bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of Global Warming:
A Meta-Analysis of Temperature Management in Aortic Arch Surgery
Authors: Huber Florian , Schachner Bruno , Gottsberger Jessica Zofia , Benedikt Peter , Zierer Andreas Florian 
Published: April 2023

Objectives: Treatment of aortic pathologies involving the distal ascending aorta, aortic arch, and descending aorta remains a complex and challenging procedure. Appropriate management is important to achieve satisfactory outcome. Surgical management aims to reduce the time of circulatory arrest. The optimal level of hypothermia is still a matter of debate. The present meta-analysis shows the influence of different temperature levels on mortality and morbidity following aortic arch surgery.
Methods: We performed a meta-analysis of published data between January 2000 and March 2020 based on a literature research. 120 studies were included with a total of 32 323 patients divided into three different groups of systemic hypothermia (temperature group 1: ≥ 25 °C, temperature group 2: 25-20°C, temperature group 3: ≤ 20°C) were used for statistical analysis.
Results: Early mortality was lowest in temperature group 1 compared to group 2 (OR = 1.42; 95% CI, 1.09-1.85; p=0.01) and group 3 (OR = 1.74; 95% CI, 1.20–2.52; p=0.003). Perioperative stroke appeared to be less frequently in temperature group 1 versus group 2 (OR = 1.48; 95% CI, 1.20-1.82; p=0.0002) and group 3 (OR = 1.61; 95% CI, 1.19 - 2.18; p=0.002). Similar results are obtained concerning new renal insufficiency (group 1 versus group 2: OR = 1.20; 95% CI, 0.91-1.57, p=0.19; group 1 versus 3: OR = 0.94; 95% CI, 0.67 - 1.32, p=0.73) and re-exploration for bleeding (group 1 versus group 2: OR = 1.10; 95% CI, 0.80-1.53, p=0.55; group 1 versus group 3: OR = 1.92; 95% CI, 1.26 - 2.94, p=0,0025).
Conclusions: We observed that moderate level of hypothermia during circulatory arrest reduced the incidence of early mortality. Most dreaded neurologic complications occurred less frequently in TG 1. In contrast there was no difference with regards with new onset of renal failure which is commonly accepted as a reliable marker of the quality of visceral organ protection.
Rates of Burnout in Female Orthopaedic Surgeons Correlate with Barriers to Gender Equity
Authors: Hiemstra Laurie A. , Kerslake Sarah , Fritz Julie-Anne , Clark Marcia , Temple-Oberle Claire , Boynton Erin , Lafave Mark 
Published: April 2023

Background:
The primary purpose of this study was to investigate the relationships between career burnout and the barriers to gender equity identified by Canadian female orthopaedic surgeons. A secondary purpose was to assess relationships between the demographic characteristics of the female surgeons and career burnout and job satisfaction.

Methods:
An electronic survey was distributed to 330 Canadian female orthopaedic surgeons. Demographic variables including age, stage and years in practice, practice setting, and marital status were collated. The survey included the Gender Bias Scale (GBS) questionnaire and 2 questions each about career burnout and job satisfaction. The Pearson r correlation coefficient evaluated the relationships among the higher- and lower-order factors of the GBS, burnout, and job satisfaction. Spearman rank correlation coefficient assessed relationships among burnout, job satisfaction, and demographic variables.

Results:
Survey responses were received from 218 (66.1%) of the 330 surgeons. A total of 110 surgeons (50.5%) agreed or strongly agreed that they felt career burnout (median score = 4). Burnout was positively correlated with the GBS higher-order factors of Male Privilege (r = 0.215, p < 0.01), Devaluation (r = 0.166, p < 0.05), and Disproportionate Constraints (r = 0.152, p < 0.05). Job satisfaction (median = 4) was reported by 168 surgeons (77.1%), and 66.1% were also satisfied or very satisfied with their role in the workplace (median = 4). Burnout was significantly negatively correlated with surgeon age and job satisfaction.

Conclusions:
Half of the female orthopaedic surgeons reported symptoms of career burnout. Significant relationships were evident between burnout and barriers to gender equity. Identification of the relationships between gender-equity barriers and burnout presents an opportunity to modify organizational systems to dismantle barriers and reduce this occupational syndrome.

