bluuebunny/crossref_metadata_2025_split huggingface dataset:
The influence of mouth opening on pharyngeal pressure loss and its underlying mechanism: A computational fluid dynamic analysis
Authors: Hu Bin , Yin Guoping , Fu Song , Zhang Baoshou , Shang Yan , Zhang Yuhuan , Ye Jingying 
Published: January 2023

Objective: During inspiration, mechanical energy generated from respiratory muscle produces a negative pressure gradient to fulfill enough pulmonary ventilation. The pressure loss, a surrogate for energy loss, is considered as the portion of negative pressure without converting into the kinetic energy of airflow. Mouth opening (MO) during sleep is a common symptom in patients with obstructive sleep apnoea-hypopnea syndrome (OSAHS). This study aimed to evaluate the effects of mouth opening on pharyngeal pressure loss using computational fluid dynamics (CFD) simulation.Methods: A total of four subjects who were morphologically distinct in the pharyngeal characteristics based on Friedman tongue position (FTP) grades were selected. Upper airway computed tomography (CT) scan was performed under two conditions: Mouth closing (MC) and mouth opening, in order to reconstruct the upper airway models. computational fluid dynamics was used to simulate the flow on the two different occasions: Mouth closing and mouth opening.Results: The pharyngeal jet was the typical aerodynamic feature and its formation and development were different from mouth closing to mouth opening in subjects with different Friedman tongue position grades. For FTP I with mouth closing, a pharyngeal jet gradually formed with proximity to the velopharyngeal minimum area plane (planeAmin). Downstream the planeAmin, the jet impingement on the pharyngeal wall resulted in the frictional loss associated with wall shear stress (WSS). A rapid luminal expansion led to flow separation and large recirculation region, corresponding to the interior flow loss. They all contributed to the pharyngeal total pressure loss. While for FTP I with mouth opening, the improved velopharyngeal constriction led to smoother flow and a lower total pressure loss. For FTP IV, the narrower the planeAmin after mouth opening, the stronger the jet formation and its impingement on the pharyngeal wall, predicting a higher frictional loss resulted from higher WSS. Besides, a longer length of the mouth opening-associated constant constrictive segment was another important morphological factor promoting frictional loss.Conclusion: For certain OSAHS patients with higher Friedman tongue position grade, mouth opening-related stronger jet formation, more jet breakdown and stronger jet flow separation might contribute to the increased pharyngeal pressure loss. It might require compensation from more inspiratory negative static pressure that would potentially increase the severity of OSAHS.
Biomarkers for prognostic functional recovery poststroke: A narrative review
Authors: Zhang Jack Jiaqi , Sánchez Vidaña Dalinda Isabel , Chan Jackie Ngai-Man , Hui Edward S. K. , Lau Kui Kai , Wang Xin , Lau Benson W. M. , Fong Kenneth N. K. 
Published: January 2023

Background and objective: Prediction of poststroke recovery can be expressed by prognostic biomarkers that are related to the pathophysiology of stroke at the cellular and molecular level as well as to the brain structural and functional reserve after stroke at the systems neuroscience level. This study aimed to review potential biomarkers that can predict poststroke functional recovery.Methods: A narrative review was conducted to qualitatively summarize the current evidence on biomarkers used to predict poststroke functional recovery.Results: Neurophysiological measurements and neuroimaging of the brain and a wide diversity of molecules had been used as prognostic biomarkers to predict stroke recovery. Neurophysiological studies using resting-state electroencephalography (EEG) revealed an interhemispheric asymmetry, driven by an increase in low-frequency oscillation and a decrease in high-frequency oscillation in the ipsilesional hemisphere relative to the contralesional side, which was indicative of individual recovery potential. The magnitude of somatosensory evoked potentials and event-related desynchronization elicited by movement in task-related EEG was positively associated with the quantity of recovery. Besides, transcranial magnetic stimulation (TMS) studies revealed the potential values of using motor-evoked potentials (MEP) and TMS-evoked EEG potentials from the ipsilesional motor cortex as prognostic biomarkers. Brain structures measured using magnetic resonance imaging (MRI) have been implicated in stroke outcome prediction. Specifically, the damage to the corticospinal tract (CST) and anatomical motor connections disrupted by stroke lesion predicted motor recovery. In addition, a wide variety of molecular, genetic, and epigenetic biomarkers, including hemostasis, inflammation, tissue remodeling, apoptosis, oxidative stress, infection, metabolism, brain-derived, neuroendocrine, and cardiac biomarkers, etc., were associated with poor functional outcomes after stroke. However, challenges such as mixed evidence and analytical concerns such as specificity and sensitivity have to be addressed before including molecular biomarkers in routine clinical practice.Conclusion: Potential biomarkers with prognostic values for the prediction of functional recovery after stroke have been identified; however, a multimodal approach of biomarkers for prognostic prediction has rarely been studied in the literature. Future studies may incorporate a combination of multiple biomarkers from big data and develop algorithms using data mining methods to predict the recovery potential of patients after stroke in a more precise way.
A study on the material properties of novel PEGDA/gelatin hybrid hydrogels polymerized by electron beam irradiation
Authors: Şener Raman Tuğçe , Kuehnert Mathias , Daikos Olesya , Scherzer Tom , Krömmelbein Catharina , Mayr Stefan G. , Abel Bernd , Schulze Agnes 
Published: January 2023

