bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracranial anticoagulant related bleedings admitted to intensive care units: a French multicenter retrospective study
Authors: Botrel Thomas , Cunat Sibylle , Helms Julie , Lemarié Jérémie , Gaillon Jeanne , Préau Sébastien , Favory Raphael , Thille Arnaud W. , Boissier Florence , Maury Eric , Joffre Jérémie , Ait-Oufella Hafid 
Published: August 2023

Abstract
Background
Anticoagulants are widely used but can lead to iatrogenic events such as bleeding. Limited data exists regarding the characteristics and management of patients admitted to intensive care units (ICU) for severe anticoagulant-related extracranial bleeding.

Methods
A retrospective observational study was conducted in five French ICUs. From January 2007 to December 2018, all patients aged over 18 years admitted to ICU for extracranial bleeding while receiving therapeutic anticoagulation were included.

Results
486 patients were included, mainly male (61%) with an average age of 73 ± 13 years. Most patients had comorbidities, including hypertension (68%), heart disease (49%) and diabetes (33%). Patients were treated by vitamin K antagonists (VKA, 54%), heparins (25%) and direct oral anticoagulants (DOAC, 7%). The incidence of patients admitted to ICU for anticoagulant-related bleeding increased from 3.2/1000 admissions in 2007 to 5.8/1000 in 2018. This increase was particularly high for DOAC class. Upon admission, patients exhibited severe organ failure, as evidenced by a high SOFA score (7 ± 4) and requirement for organ support therapies such as vasopressors (31.5%) and invasive mechanical ventilation (34%). Adherence to guidelines for the specific treatment of anticoagulant-related bleeding was generally low. ICU mortality was 27%. In multivariate analysis, five factors were independently associated with mortality: chronic hypertension, need for vasopressors, impaired consciousness, hyperlactatemia and prolonged aPTT > 1.2.

Conclusion
Anticoagulant-related extracranial bleeding requiring ICU admission is a serious complication responsible for organ failure and significant mortality. Its incidence is rising. The therapeutic management is suboptimal and could be improved by educational programs.
A Culex quinquefasciatus strain resistant to the binary toxin from Lysinibacillus sphaericus displays altered enzyme activities and energy reserves
Authors: Menezes Heverly Suzany G. , Costa-Latgé Samara G. , Genta Fernando A. , Napoleão Thiago H. , Paiva Patrícia M. G. , Romão Tatiany P. , Silva-Filha Maria Helena N. L. 
Published: August 2023

Abstract
Background
The resistance of a Culex quinquefasciatus strain to the binary (Bin) larvicidal toxin from Lysinibacillus sphaericus is due to the lack of expression of the toxin’s receptors, the membrane-bound Cqm1 α-glucosidases. A previous transcriptomic profile of the resistant larvae showed differentially expressed genes coding Cqm1, lipases, proteases and other genes involved in lipid and carbohydrate metabolism. This study aimed to investigate the metabolic features of Bin-resistant individuals by comparing the activity of some enzymes, energy reserves, fertility and fecundity to a susceptible strain.

Methods
The activity of specific enzymes was recorded in midgut samples from resistant and susceptible larvae. The amount of lipids and reducing sugars was determined for larvae and adults from both strains. Additionally, the fecundity and fertility parameters of these strains under control and stress conditions were examined.

Results
Enzyme assays showed that the esterase activities in the midgut of resistant larvae were significantly lower than susceptible ones using acetyl-, butyryl- and heptanoyl-methylumbelliferyl esthers as substrates. The α-glucosidase activity was also reduced in resistant larvae using sucrose and a synthetic substrate. No difference in protease activities as trypsins, chymotrypsins and aminopeptidases was detected between resistant and susceptible larvae. In larval and adult stages, the resistant strain showed an altered profile of energy reserves characterized by significantly reduced levels of lipids and a greater amount of reducing sugars. The fertility and fecundity of females were similar for both strains, indicating that those changes in energy reserves did not affect these reproductive parameters.

Conclusions
Our dataset showed that Bin-resistant insects display differential metabolic features co-selected with the phenotype of resistance that can potentially have effects on mosquito fitness, in particular, due to the reduced lipid accumulation.

