bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment of patients with metastatic epidural spinal cord compression using an enhanced recovery after surgery program
Authors: Lei Mingxing , Zheng Wenjing , Cao Yuncen , Cao Xuyong , Shi Xiaolin , Su Xiuyun , Liu Yaosheng 
Published: May 2023

Purpose: The aims of this study were to introduce a new medical, pathway based on the concept of “enhanced recovery after surgery” (ERAS) for patients with metastatic epidural spinal cord compression (MESCC), and to test whether the ERAS program could improve clinical metrics among such patients.Methods: Data from patients with MESCC (n = 98), collected between December 2016 and December 2019 (Non-ERAS cohort), and from 86 patients with metastatic epidural spinal cord compression collected between January 2020 and December 2022 (ERAS cohort), were retrospectively analyzed. Patients were treated by decompressive surgery combined with transpedicular screw implantation and internal fixation. Patient baseline clinical characteristics were collected and compared between the two cohorts. Surgical outcomes analyzed included operation time; intraoperative blood loss; postoperative length of hospital stay; time to ambulation, regular diet, urinary catheter removal, and radiation therapy; perioperative complications; anxiety; depression; and satisfaction with treatment.Results: No significant differences in clinical characteristics were found between the non-ERAS and enhanced recovery after surgery cohorts (all p &gt; 0.050), indicating that the two cohorts were comparable. Regarding surgical outcomes, the enhanced recovery after surgery cohort had significantly less intraoperative blood loss (p &lt; 0.001); shorter length of postoperative hospital stay (p &lt; 0.001); shorter time to ambulation (p &lt; 0.001), regular diet (p &lt; 0.001), urinary catheter removal (p &lt; 0.001), radiation administration (p &lt; 0.001), and systemic internal therapy (p &lt; 0.001); lower perioperative complication rate (p = 0.024); less postoperative anxiety (p = 0.041); and higher score for satisfaction with treatment (p &lt; 0.001); whereas operation time (p = 0.524) and postoperative depression (p = 0.415) were similar between the two cohorts. Compliance analysis demonstrated that ERAS interventions were successfully conducted in the vast majority of patients.Conclusion: The enhanced recovery after surgery intervention is beneficial to patients with metastatic epidural spinal cord compression, according to data on intraoperative blood loss; length of hospital stay; time to ambulation, regular diet, urinary catheter removal, radiation exposure, and systemic internal therapy; perioperative complication; alleviation of anxiety; and improvement of satisfaction. However, clinical trials to investigate the effect of enhanced recovery after surgery are needed in the future.
Early peripheral blood lymphocyte subsets and cytokines in predicting the severity of influenza B virus pneumonia in children
Authors: Ma Lu , Yan Jingli , Song Wenliang , Wu Bo , Wang Zeyu , Xu Wei 
Published: May 2023

BackgroundChildren with influenza B virus infection have a higher susceptibility and higher severity of illness. The activation and disorder of immune function play an important role in the severity of influenza virus infection. This study aims to investigate whether early lymphocyte count and cytokines can provide predictive value for the progression in children with influenza B virus pneumonia.MethodsA retrospective cohort study was conducted to analyze the clinical data of children with influenza B virus pneumonia from December 1, 2021, to March 31, 2022, in the National Children’s Regional Medical Center (Shengjing Hospital of China Medical University). According to the severity of the disease, the children were divided into a mild group and a severe group, and the clinical characteristics, routine laboratory examination, lymphocyte subsets, and cytokines were compared.ResultsA total of 93 children with influenza B virus pneumonia were enrolled, including 70 cases in the mild group and 23 cases in the severe group. Univariate analysis showed that drowsiness, dyspnea, white blood cell (WBC), lymphocytes, monocytes, procalcitonin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), fibrinogen (FIB), Immunoglobulin M (IgM), lung consolidation, total T cell count, CD4+ T cell count, CD8+ T cell count, NK cell count, NK cell % and B cell % had statistical differences between the mild and severe groups (P&lt;0.05). In multivariate logistic regression analysis, reduced ALT (OR = 1.016), FIB (OR = 0.233), CD8+ T cell count (OR = 0.993) and NK cell count (OR = 0.987) were independently associated with the development of severe influenza B virus pneumonia.ConclusionsThe levels of T lymphocytes and NK cells were related to the progression of influenza B virus pneumonia in children, and the reduction of CD8+ T cell count and NK cell count can be used as independent risk factors for predicting the severity of influenza B virus pneumonia.
The effects of plasma to red blood cells transfusion ratio on in-hospital mortality in patients with acute type A aortic dissection
Authors: Yao Run , Yan Danyang , Fu Xiangjie , Deng Ying , Xie Xi , Li Ning 
Published: May 2023