Clinical Relevance:
Given the relationships between gender inequity and career burnout in this study of female orthopaedic surgeons, actions to dismantle gender barriers and address systemic biases are necessary at all career stages to reduce burnout.
Research Objectives: This research aimed to approach the management of municipal fiscal policies by investigating the causes of its economic growth and examining its fiscal and historical effects on the variation of GDP in municipalities. Theoretic Background: Institutional theory and endogenous economic growth was used to support our models and posterior analysis. Methodology: We used the Brazilian municipalities as our case study, taking the IBGE and STN databases for the period from 2002 to 2018. We examined the effects of municipal fiscal variables, such as expenses and revenues, and historical facts on the variation rates of municipal GDPs by using panel data models. Findings: Results show that historical factors were statistically significant for municipal economic growth. Specifically, in the Brazilian case, municipalities close to the Sugar and Coffee Cycles regions and those that have been the farthest municipalities away from Portugal. Originality: We couldn’t find similar studies with this approach to the best of our knowledge. Theoretical and practical contributions: Findings obtained from this research are relevant for policymakers in general since they point to the role of historical factors in public economic policies. Keywords: Fiscal policy, Economic growth, Historical factors.
Authors: MENKE WAGNER BRIGNOL , GARTNER IVAN 
Published: April 2023

Research Objectives: This research aimed to approach the management of municipal fiscal policies by investigating the causes of its economic growth and examining its fiscal and historical effects on the variation of GDP in municipalities.
Theoretic Background: Institutional theory and endogenous economic growth was used to support our models and posterior analysis.
Methodology: We used the Brazilian municipalities as our case study, taking the IBGE and STN databases for the period from 2002 to 2018. We examined the effects of municipal fiscal variables, such as expenses and revenues, and historical facts on the variation rates of municipal GDPs by using panel data models.
Findings: Results show that historical factors were statistically significant for municipal economic growth. Specifically, in the Brazilian case, municipalities close to the Sugar and Coffee Cycles regions and those that have been the farthest municipalities away from Portugal.
Originality: We couldn’t find similar studies with this approach to the best of our knowledge.
Theoretical and practical contributions: Findings obtained from this research are relevant for policymakers in general since they point to the role of historical factors in public economic policies.

Keywords:Fiscal policy, Economic growth, Historical factors.
Relationships between Levels of Bureaucracy and their Effects on the Co-production of Public Health Services
Authors: Faria Zimmer Santos Grazielli , Chies Schommer Paula 
Published: April 2023

Research objective: This research analyzes how relationships between different levels of local bureaucracy (top, mid, and street-level) – and the context of rules and values in which they operate – affect the practices of co-production of public health services.
Theoretical Framework: The study is based on two distinct theoretical concepts rarely associated in the literature: the co-production of public services and levels of bureaucracy.
Methodology: It is a qualitative research examining the family health strategy in three medium-sized Brazilian municipalities.
Results: The six co-production arrangements identified showed that co-production practices materialize in different ways, sharing more or less power with users, depending on the different patterns of relationship between levels of bureaucracy and the bureaucracy and citizens.
Originality: Few studies analyze co-production from the state’s point of view. Therefore, this research explores a gap in the literature, focusing on the relationships between levels of bureaucracy and their influence on public service co-production practices.
Theoretical and practical contributions: The results raised four points to be theoretically developed, points that also deserve the attention of practitioners operating in co-production: (1) Any level of bureaucracy can offer resistance or openness to co-production, and this is not hierarchically determined; (2) A structure of support and incentive for co-production by the top and mid-level bureaucracy does not guaranteethe engagement of street-level bureaucracy; (3) The collaboration of top and mid-level bureaucracy is essential to expand co-production results; (4) Different relationship patterns between levels of bureaucracy and between the bureaucracy and citizens.