Graphical Abstract
Adherence to rehabilitation and home exercise after myocardial infarction: a qualitative study of expectations, barriers and drivers
Authors: Serves Nina , Pazart Lionel , Gabriel Damien , Mourot Laurent , Ecarnot Fiona 
Published: August 2023

Abstract
Background
Cardiac rehabilitation is a key component of secondary prevention, but uptake is often low, and motivation to pursue exercise and lifestyle changes may be lacking in patients who have suffered from acute myocardial infarction (AMI). We explored the intentions of patients hospitalized for AMI regarding attendance at cardiac rehabilitation and the future pursuit of regular physical exercise at home.

Methods
We performed a qualitative study using semi-structured interviews. Eligible patients were those hospitalized for AMI in the cardiology unit of a large university hospital in Eastern France between 10/11/2021 and 7/3/2022, and who were deemed eligible for rehabilitation by the treating physician. Patients were interviewed before discharge. Interviews were transcribed and analysed by thematic analysis. We administered the Global Physical Activity Questionnaire (GPAQ) questionnaire to all participants.

Results
Of 17 eligible patients, 15 were interviewed, at which point saturation was reached. The majority were males (n = 13, 86%), median age 54 years (41–61). Three key themes emerged: Firstly, there is a mismatch between patients’ perceptions of their physical activity and actual level of activity as assessed by objective tools. Second, cardiac rehabilitation is seen as a vector for information about the return to home after AMI. Third, regarding the intention to change lifestyle, there are persisting obstacles, drivers, fears and expectations.

Conclusion
Patients with AMI often overestimate how physically active they are. Even close to discharge, patients have persisting informational needs, and many see cardiac rehabilitation as a means to obtain this information, rather than as a therapeutic intervention.
The specific DNA methylation landscape in focal cortical dysplasia ILAE type 3D
Authors: Wang Dan-Dan , Katoch Mitali , Jabari Samir , Blumcke Ingmar , Blumenthal David B. , Lu De-Hong , Coras Roland , Wang Yu-Jiao , Shi Jie , Zhou Wen-Jing , Kobow Katja , Piao Yue-Shan 
Published: August 2023

AbstractFocal Cortical Dysplasia (FCD) is a frequent cause of drug-resistant focal epilepsy in children and young adults. The international FCD classifications of 2011 and 2022 have identified several clinico-pathological subtypes, either occurring isolated, i.e., FCD ILAE Type 1 or 2, or in association with a principal cortical lesion, i.e., FCD Type 3. Here, we addressed the DNA methylation signature of a previously described new subtype of FCD 3D occurring in the occipital lobe of very young children and microscopically defined by neuronal cell loss in cortical layer 4. We studied the DNA methylation profile using 850 K BeadChip arrays in a retrospective cohort of 104 patients with FCD 1 A, 2 A, 2B, 3D, TLE without FCD, and 16 postmortem specimens without neurological disorders as controls, operated in China or Germany. DNA was extracted from formalin-fixed paraffin-embedded tissue blocks with microscopically confirmed lesions, and DNA methylation profiles were bioinformatically analyzed with a recently developed deep learning algorithm. Our results revealed a distinct position of FCD 3D in the DNA methylation map of common FCD subtypes, also different from non-FCD epilepsy surgery controls or non-epileptic postmortem controls. Within the FCD 3D cohort, the DNA methylation signature separated three histopathology subtypes, i.e., glial scarring around porencephalic cysts, loss of layer 4, and Rasmussen encephalitis. Differential methylation in FCD 3D with loss of layer 4 mapped explicitly to biological pathways related to neurodegeneration, biogenesis of the extracellular matrix (ECM) components, axon guidance, and regulation of the actin cytoskeleton. Our data suggest that DNA methylation signatures in cortical malformations are not only of diagnostic value but also phenotypically relevant, providing the molecular underpinnings of structural and histopathological features associated with epilepsy. Further studies will be necessary to confirm these results and clarify their functional relevance and epileptogenic potential in these difficult-to-treat children.
Harnessing education and lifestyle change to support transitional health for returning citizens: a feasibility study protocol
Authors: Sneed Rodlescia S. , El-Alamin Leon , Thrower Marsha , Nadrowski Jessica , Habermehl Kayla 
Published: August 2023

Abstract
Background
Exercise and healthy eating are known to reduce chronic disease risk; however, formerly incarcerated individuals (i.e., returning citizens) face significant social barriers when attempting to engage with existing community-based physical activity and nutrition programs. Given the high disease burden and unique educational needs of returning citizens, this proposed work fills an important gap in the support services currently offered to this population.