BackgroundBlood transfusion is a frequent and necessary practice in acute type A aortic dissection (AAAD) patients, but the effect of plasma/red blood cells (RBCs) ratio on mortality remains unclear. The aim of this study is to investigate the association between plasma/RBCs transfusion ratio and in-hospital mortality in patients with AAAD.MethodsPatients were admitted to Xiangya Hospital of Central South University from January 1, 2016 to December 31, 2021. Clinical parameters were recorded. Multivariate Cox regression model was used to analyze the association between transfusion and in-hospital mortality. We used the smooth curve fitting and segmented regression model to assess the threshold effect between plasma/RBCs transfusion ratio and in-hospital mortality in patients with AAAD.ResultsThe volumes of RBCs [14.00 (10.12–20.50) unit] and plasma [19.25 (14.72–28.15) unit] transfused in non-survivors were significantly higher than in survivors [RBCs: 8.00 (5.50–12.00) unit]; plasma: [10.35 (6.50–15.22) unit]. Multivariate Cox regression analysis showed plasma transfusion was an independent risk factor of in-hospital mortality. Adjusted HR was 1.03 (95% CI: 0.96–1.11) for RBCs transfusion and 1.08 (95% CI: 1.03–1.13) for plasma transfusion. In the spline smoothing plot, mortality risk increased with plasma/RBCs transfusion ratio leveling up to the turning point 1. Optimal plasma/RBCs transfusion ratio with least mortality risk was 1. When the plasma/RBCs ratio was &lt;1 (adjusted HR per 0.1 ratio: 0.28, 95% CI per 0.1 ratio: 0.17–0.45), mortality risk decreased with the increase of ratio. When the plasma/RBCs ratio was 1–1.5 (adjusted HR per 0.1 ratio: 2.73, 95% CI per 0.1 ratio:1.13–6.62), mortality risk increased rapidly with the increase of ratio. When the plasma/RBCs ratio was &gt;1.5 (adjusted HR per 0.1 ratio: 1.09, 95% CI per 0.1 ratio:0.97–1.23), mortality risk tended to reach saturation, and increased non-significantly with the increase of ratio.ConclusionA 1:1 plasma/RBCs ratio was associated with the lowest mortality in the patients with AAAD. And non-linear relationship existed between plasma/RBCs ratio and mortality.
Individualized QT interval (QTi) is a powerful diagnostic tool in long QT syndrome: results from a large validation study
Authors: Robyns Tomas , Nuyens Dieter , Vandenberk Bert , Haemers Peter , Breckpot Jeroen , Garweg Christophe , Ector Joris , Willems Rik 
Published: May 2023

AimsDiagnosis of Long QT syndrome (LQTS) is based on prolongation of the QT interval corrected for heart rate (QTc) on surface ECG and genotyping. However, up to 25% of genotype positive patients have a normal QTc interval. We recently showed that individualized QT interval (QTi) derived from 24 h holter data and defined as the QT value at the intersection of an RR interval of 1,000 ms with the linear regression line fitted through QT-RR data points of each individual patient was superior over QTc to predict mutation status in LQTS families. This study aimed to confirm the diagnostic value of QTi, fine-tune its cut-off value and evaluate intra-individual variability in patients with LQTS.MethodsFrom the Telemetric and Holter ECG Warehouse, 201 recordings from control individuals and 393 recordings from 254 LQTS patients were analysed. Cut-off values were obtained from ROC curves and validated against an in house LQTS and control cohort.ResultsROC curves indicated very good discrimination between controls and LQTS patients with QTi, both in females (AUC 0.96) and males (AUC 0.97). Using a gender dependent cut-off of 445 ms in females and 430 ms in males, a sensitivity of 88% and specificity of 96% were achieved, which was confirmed in the validation cohort. No significant intra-individual variability in QTi was observed in 76 LQTS patients for whom at least two holter recordings were available (483 ± 36 ms vs. 489 ± 42 ms, p = 0.11).ConclusionsThis study confirms our initial findings and supports the use of QTi in the evaluation of LQTS families. Using the novel gender dependent cut-off values, a high diagnostic accuracy was achieved.
Evaluating heart rate variability with 10 second multichannel electrocardiograms in a large population-based sample
Authors: Krause Elischa , Vollmer Marcus , Wittfeld Katharina , Weihs Antoine , Frenzel Stefan , Dörr Marcus , Kaderali Lars , Felix Stephan B. , Stubbe Beate , Ewert Ralf , Völzke Henry , Grabe Hans J. 
Published: May 2023