Keywords:Co-production, Levels of bureaucracy, Co-production arrangements, Co-production of public health services.
Serum exosomal long non-coding RNA growth arrest-specific 5 predicts 3-month mortality in acute-on-chronic hepatitis B liver failure
Authors: Sun Cheng-Xi , Han Li-Yan , Wang Kai , Gao Shuai 
Published: April 2023

Abstract
Background: Acute-on-chronic hepatitis B liver failure (ACHBLF) is a severe clinical syndrome with high mortality. We aim to evaluate the potential role of serum exosomal long noncoding RNA (lncRNA) growth arrest-specific 5 (GAS5) in ACHBLF and its predictive value for 3-month mortality.
Methods: We enrolled 110 patients with ACHBLF and 42 healthy controls (HCs) from December 2017 to June 2022. Exosomes were isolated from the serum of the participants. Serum exosomal lncRNA GAS5 was detected using quantitative real-time polymerase chain reaction. Univariate and multivariate cox proportional hazards regression analysis were used to identify the independent prognostic predictors. The functional role of lncRNA GAS5 on hepatocyte phenotypes was investigated through loss-of-function and gain-of-function assays. Exosomal labeling and cell uptake assay were used to determine the exosomes-mediated transmission of lncRNA GAS5 in hepatocytes.
Results: The serum exosomal lncRNA GAS5 was significantly higher in patients with ACHBLF than HCs. It was identified to be an independent predictor for 3-month mortality of ACHBLF. It showed high predictive value for 3-month mortality of ACHBLF and yielded an area under the receiver operating characteristic curve (AUC) value of 0.88, which was markedly higher than MELD score (AUC 0.73; P<0.01). Further study found that lncRNA GAS5 could inhibit hepatocytes proliferation and increase hepatocytes apoptosis. Exosomes-mediated lncRNA GAS5 transfer promoted hepatocytes injury. The knocked down of lncRNA GAS5 weakened H2O2-induced hepatocytes injury.
Conclusions: We revealed that serum exosomal lncRNA GAS5 might promote hepatocytes injury and showed high predictive value for 3-month mortality in ACHBLF.
Anti-inflammatory Potential of some Eudesmanolide and Guaianolide Sesquiterpenes
Authors: ‎ Shagufta Perveen , Hamedi Azadeh , Pasdaran Ardalan , ‎ Reza Heidari , Azam Muhammad Shafiq ul , ‎ Sobia Tabassum , ‎ Rashad Mehmood , ‎ Jiangnan Peng 
Published: April 2023

Abstract
Ten sesquiterpene lactones isolated from Anvillea garcinii (Burm.f.) DC ethanolic extract were assessed for their anti-inflammatory potential by myeloperoxidase (MPO) activity assignment, and ‎mice paw swelling model. 3α,4α-10β-trihydroxy-8α-acetyloxyguaian-12,6α-olide (1), epi-vulgarin (3), 9a-hydroxyparthenolide (4), garcinamine C (7), garcinamine D (8), garcinamine E (9), and 4, 9-dihydroxyguaian-10(14)-en-12-olide ‎(10) showed explicit ‎anti-inflammatory activity in rodent paw oedema and MPO assignment. The findings of this study showed that the α-methylene γ-lactone moiety does not always guarantee an anti-inflammatory effect, but the presence of proline at the C3 of the lactone ring improves the binding of sesquiterpene lactones with MPO isoenzymes, resulting in a more potent inhibition.
Correlation analysis between 3D and plane DAT binding parameters of 11C-CFT PET/CT and the clinical characteristics of patients with Parkinson's disease
Authors: Wu Xiaodong , Wei Feng , Gan Jing , Li Ziyuan , Wu Ping , Liang Sheng , Ma Yufei , Ding Lin , Zuo Chuantao , Liu Zhenguo , Wang Hui , Yin Yafu 
Published: April 2023