Methods
This article describes a process for evaluating the feasibility and acceptability of a physical activity and nutrition intervention tailored to the needs of returning citizens via a partnership between an academic research organization and a community-based reentry program for returning citizens. Staff from the community-based reentry program will train four returning citizens as group fitness instructors and work with a nutritionist to design a 16-week nutrition education curriculum. Reentry program staff will enroll up to 15 formerly incarcerated adults (aged 18 +) in the exercise and nutrition program. Participants will take part in weekly nutrition classes led by the nutritionist and weekly group exercise classes led by a peer instructor. Research staff will evaluate program success in four domains: reach, preliminary effectiveness, implementation, and maintenance.

Results
This feasibility study will allow us to design and test a program that can eventually be evaluated in a large, randomized trial. It also addresses the multitude of social determinants that impact the health of returning citizens and builds a framework for program sustainability. Individuals recruited as fitness trainers will acquire skills and certifications that may be used to sustain physical fitness activities within the reentry program.

Conclusions
This feasibility study will test our ability to address social determinants that impact the health of returning citizens through a peer-led physical activity and nutrition programming. In the long term, study results may inform development and implementation of reentry programming and policy on a wider scale.
Private banking development in China under two organizational structures: Economic analysis from an organizational innovation perspective
Authors: Liu He , Bai Yun , Huang Zhiguang , Qiao Han , Wang Shouyang 
Published: August 2023

AbstractThis paper investigates optimal decisions for private banking development in China under two innovative organizational structures—the big retail mode (BRM) and the independent development mode (IDM). Under the BRM, the retail and private banking divisions form a cooperative relationship wherein the former transfers high-net-worth customers to the latter. In addition, retail banking receives a share of private banking revenues. We investigate the optimal revenue-sharing ratio between the two divisions and the optimal effort by private banking to serve transferred customers within the cooperative relationship. The analytical results show that as the private banking division becomes more developed, the optimal revenue-sharing ratio decreases, and the private banking division’s optimal effort to serve transferred customers decreases because it puts more effort into acquiring new customers. Under the IDM, the two divisions form a competitive relationship since they compete to acquire customers independently. We investigate customer acquisition efforts in this interdivisional competition. Optimal customer acquisition efforts by both divisions increase in potential assets and rates of return. This paper contributes to the literature by (1) analyzing financial innovation by private banks from an organizational perspective; (2) providing an economic analysis for private banking development in China.
A novel tuberculosis model incorporating a Caputo fractional derivative and treatment effect via the homotopy perturbation method
Authors: Olayiwola Morufu Oyedunsi , Adedokun Kamilu Adewale 
Published: August 2023

Abstract
Background
Tuberculosis (TB), caused by Mycobacterium tuberculosis, is a contagious infectious disease that primarily targets the lungs but can also impact other critical systems such as the bones, joints, and neurological system. Despite significant efforts to combat TB, it remains a major global health concern. To address this challenge, this study aims to explore and evaluate various tuberculosis control approaches using a mathematical modeling framework.

Results
The study utilized a novel SEITR mathematical model to investigate the impact of treatment on physical limitations in tuberculosis. The model underwent qualitative analysis to validate key aspects, including positivity, existence, uniqueness, and boundedness. Disease-free and endemic equilibria were identified, and both local and global stability of the model was thoroughly examined using the derived reproduction number. To estimate the impact of each parameter on each compartment, sensitivity analysis was conducted, and numerical simulations were performed using Maple 18 software with the homotopy perturbation method. The obtained results are promising and highlight the potential of the proposed interventions to significantly reduce tuberculosis virus prevalence. The findings emphasize the significance of fractional-order analysis in understanding the effectiveness of treatment strategies for mitigating tuberculosis prevalence. The study suggests that the time fractional dynamics of TB treatment correspond to the treatment’s efficacy, as the conceptual results showed that non-local interactions between the disease and the treatment may lead to more accurate ways of eradicating tuberculosis in real-world scenarios. These insights contribute to a better understanding of effective treatment strategies and their potential impact on tuberculosis control and public health.