Gelatin-based hydrogels are highly desirable biomaterials for use in wound dressing, drug delivery, and extracellular matrix components due to their biocompatibility and biodegradability. However, insufficient and uncontrollable mechanical properties and degradation are the major obstacles to their application in medical materials. Herein, we present a simple but efficient strategy for a novel hydrogel by incorporating the synthetic hydrogel monomer polyethylene glycol diacrylate (PEGDA, offering high mechanical stability) into a biological hydrogel compound (gelatin) to provide stable mechanical properties and biocompatibility at the resulting hybrid hydrogel. In the present work, PEGDA/gelatin hybrid hydrogels were prepared by electron irradiation as a reagent-free crosslinking technology and without using chemical crosslinkers, which carry the risk of releasing toxic byproducts into the material. The viscoelasticity, swelling behavior, thermal stability, and molecular structure of synthesized hybrid hydrogels of different compound ratios and irradiation doses were investigated. Compared with the pure gelatin hydrogel, 21/9 wt./wt. % PEGDA/gelatin hydrogels at 6 kGy exhibited approximately up to 1078% higher storage modulus than a pure gelatin hydrogel, and furthermore, it turned out that the mechanical stability increased with increasing irradiation dose. The chemical structure of the hybrid hydrogels was analyzed by Fourier-transform infrared (FTIR) spectroscopy, and it was confirmed that both compounds, PEGDA and gelatin, were equally present. Scanning electron microscopy images of the samples showed fracture patterns that confirmed the findings of viscoelasticity increasing with gelatin concentration. Infrared microspectroscopy images showed that gelatin and PEGDA polymer fractions were homogeneously mixed and a uniform hybrid material was obtained after electron beam synthesis. In short, this study demonstrates that both the presence of PEGDA improved the material properties of PEGDA/gelatin hybrid hydrogels and the resulting properties are fine-tuned by varying the irradiation dose and PEGDA/gelatin concentration.
Impact of pulmonary arterial systolic pressure on patients with mitral valve disease combined with atrial fibrillation
Authors: Zheng Tie , Zhao Yichen , Ye Qing , Zheng Shuai , Meng Fei , Hu Qiuming , Zhang Haibo , Han Jie , Tian Baiyu , Zhu Junming , Wang Jiangang 
Published: January 2023

ObjectiveTo determine whether different changes of pulmonary artery systolic pressure (PASP) after surgeries have an impact on the long-term outcomes in patients with rheumatic and degenerative mitral valve (MV) disease and atrial fibrillation.MethodsBetween 2004 and 2016, 1,188 patients with rheumatic and degenerative MV disease undergoing MV and Cox-Maze procedure were identified. Clinic outcomes, as well as rhythm state and echocardiography indices in long-term follow-up were recorded. Patients were grouped by the changes of PASP (persistently normal, persistently increased, increased, and decreased) from preoperative estimation to follow-up.ResultsA complete echocardiography was performed at baseline and after 5 years. During follow-up, free of death and atrial fibrillation (AF) off antiarrhythmic drugs was 90 and 61%, 78 and 41% at 5 and 10 years, respectively. Survival rate was higher in patients with persistently normal and became worse in patients with persistently increased and increased PASP (log-rank 166.0, P &lt; 0.0001). Moreover, the patients with persistently normal PASP had a lowest risk of recurrent AF (SHR: 0817; CI: 0.765–0.872; P &lt; 0.0001) after considering death as a competing risk. A persistently normal PASP at follow-up and degenerative MV disease were associated with improved survival and sinus rhythm (SR) maintenance at multivariable Cox regression analysis (P &lt; 0.05).ConclusionPatients with degenerative MV disease or have persistently normal PASP during follow-up have better survival and SR maintenance rate than patients with either rheumatic MV disease or persistently abnormal PASP.
The association between chronic heart failure and frailty index: A study based on the National Health and Nutrition Examination Survey from 1999 to 2018
Authors: Chen Xiaozhe , Hou Chunlei , Yao Lei , Ma Yulong , Li Yunfeng , Li Jianhua , Gui Mingtai , Wang Mingzhu , Zhou Xunjie , Lu Bo , Fu Deyu 
Published: January 2023