Abstract
Background: To explore the correlation between dopamine transporter (DAT) PET/CT and the clinical characteristics and the scales of Parkinson’s disease (PD) patients, furthermore explore the scientificity and feasibility of incorporating 3D-dopaminergic binding parameters into the clinical scoring system for PD.
Methods: A total of 75 patients with PD were retrospectively included. The clinical characteristics (including age, gender, disease duration), modified Hoehn-Yahr (H-Y) grading, UPDRS (the unified Parkinson's disease rating scale) II & III and Mini-Mental State Examination (MMSE) of PD patients in corresponding time periods were obtained. DAT binding parameters and their derived parameters based on plane and 3D images in neostriatum were analyzed for the consistency of plane and 3D parameters, and the correlation between the above parameters and the clinical characteristics of patients.
Results: The DAT binding parameters based on 3D images had good consistency with the plane parameters (p<0.05). The asymmetry index (AI) of DAT binding parameters based on 3D and plane images had good consistency in anterior putamen (p<0.05). The plane parameters of anterior and posterior putamen were correlated with the UPDRS II-III score and H-Y score of PD patients (p<0.05), the parameter in caudate nucleus was only correlated with UPDRS II and MMSE. The 3D parameters in neostriatum showed good statistical correlation with the disease duration, UPDRS II-III score, H-Y score, H-Y course of PD patients (p<0.05), and the AI was significantly correlated with MMSE (p<0.05). The 3D parameters in putamen and posterior putamen had good statistical correlation with the UPDRS II-III score, H-Y score and H-Y course of PD patients (p<0.05). The AI in the putamen showed statistical correlation with the UPDRS III score and MMSE. The AI in posterior putamen showed statistical correlation with the UPDRS II score (p<0.05).
Conclusions: The quantitative parameters based on plane and 3D images of 11C-CFT PET/CT had good consistency, and 3D parameters in neostriatum had a better correlation with the activities of daily living, UPDRS motor score, the severity and duration of disease and cognition than plane parameters in PD patients.
Identifying G6PC3 as a potential key molecule in hypoxic glucose metabolism of glioblastoma derived from the depiction of 18F-fluoromisonidazole and 18F-fluorodeoxyglucose positron emission tomography
Authors: Okamoto Michinari , Yamaguchi Shigeru , Sawaya Ryosuke , Echizenya Sumire , Ishi Yukitomo , Kaneko Sadahiro , Motegi Hiroaki , Toyonaga Takuya , Hirata Kenji , Fujimura Miki 
Published: April 2023

Abstract
Background: Glioblastoma is the most offensive primary brain tumour, defined by its distinctive intratumoral hypoxia. Sequential preoperative evaluations using 18F-fluoromisonidazole (FMISO) and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) could determine the degree of glucose metabolism with the hypoxic condition. However, the molecular mechanism of glucose metabolism under hypoxia in glioblastoma remains unclear. The goal of this research was to determine the key molecules of hypoxic glucose metabolism.
Results: Using surgically derived specimens, gene expressions linked to glucose metabolism were evaluated in patients with glioblastoma (n = 33) who had preoperative FMISO and FDG PET to determine affected molecules according to hypoxic conditions. Tumour in vivo metabolic activities was semiquantitatively assessed by lesion normal tissue-ratio (LNR). Among the genes involving the glucose metabolic pathway, mRNA expression of glucose-6-phosphatase 3 (G6PC3) correlated with FDG LNR (P = 0.03). Furthermore, G6PC3 mRNA expression in FMISO high-accumulated glioblastomas was considerably higher than that in FMISO low-accumulated glioblastomas (P < 0.01). Protein expression of G6PC3 conformed with mRNA expression, which was determined by immunofluorescence analysis. These outcomes implied that the G6PC3 expression might be influenced by the hypoxic condition in glioblastomas. We then assessed the clinical relevance of G6PC3 regarding prognosis. The connection between gene expression and overall survival was investigated in another independent non-overlapping clinical cohort, and confirmed by the cancer genome atlas (TCGA) database. Among the glioblastoma patients who received gross total resection, mRNA expressions of G6PC3 in the patients with low prognosis (less than 1-year survival) were considerably higher than that in the patients who survive more than 3 years. Furthermore, high mRNA expression of G6PC3 was linked to poor overall survival in glioblastoma, as determined by the TCGA database.
Conclusion: G6PC3 was significantly demonstrated in glioblastoma tissues with coincidentally high FDG and FMISO accumulation. Furthermore, it might function as a prognostic biomarker of glioblastoma. Therefore, G6PC3 is a potential key molecule of glucose metabolism under hypoxia in glioblastoma.
Impact of non-regional lymph node metastases accurately revealed on 18F-PSMA-1007 PET/CT in the clinical management of metastatic hormone-sensitive prostate cancer
Authors: Jiang Zhangdong , Fan Junjie , Gan Chaosheng , Dong Xiaoxin , Gao Guoqiang , Wang Zhuonan , He Dalin , Li Lei , Duan XiaoYi , Wu Kaijie 
Published: April 2023