Conclusions
In conclusion, scientists, researchers, and healthcare personnel are urged to take action and utilize the discoveries from this research to facilitate the eradication of the hazardous tuberculosis bacteria.
Role of MRI in diagnosis of pulmonary embolism
Authors: Mohammad Abolhasan Haseib , Mostafa Hossam Mohammed , Megaly Hasan Ibarhim , Mohamed Mohamed Zidan , Taha Mohamad Gaber , Abdelal Sherif M. 
Published: August 2023

Abstract
Background
Pulmonary embolism (PE) is considered a serious condition and has clinical challenges in diagnosis. Computed tomography pulmonary angiography (CTPA) is considered the gold standard in PE diagnosis. Contrast-enhanced MRA also has a strong useful role in the diagnosis. Our study aims to assess the role of non-contrast MRA in diagnosis of acute pulmonary embolism compared to either CT pulmonary angiography or contrast enhanced MRA.

Results
In total, 50 patients with PE confirmed by either CTPA or CE-MRA were included in this study. All patients underwent non-contrast MRPA during the three consecutive days after CTPA or at the same examination setting in CE-MRA. The results were compared and statistically analyzed.
The mean age of our study group was 47.80 ± 14.01 years. Males represented 56% (28/50) and females 44% (22/50). The per-vessel sensitivity, specificity and accuracy of non-contrast MRPA reached about 100% for each parameter at the level of the pulmonary trunk, main pulmonary and lobar arteries. At the segmental level, sensitivity, specificity, and accuracy reached about 88%, 100%, and 94%, while at the subsegmental level, about 35%, 100%, and 66% respectively. The overall sensitivity, specificity, and accuracy of non-contrast MRPA regardless of the site were 84%, 100%, and 90% respectively.

Conclusions
Non-contrast pulmonary MRA has a high sensitivity and specificity in the diagnosis of PE, especially in proximal pulmonary arteries. So, it can be used as an alternative to the CTA and CE-MRA, especially when the CTA and the use of gadolinium are contraindicated.
Utility of Polygenic Scores for Differentiating Diabetes Diagnosis Among Patients With Atypical Phenotypes of Diabetes
Authors: Billings Liana K , Shi Zhuqing , Wei Jun , Rifkin Andrew S , Zheng S Lilly , Helfand Brian T , Ilbawi Nadim , Dunnenberger Henry M , Hulick Peter J , Qamar Arman , Xu Jianfeng 
Published: August 2023

Abstract

Context
Misclassification of diabetes type occurs in people with atypical presentations of type 1 diabetes (T1D) or type 2 diabetes (T2D). Although current clinical guidelines suggest clinical variables and treatment response as ways to help differentiate diabetes type, they remain insufficient for people with atypical presentations.

Objective
This work aimed to assess the clinical utility of 2 polygenic scores (PGSs) in differentiating between T1D and T2D.

Methods
Patients diagnosed with diabetes in the UK Biobank were studied (N = 41 787), including 464 (1%) and 15 923 (38%) who met the criteria for classic T1D and T2D, respectively, and 25 400 (61%) atypical diabetes. The validity of 2 published PGSs for T1D (PGST1D) and T2D (PGST2D) in differentiating classic T1D or T2D was assessed using C statistic. The utility of genetic probability for T1D based on PGSs (GenProb-T1D) was evaluated in atypical diabetes patients.

Results
The joint performance of PGST1D and PGST2D for differentiating classic T1D or T2D was outstanding (C statistic = 0.91), significantly higher than that of PGST1D alone (0.88) and PGST2D alone (0.70), both P less than .001. Using an optimal cutoff of GenProb-T1D, 23% of patients with atypical diabetes had a higher probability of T1D and its validity was independently supported by clinical presentations that are characteristic of T1D.