IntroductionHeart rate variability (HRV), defined as the variability of consecutive heart beats, is an important biomarker for dysregulations of the autonomic nervous system (ANS) and is associated with the development, course, and outcome of a variety of mental and physical health problems. While guidelines recommend using 5 min electrocardiograms (ECG), recent studies showed that 10 s might be sufficient for deriving vagal-mediated HRV. However, the validity and applicability of this approach for risk prediction in epidemiological studies is currently unclear to be used.MethodsThis study evaluates vagal-mediated HRV with ultra-short HRV (usHRV) based on 10 s multichannel ECG recordings of N = 4,245 and N = 2,392 participants of the Study of Health in Pomerania (SHIP) from two waves of the SHIP-TREND cohort, additionally divided into a healthy and health-impaired subgroup. Association of usHRV with HRV derived from long-term ECG recordings (polysomnography: 5 min before falling asleep [N = 1,041]; orthostatic testing: 5 min of rest before probing an orthostatic reaction [N = 1,676]) and their validity with respect to demographic variables and depressive symptoms were investigated.ResultsHigh correlations (r = .52–.75) were revealed between usHRV and HRV. While controlling for covariates, usHRV was the strongest predictor for HRV. Furthermore, the associations of usHRV and HRV with age, sex, obesity, and depressive symptoms were similar.ConclusionThis study provides evidence that usHRV derived from 10 s ECG might function as a proxy of vagal-mediated HRV with similar characteristics. This allows the investigation of ANS dysregulation with ECGs that are routinely performed in epidemiological studies to identify protective and risk factors for various mental and physical health problems.
Introduction of an EdTech intervention to support learning of foundational skills in Sierra Leone: policy, teacher, and community perspectives
Authors: Lurvink Anne-Fleur , Pitchford Nicola J. 
Published: May 2023

BackgroundLike many other countries, Sierra Leone faces significant challenges with primary education resulting in many children leaving primary school without acquiring basic foundational skills. To address these challenges, an educational technology (EdTech) intervention was implemented in 20 primary schools located in two marginalized districts in Sierra Leone. While this EdTech intervention has been shown to raise learning outcomes, little is known about the impacts on the broader education ecosystem. This paper investigates how this EdTech intervention might address some the challenges faced with primary education in Sierra Leone, by examining policy, teacher, and community perspectives.MethodA mixed methods approach was employed which included a policy mapping exercise, a survey of teachers training needs in supporting the development of foundational skills with grade 1 learners, an interview with teachers after they had delivered the EdTech intervention to garner their perceptions and experiences of using the technology in their class, and focus groups with teachers and other community members to gain insights into how the EdTech intervention had been received.ResultsFindings from the policy mapping exercise and quantitative data from the survey of teacher training needs were triangulated with qualitative data from the interviews and focus groups. Four key themes emerged relating to the effective and sustained use of this EdTech intervention to support the acquisition of foundational skills by primary school children in Sierra Leone: (1) the need for continued teacher professional development, (2) the use of English as the language of instruction, (3) access to the technology by children with special educational needs and disabilities (SEND), and (4) the importance of active community engagement in supporting the intervention.DiscussionCollectively, results indicated that the EdTech intervention employed in this study aligned well to the education policy in Sierra Leone. Enhanced teacher training is needed, especially in using English as the language of instruction, and continued community engagement is essential for scaling the intervention effectively and ensuring that all children, including those with SEND, access the technology at primary school. These results have implications for other EdTech intervention deployed in resource-poor settings to enhance learning of foundational skills.
The crosstalk between FGF21 and GH leads to weakened GH receptor signaling and IGF1 expression and is associated with growth failure in very preterm infants
Authors: Mistry Jayna N. , Silvennoinen Sanna , Zaman Farasat , Sävendahl Lars , Mariniello Katia , Hall Charlotte , Howard Sasha R. , Dunkel Leo , Sankilampi Ulla , Guasti Leonardo 
Published: May 2023