Abstract
Background: Non-regional lymph node (NRLN) metastases has shown increasing importance in the prognosis evaluation and clinical management of primary metastatic hormone-sensitive prostate cancer (mHSPC). Hence, this study aimed to investigate the concordance rates between 18F-PSMA-1007 PET/CT and conventional imaging (CI) in revealing NRLN metastases, and explore the impact of NRLN metastases on the management of primary mHSPC.
Methods: The medical records of 224 patients with primary mHSPC were retrospectively reviewed. Among patients who received 18F-PSMA-1007 PET/CT and CI before initial treatment, the concordance rates between 18F-PSMA-1007 PET/CT and CI were analyzed. The primary endpoint was progression-free survival (PFS), and Cox regression analyses were performed to explore independent predictors of PFS.
Results: A total of 99 patients (44.2%) received both 18F-PSMA-1007 PET/CT and CI, the concordance rate in revealing NRLN metastases was only 61.62%, and Cohen’s kappa coefficient was as low as 0.092. Cox regression revealed that androgen deprivation therapy (ADT), N1, high-volume, NRLN and visceral metastases were associated with worse PFS (all P<0.05). In patients with low-volume disease, the median PFS of patients with NRLN metastases was significantly shorter than that of patients without NRLN metastases (19.5 vs. 27.5 months, P=0.01), while the difference between patients with low-volume plus NRLN metastases and high-volume disease was not significant (19.5 vs. 16.9 months, P=0.55). Moreover, early docetaxel chemotherapy significantly prolonged the PFS of these patients compared with ADT alone (20.7 vs. 12.3 months, P=0.008).
Conclusion: NRLN metastases could be accurately revealed by 18F-PSMA-1007 PET/CT, which should be considered a high-volume feature, especially concomitant with bone metastases. Furthermore, patients with low-volume plus NRLN metastases may be suitable for more intensive treatment, such as early docetaxel chemotherapy.
Diagnosis of Pulmonary Scedosporium apiospermum Infection from Bronchoalveolar Lavage Fluid by Metagenomic Next-Generation Sequencing in an Immunocompetent Female Patient with Normal Lung Structure: A Case Report and Literature Review
Authors: Han Jingru , Liang Lifang , Li Qingshu , Deng Ruihang , Liu Chenyang , Wu Xuekai , Zhang Yuxin , Zhang Ruowen , Dai Haiyun 
Published: April 2023

Abstract
Background: Scedosporium apiospermum (S.apiospermum) belongs to the asexual form of Pseudallescheria boydiiand is widely distributed in various environments. S. apiospermumis the most common cause of pulmonary infection; however, invasive diseases are usually limited to patients with immunodeficiency.
Case presentation: A 54-year-old Chinese non-smoker female patient with normal lung structure and function was diagnosed with pulmonary S. apiospermum infection by metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF). The patient was admitted to the hospital after experiencing intermittent right chest pain for 8 months. Chest computed tomography revealed a thick-walled cavity in the upper lobe of the right lung with mild soft tissue enhancement. S. apiospermum was observed by the mNGS of BALF, sequence number 283. Following treatment with voriconazole (300 mg q12h d1; 200 mg q12h d2-d20), there was no improvement in chest imaging, and a thoracoscopic right upper lobectomy was performed. Postoperative pathological results observed silver staining and PAS-positive oval spores in the alveolar septum, bronchiolar wall, and alveolar cavity, and fungal infection was considered. The patient’s symptoms improved; the patient continued voriconazole for 2 months after surgery. No signs of radiological progression or recurrence were observed at the 10-month postoperative follow-up.
Conclusion: This case report indicates that S. apiospermum infection can occur in immunocompetent individuals and that the mNGS of BALF can assist in its diagnosis and treatment. Additionally, the combined therapy of antifungal drugs and surgery exhibits a potent effect on the disease.