Conclusion
PGST1D and PGST2D can be used to discriminate classic T1D and T2D and have potential clinical utility for differentiating these 2 types of diseases among patients with atypical diabetes.
Insulin Signaling Is Preserved in Skeletal Muscle During Early Diabetic Ketoacidosis
Authors: Fisker Frederikke A , Voss Thomas S , Svart Mads V , Kampmann Ulla , Vendelbo Mikkel H , Bengtsen Mads B , Lauritzen Esben S , Møller Niels , Jessen Niels 
Published: August 2023

Abstract

Background and aims
During diabetic ketoacidosis (DKA), muscle tissue develops a profound insulin resistance that complicates reversal of this potentially lethal condition. We have investigated mediators of insulin action in human skeletal muscle during total insulin withdrawal in patients with type 1 diabetes, under the hypothesis that initial phases of DKA are associated with impaired postreceptor signaling.

Materials and methods
Muscle biopsies were obtained during a randomized, controlled, crossover trial involving 9 patients with type 1 diabetes. The subjects were investigated during a high-dose insulin clamp preceded by either: (1) insulin-controlled euglycemia (control) or (2) total insulin withdrawal for 14 hours. Insulin action in skeletal muscle and whole-body substrate metabolism were investigated using western blot analysis and indirect calorimetry respectively.

Results
During insulin withdrawal, insulin-stimulated dephosphorylation of glycogen synthase decreased by ∼30% (P &lt; .05) compared with the control situation. This was associated with a decrease in glucose oxidation by ∼30% (P &lt; .05). Despite alterations in glucose metabolism, insulin transduction to glucose transport and protein synthesis (Akt, AS160, mammalian target of rapamycin, and eukaryotic translation initiation factor 4E binding protein) was intact, and glucose transporter (GLUT4) and mitochondrial proteins (succinate dehydrogenase complex, subunit A and prohibitin 1) protein expression were unaffected by the intervention.

Conclusion
DKA impairs insulin-stimulated activation of glycogen synthase, whereas insulin signal transduction to glucose transport and protein synthesis remains intact. Reversal of insulin resistance during treatment of DKA should target postreceptor mediators of glucose uptake.

Clinical Trial Registration number
NCT02077348.
Metformin and Combined Oral Contraceptive Pills in the Management of Polycystic Ovary Syndrome: A Systematic Review and Meta-analysis
Authors: Melin Johanna , Forslund Maria , Alesi Simon , Piltonen Terhi , Romualdi Daniela , Spritzer Poli Mara , Tay Chau Thien , Pena Alexia , Witchel Selma Feldman , Mousa Aya , Teede Helena 
Published: August 2023

Abstract

Context
Polycystic ovary syndrome (PCOS) affects more than 1 in 10 women.

Objective
As part of the 2023 International PCOS Guidelines update, comparisons between combined oral contraceptive pills (COCP), metformin, and combination treatment were evaluated.

Data Sources
Ovid Medline, Embase, PsycINFO, All EBM, and CINAHL were searched.

Study Selection
Women with PCOS included in randomized controlled trials (RCTs).

Data Extraction
We calculated mean differences and 95% CIs regarding anthropometrics, metabolic, and hyperandrogenic outcomes. Meta-analyses and quality assessment using GRADE were performed.

Data Synthesis
The search identified 1660 publications; 36 RCTs were included. For hirsutism, no differences were seen when comparing metformin vs COCP, nor when comparing COCP vs combination treatment with metformin and COCP. Metformin was inferior on free androgen index (FAI) (7.08; 95% CI 4.81, 9.36), sex hormone binding globulin (SHBG) (−118.61 nmol/L; 95% CI −174.46, −62.75) and testosterone (0.48 nmol/L; 95% CI 0.32, 0.64) compared with COCP. COCP was inferior for FAI (0.58; 95% CI 0.36, 0.80) and SHBG (−16.61 nmol/L; 95% CI −28.51, −4.71) compared with combination treatment, whereas testosterone did not differ. Metformin lowered insulin (−27.12 pmol/L; 95% CI −40.65, −13.59) and triglycerides (−0.15 mmol/L; 95% CI −0.29, −0.01) compared with COCP. COCP was inferior for insulin (17.03 pmol/L; 95% CI 7.79, 26.26) and insulin resistance (0.44; 95% CI 0.17, 0.70) compared with combination treatment.

Conclusions
The choice of metformin or COCP treatment should be based on symptoms, noting some biochemical benefits from combination treatment targeting both major endocrine disturbances seen in PCOS (hyperinsulinemia and hyperandrogenism).