-level productivity.

Conclusions
These results have implications for rural development policies in Nigeria aimed at nudging farmers to adopt multiple technologies on their plots, while enhancing an outward shift of their crop production functions. Providing technical and financial resources to extension agents is crucial so they could better reach rural smallholder households with the knowledge and benefits of these SAPs. In addition, smallholder households should diversify their livelihood portfolios to include non-farm income generating activities. Agricultural Research and Development should target factors that respond to climate variabilities (such as drought resistant and early maturing varieties). There is a need for improved infrastructures (road networks to allow easy market access as well as access to credit) that will allow farmers to access these innovations.