BackgroundFibroblast growth factor 21 (FGF21) is an essential metabolic regulator that adapts to changes in nutritional status. Severe childhood undernutrition induces elevated FGF21 levels, contributing to growth hormone (GH) resistance and subsequent linear growth attenuation potentially through a direct action on chondrocytes.MethodsIn this study, we assessed expression of the components of both GH and FGF21 pathways in rare and unique human growth plates obtained from children. Moreover, we investigated the mechanistic interplay of FGF21 on GH receptor (GHR) signaling in a heterologous system.ResultsChronic FGF21 exposure increased GH-induced GHR turnover and SOCS2 expression, leading to the inhibition of STAT5 phosphorylation and IGF-1 expression. The clinical significance of FGF21 signaling through GH receptors was tested in nutritionally driven growth failure seen in very preterm (VPT) infants right after birth. VPT infants display an immediate linear growth failure after birth followed by growth catch-up. Consistent with the in vitro model data, we show that circulating FGF21 levels were elevated during deflection in linear growth compared to catch-up growth and were inversely correlated with the length velocity and circulating IGF1 levels.ConclusionsThis study further supports a central role of FGF21 in GH resistance and linear growth failure and suggests a direct action on the growth plate.
Plant diversity patterns along an elevation gradient: the relative impact of environmental and spatial variation on plant diversity and assembly in arid and semi-arid regions
Authors: He Xinrui , Arif Muhammad , Zheng Jie , Ni Xilu , Yuan Zhongxun , Zhu Qiang , Wang Jifei , Ding Dongdong , Li Changxiao 
Published: May 2023

The spatial distribution pattern of species diversity and its driving variables are essential to understanding how biodiversity will respond to the threat of future climatic instability. This study examines how the alpha and beta diversity indices vary along the elevation gradient and which factors are more responsible for arid and semi-arid plant diversity and community assembly. There were 121 species from 90 genera and 42 families found at elevations ranging from 1,200 to 2,600 m within the Ningxia Helan Mountain National Nature Reserve in China. These were primarily shrubs and herbs with characteristics adapted to extreme temperatures. The diversity of both the shrub layer and the herb layer was highest at mid-elevation, underscoring the importance of protecting mid-elevation ecosystems. Climatic distance and topographic distance were more influential than spatial distance in driving the species composition change of shrubs and herbs. In the herb layer, climatic, topographic, and spatial factors contributed more to community assembly than shrub communities. In this case, improving the environment in the community or introducing herbs could help the restoration of these places. These findings provide insight into biogeographic patterns, biodiversity growth mechanisms, and community formation processes. Moreover, it can improve projections of climate change within and across ecosystems and provide the scientific basis for the use and management of plant resources in arid and semi-arid regions.
Identification of hsa-miR-619-5p and hsa-miR-4454 in plasma-derived exosomes as a potential biomarker for lung adenocarcinoma
Authors: Feng Linxiang , Feng Zian , Hu Jie , Gao Jiahui , Li Ang , He Xiaodong , Liu Liu , Shen Zuojun 
Published: May 2023

Introduction: Lung cancer has long been at the forefront of all cancers in terms of incidence and mortality. Lung adenocarcinoma is the most common type of lung cancer, accounting for 40% of all lung cancer types. Exosomes can act as biomarkers of tumors and thus play an important role.Methods: In this article, high-throughput sequencing of miRNAs in plasma exosomes from lung adenocarcinoma patients and healthy individuals was performed to obtain 87 upregulated miRNAs, which were then combined with data from the GSE137140 database uploaded by others for screening. The database included 1566 preoperative lung cancer patients, 180 postoperative patients, and 1774 non-cancerous controls. We overlapped the miRNAs upregulated in the serum of lung cancer patients in the database relative to those of non-cancer controls and post-operative patients with the upregulated miRNAs obtained from our next-generation sequencing to obtain nine miRNAs. Two miRNAs that were not reported as tumor markers in lung cancer, hsa-miR-4454 and hsa-miR-619-5p, were selected from them and then validated by qRT-PCR, and further analysis of miRNAs was performed using bioinformatics.Results: Real-time quantitative PCR showed that the expression levels of hsa-miR-4454 and hsa-miR-619-5p in plasma exosomes of patients with lung adenocarcinoma were significantly up-regulated. The AUC values of hsa-miR-619-5p and hsa-miR-4454 were 0.906 and 0.975, respectively, both greater than 0.5, showing good performance. The target genes of miRNAs were screened by bioinformatics methods, and the regulatory network between miRNAs and lncRNAs and mRNAs was studied.Discussion: Our work demonstrated that hsa-miR-4454 and hsa-miR-619-5p have the potential to be used as biomarkers for the early diagnosis of lung adenocarcinoma.
Anti-tumor efficacy of anti-GD2 CAR NK-92 cells in diffuse intrinsic pontine gliomas
Authors: Zuo Pengcheng , Li Yaopeng , He Chi , Wang Tantan , Zheng Xu , Liu Hao , Wu Zhen , Zhang Junting , Liao Xuebin , Zhang Liwei 
Published: May 2023