ObjectiveThis study aims to explore the association between the frailty index and chronic heart failure (CHF).MethodsWe collected data from the National Health and Nutrition Examination Survey (NHANES) (1998–2018) database to assess the association between CHF and frailty. Demographic, inquiry, laboratory examinations, and characteristics were gathered to compare CHF and non-CHF groups. Multiple logistic regression analysis was performed to explore the relationship between frailty and CHF. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence interval (CI) for mortality from all causes and cardiovascular disease (CVD).ResultsA total of 16,175 participants with cardiac and cerebrovascular disease were categorized into CHF (n = 1,125) and non-CHF (n = 15,050) groups. In patients with CHF, the prevalence of frailty, pre-frailty, and non-frailty were 66.31, 30.93, and 2.75%, respectively. In multiple logistic regression, patients with CHF who were male (OR = 0.63, 95% CI: 3.11–5.22), whose annual family income was over $20,000 (OR = 0.52, 95% CI: 0.37–0.72, p &lt; 0.001), or with normal hemoglobin level (OR = 0.77, 95% CI: 0.68–0.88, P &lt; 0.001) had a lower likelihood of frailty. CHF patients with hypertension (OR = 3.60, 95% CI: 2.17–5.99, P &lt; 0.0001), coronary heart disease (OR = 1.76, 95% CI: 1.10–2.84, P = 0.02), diabetes mellitus (OR = 1.89, 95% CI: 1.28–2.78, P &lt; 0.001), and stroke (OR = 2.52, 95% CI: 1.53–4.15, P &lt; 0.001) tended to be frail. Survival analysis suggested that pre-frailty and frailty were related to poor all-cause deaths (HR = 1.48, 95% CI: 1.36–1.66; HR = 2.77, 95% CI: 2.40–3.18) and CVD mortality (HR = 1.58, 95% CI: 1.26–1.97; HR = 2.55, 95% CI: 2.02–3.21). CHF patients with frailty were strongly connected with all-cause death (HR = 2.14, 95% CI: 1.27–3.62).ConclusionFrailty was positively associated with CHF. Patients with CHF who were male, whose annual family income was over $20,000, or with normal hemoglobin level were negatively correlated to frailty. For patients with cardiac and cerebrovascular disease as well as CHF, frailty was strongly connected with all-cause death.
Periodontitis was associated with worse clinical outcomes after catheter ablation for paroxysmal atrial fibrillation
Authors: Tashiro Akira , Yonetsu Taishi , Aoyama Norio , Shiheido-Watanabe Yuka , Niida Takayuki , Miyazaki Shinsuke , Maejima Yasuhiro , Goya Masahiko , Isobe Mitsuaki , Iwata Takanori , Sasano Tetsuo 
Published: January 2023