BackgroundDiffuse intrinsic pontine gliomas (DIPGs) are rare and fatal pediatric brainstem gliomas with no cure. Chimeric antigen receptor (CAR)-engineered natural killer (NK) cells have been proven effective in treating glioblastoma (GBM) in preclinical studies. However, there are no relevant studies on the CAR-NK treatment for DIPG. Our study is the first to evaluate the anti-tumor activity and safety of GD2-CAR NK-92 cells treatment for DIPG.MethodsFive patient-derived DIPG cells and primary pontine neural progenitor cell (PPC) were used to access disialoganglioside GD2 expression. Cell killing activity of GD2-CAR NK-92 cells was analyzed by in vitro cytotoxicity assays. Two DIPG patient-derived xenograft models were established to detect the anti-tumor efficacy of GD2-CAR NK-92 cells in vivo.ResultsAmong the five patient-derived DIPG cells, four had high GD2 expression, and one had low GD2 expression. In in vitro assays, GD2-CAR NK-92 cells could effectively kill DIPG cells with high GD2 expression while having limited activity against DIPG cells with low GD2 expression. In in vivo assays, GD2-CAR NK-92 cells could inhibit tumor growth in TT150630 DIPG patient-derived xenograft mice (high GD2 expression) and prolong the overall survival of the mice. However, GD2-CAR NK-92 showed limited anti-tumor activity for TT190326DIPG patient-derived xenograft mice (low GD2 expression).ConclusionOur study demonstrates the potential and safety of GD2-CAR NK-92 cells for adoptive immunotherapy of DIPG. The safety and anti-tumor effect of this therapy need to be further demonstrated in future clinical trials.
Enhancing the therapeutic activity of hyperimmune IgG against chikungunya virus using FcγRIIIa affinity chromatography
Authors: Fox Julie M. , Roy Vicky , Gunn Bronwyn M. , Bolton Glen R. , Fremont Daved H. , Alter Galit , Diamond Michael S. , Boesch Austin W. 
Published: May 2023

IntroductionChikungunya virus (CHIKV) is a re-emerging mosquito transmitted alphavirus of global concern. Neutralizing antibodies and antibody Fc-effector functions have been shown to reduce CHIKV disease and infection in animals. However, the ability to improve the therapeutic activity of CHIKV-specific polyclonal IgG by enhancing Fc-effector functions through modulation of IgG subclass and glycoforms remains unknown. Here, we evaluated the protective efficacy of CHIKV-immune IgG enriched for binding to Fc-gamma receptor IIIa (FcγRIIIa) to select for IgG with enhanced Fc effector functions.MethodsTotal IgG was isolated from CHIKV-immune convalescent donors with and without additional purification by FcγRIIIa affinity chromatography. The enriched IgG was characterized in biophysical and biological assays and assessed for therapeutic efficacy during CHIKV infection in mice.ResultsFcγRIIIa-column purification enriched for afucosylated IgG glycoforms. In vitro characterization showed the enriched CHIKV-immune IgG had enhanced human FcγRIIIa and mouse FcγRIV affinity and FcγR-mediated effector function without reducing virus neutralization in cellular assays. When administered as post-exposure therapy in mice, CHIKV-immune IgG enriched in afucosylated glycoforms promoted reduction in viral load.DiscussionOur study provides evidence that, in mice, increasing Fc engagement of FcγRs on effector cells, by leveraging FcγRIIIa-affinity chromatography, enhanced the antiviral activity of CHIKV-immune IgG and reveals a path to produce more effective therapeutics against these and potentially other emerging viruses.