BackgroundPeriodontitis (PD), a common chronic inflammatory disease, may be associated with the subsequent development of atrial fibrillation (AF) through a mechanism of systemic inflammation. However, little is known about the impact of PD on the recurrence of atrial fibrillation after catheter ablation (CA).MethodsA total of 132 patients (age 62.2 ± 10.6 years; 72.7% male) who underwent periodontal examinations and the first CA for paroxysmal atrial fibrillation (PAF) were investigated. Clinical periodontal examination was performed by independent trained periodontists, and patients were diagnosed with PD when the maximum periodontal probing depth was equal to or greater than 4 mm and bleeding on probing was evident. Of these, 71 patients (54%) were categorized as those with PD (PD group) and the other 61 (46%) as those without PD (non-PD group). Pulmonary vein isolation was performed in a standard fashion.ResultsKaplan–Meier curve analysis revealed worse atrial arrhythmia recurrence-free survival probabilities after CA for PAF in the PD group than in the non-PD group (64.8% versus 80.3%, respectively; p = 0.024) during a median follow-up period of 3.0 (interquartile range: 1.1–6.4) years. Cox regression analysis revealed PD as a significant predictor of arrhythmia recurrence (hazard ratio: 2.063, 95% confidence interval: 1.018–4.182), after adjusting for age and gender.ConclusionPeriodontitis was independently associated with an increased risk of arrhythmia recurrence after the first CA for PAF. Our results may suggest that the periodontal status is potentially a modifiable determinant of the outcomes after PAF ablation, and further prospective studies are warranted.
End-diastolic forward flow in repaired tetralogy of Fallot: Mid-term outcomes from a single center
Authors: Huang Ying , Cai Xiaowei , Zhong Lishan , Xie Wen , Lou Qi , Ma Jianrui , Chen Jimei , Zhuang Jian , Wen Shusheng , Zhao Junfei 
Published: January 2023

BackgroundPulmonary arterial end-diastolic forward flow (EDFF) following repaired tetralogy of Fallot (rTOF) is recognized as right ventricular (RV) restrictive physiology, which is closely related to poor prognosis. This study sought to review mid-term experience and investigate the risk factors of EDFF in the rTOF patients.MethodsFrom September 2016 to January 2019, 100 patients (age &lt; 18 years old) who underwent complete tetralogy of Fallot (TOF) repair were enrolled and were divided into EDFF group (n = 52) and non-EDFF group (n = 48) based on the presence of postoperative EDFF. Elastic net analysis was performed for variable selection. Univariate and multivariate logistic analyses were used to analyze the correlation between risk factors and EDFF.ResultsEnd-diastolic forward flow group had lower systolic blood pressure (P = 0.037), diastolic blood pressure (P = 0.027), and higher vasoactive-inotrope score within 24 h after surgery (P = 0.022) than non-EDFF group. Transannular patch (TAP) was an independent predictor of postoperative EDFF [P = 0.029, OR: 2.585 (1.102∼6.061)]. Patients were followed up for a median of 2.6 years [interquartile range (IQR) 1.6] after the first TOF repair. During follow-up, the prevalence of the EDFF was lower in those with pulmonary valve (PV) reconstructions than that in those undergoing patch enlargement without PV reconstructions in the primary TOF repair (P &lt; 0.001).ConclusionEnd-diastolic forward flow was associated with TAP. Patients with EDFF might have a transient hemodynamic instability in the early postoperative period. PV reconstructions in the TOF repair might reduce the incidence of EDFF in the mid-term follow-up.
Trend and early outcomes in isolated surgical aortic valve replacement in the United Kingdom
Authors: Chan Jeremy , Dimagli Arnaldo , Fudulu Daniel P. , Sinha Shubhra , Narayan Pradeep , Dong Tim , Angelini Gianni D. 
Published: January 2023

ObjectiveSurgical aortic valve replacement (SAVR) is traditionally the gold-standard treatment in patients with aortic valve disease. The advancement of transcatheter aortic valve replacement (TAVR) provides an alternative treatment to patients with high surgical risks and those who had previous cardiac surgery. We aim to evaluate the trend, early clinical outcomes, and the choice of prosthesis use in isolated SAVR in the United Kingdom.MethodsAll patients (n = 79,173) who underwent elective or urgent isolated surgical aortic valve replacement (SAVR) from 1996 to 2018 were extracted from the National Adult Cardiac Surgery Audit database. Patients who underwent additional procedures and emergency or salvage SAVR were excluded from the study. Trend and clinical outcomes were investigated in the whole cohort. Patients who had previous cardiac surgery, high-risk groups (EuroSCORE II &gt;4%), and predicted/observed mortality were evaluated. Furthermore, the use of biological prostheses in five different age groups, that are &lt;50, 50–59, 60–69, 70–79, and &gt;80, was investigated. Clinical outcomes between the use of mechanical and biological aortic valve prostheses in patients &lt;65 years old were analyzed.ResultsThe number of isolated SAVR increased across the study period with an average of 4,661 cases performed annually after 2010. The in-hospital/30-day mortality rate decreased from 5.28% (1996) to 1.06% (2018), despite an increasing trend in EuroSCORE II. The number of isolated SAVR performed in octogenarians increased from 596 to 2007 (the first year when TAVR was introduced in the UK) to 872 in 2015 and then progressively decreased to 681 in 2018. Biological prosthesis usage increased across all age groups, particularly in the 60–69 group, from 24.59% (1996) to 81.87% (2018). There were no differences in short-term outcomes in patients &lt;65 years old who received biological or mechanical prostheses.ConclusionSurgical aortic valve replacement remains an effective treatment for patients with isolated aortic valve disease with a low in-hospital/30-day mortality rate. The number of patients with high-risk and octogenarians who underwent isolated SAVR and those requiring redo surgery has reduced since 2016, likely due to the advancement in TAVR. The use of biological aortic prostheses has increased significantly in recent years in all age groups.
Research on the breaking mechanism of bolts and cables in the gateway driven along a small coal pillar in the Datong mining area and the corresponding control technology
Authors: Peng Cheng 
Published: January 2023

The gateway of the thick coal seam working face in the Datong mining area was excavated along a small coal pillar, resulting in serious bolt (cable) breaking failure, strong surrounding rock deformation, serious ground pressure appearance, and difficulties surrounding rock control. So, the bolt (cable) breaking characteristics and corresponding causes of the 5106 return air gateway with a small coal pillar in Dongzhouyao coal mine (a mine in the Datong mining area) were analyzed through an on-site investigation, surrounding rock geotechnical parameters test, theoretical analysis, laboratory experiment, on-site engineering test, and other research means. The study carried out laboratory testing and analysis on the stress distribution characteristics and laws of the bolts, put forward the bolt (cable) breaking mechanism and prevention countermeasures, and completed the field industrial test of the surrounding rock pressure relief and support joint control technology in the gateway. The on-site tracking and data showed that the breaking conditions of the bolts (cables) were significantly reduced by improving the initial force of the bolts (cables), optimizing the supporting materials and components, canceling the pressure ring, and implementing the hydraulic fracturing top cutting and pressure relief + high prestressed full cable support technology. The displacement of the top and bottom plates was reduced by 51%, the displacement of the two sides was reduced by 46%, and the influence distance of the working face advance stress was reduced from 85 m to 30 m. The successful implementation of the study results in the small pillar gateway of the Dongzhouyao coal mine provided a reference for the promotion and application of similar gateway conditions in the Datong mining area.
Analysis of flow field in a blast simulator combined-driven by explosive charge and compressed gas
Authors: Chen Zhuo , Ren Huiqi , Ning Huijun , Zhou Songbai , Long Zhilin , Huang Kui 
Published: January 2023

The flow field characteristics of blast simulators with the explosive-driven method and compression-driven method have been extensively investigated; however, limited effort has been made to the flow field in blast simulators combined-driven by explosive charge and compressed gas. In this paper, the finite volume method governed by the Navier–Stokes equation based on an explosive detonation and k-omega SST turbulence equation was used to analyze the flow field characteristics of blast simulators with three kinds of drive methods, namely, explosive-driven method, compression-driven method, and combined-driven method. The results show that the numerical method could simulate the flow field characteristics of the blast simulators with the explosive-driven method and compression-driven method accurately by comparing to the experimental data. Also, the influence of air turbulence on the explosion flow field cannot be neglected in the case of long running time. It is obtained that the combined-driven method could increase the pressure peak value of shock waves and extends positive pressure duration effectively, owing to the interaction of the shock waves generated from the explosive detonation and the rarefaction wave formed by rupturing the diaphragm. The first overpressure peak value, the second overpressure peak value, and the positive pressure duration obtained by the combined-driven method of 5 kg TNT and 0.3 MPa compressed gas were 1.669 times, 2.172 times, and 2.308 times more than those obtained by the explosive-driven method of 5 kg TNT, respectively. The maximum overpressure and positive pressure duration obtained by the combined-driven method of 5 kg TNT and 0.3 MPa compressed gas were 2.56 times and 1.162 times more than those obtained by the compression-driven method of 0.3 MPa compressed gas, respectively. Moreover, various shock wave environments could be simulated by controlling the charge mass of explosive charge and the initial pressure of compressed gas.