bluuebunny/crossref_metadata_2025_split huggingface dataset:
ALT/AST ratio: the useful predictive marker for insulin resistance
Authors: Han Seul Ki , Lee Taesic , Kim Moon Young 
Published: April 2023

Abstract
Background and Aims: Insulin resistance is common pathophysiology in type 2 diabetes mellitus, cardiovascular disease, and non-alcoholic fatty liver disease. As increased to the prevalence of these diseases, screening the risk for IR becomes important to prevent disease progression. To predict insulin resistance in the general population, regardless of comorbidity, we analyzed the health examination data using Alanine aninotransferase/Aspartate aminotransferase ratio for analysis.
Method: 2015, 2019, and 2020 Korea National Health and Nutrition Examination Survey (KNHANES) were analyzed to validate our hypothesis. For the evaluation of insulin resistance, the following four indices were implemented: fasting serum glucose (Glc) and insulin; Homeostatic Model Assessment for Insulin Resistance (HOMA- IR) and β cell function (HOMA- β). Pearson correlation coefficient (PCC) was implemented to evaluate the degree of association of liver profiles with indices for IR. Linear or logistic regression (LiR or LR) was implemented to identify the association of liver profiles with IR value or status, respectively. Classification performance was evaluated based on the area under curve of Receiver Operating Characteristic (AUC).
Results: Based on PCC, serum ALT in Korean men and women was positively related to four IR indices, including Glc, insulin, HOMA-IR, and HOMA-β. These positive relationships remained after selecting subjects diagnosed with diabetes or dyslipidemia, alcohol consumption, or subjects having general obesity or abdominal obesity. ALT/AST ratio was also robustly correlated with the four IR indices. In the multivariate LiR, when comparing ALT levels, ALT/AST ratio in Korean men exhibited better predictive performance for Glc and HOMA-β, besides, that in Korean women provided improved outcomes for all IR indices. Based on the prediction for the binary form of IR status, the ALT/AST ratio in Korean men and women could well predict HOMA-β and HOMA-IR, compared to the sole ALT level, respectively.
Conclusion: In the analysis that includes a large community-based population, ALT/AST ratio is a useful predictive marker compared with HOMA-IR. A simple, precise marker that is represented to ALT/AST could be a practical method to screen insulin resistance in the general population regardless of Diabetes mellitus (DM), alcohol intake, and gender.
Modified Tree Rule Firewall for Removing Redundant and Shadowing Rules in Cloud Firewall Policy
Authors: HAKANI DHWANI , MANN PALVINDER 
Published: April 2023

Abstract
Most private networks are secured by firewalls, which are crucial for safety. A firewall aims to inspect each incoming and outgoing packet before deciding whether to allow it. Among conventional firewalls, rule-based ones are the most frequently used. However, traditional Listed-Rule firewalls have limits when it comes to task performance and is ineffective when used with some networks that have very large firewall rule sets. This paper suggests a model firewall design, "Tree-Rule Firewall," which has advantages and works with expansive networks like "cloud". This paper proposes a modified tree rule firewall (MTRFcloud) for removing redundant and shadowing rules, improving cloud network security. This work first generates a tree rule firewall for the corresponding firewall policy. The suggested modified tree rule firewall does not produce redundant rules and efficiently finds the shadow rules. Then, a modified Tree-Rule firewall that manages firewall rules was tested in a cloud setting. It is shown that the updated Tree-Rule firewall provides faster processing and greater network security. With a big network, like a cloud network, the modified Tree-Rule firewall is simpler to construct and efficiently removes the redundant and shadow rules.
Avian nuptial plumage coloration changes differently when exposed to urban and rural areas
Authors: Surmacki Adrian , Siefferman Lynn , Plackowska Anna 
Published: April 2023

AbstractAvian plumage coloration could be altered by external factors like dust accumulation, but the effect of environmental conditions on such post-moult colour changes are poorly studied. Here, we investigated how exposure to the atmosphere in habitats of differing anthropogenic pressures modifies UV/blue structural plumage coloration- a sexually-selected trait in Eastern BluebirdsSialia sialis. We collected feather samples from live birds and distributed them in three types of habitats: i) urban roads with low traffic, ii) urban roads with high traffic, iii) rural roads with low traffic. After 4 weeks, the brightness of feathers decreased in all types of habitats-resulting in less-ornamented coloration. Changes in UV and blue chroma, however, varied with habitat type; chroma decreased in urban areas (becoming less ornamented), but increased in rural locations (becoming more ornamented). According to physiological models of avian colour vision, however, these changes in coloration tended to be below perceptual thresholds. Our results underscore the importance of how human activity can influence plumage colour of individual birds during the period between moult cycles which could have an impact on avian visual signaling. The study opens venues for further studies focusing on how the optical properties of specific airborne particles can influence coloration of wild-living animals.
Physical-Chemical and Energy Characterization of Residual Biomass from Baru Fruit (Dipteryx Alata Vogel)
Authors: Costa Emerson Belarmino , Gouvêa Adriana de Fátima Gomes , Carneiro Angélica de Cássia Oliveira , Carvalho Ana Márcia Macedo Ladeira , Gomes Claudia Marcia , Câmara Ana Paula 
Published: April 2023

Abstract
The use of the fruit of the species Dipteryx alata Vogel (baru) is a highly profitable and expanding activity in the Brazilian market, although the almond of the fruit has high commercial value, the processing of the fruit generates about 87% of residual biomass. The objective of this work was to characterize the biomass and biochar obtained from the residual biomass of the fruit. Biomass was characterized in relation to physical, chemical and energetic properties. Subsequently, biomass carbonization was carried out at different rates of final temperatures (450; 550 and 650 ° C). For carbonization, the gravimetric yield in biochar, bio-oil and non-condensable gases was analyzed. Biochar was characterized in relation to chemical, physical and energetic parameters. The apparent density value found for biomass was 0.917 g.cm−³ while the biochar varied from 0.723 to 0.768 g.cm−³. Regarding the chemical composition of the biomass, the extract value was 9.88%. The total lignin content was 28.29%. For the immediate chemical analysis the values were 0.40 for ash, 18.47% for fixed carbon and 81.34% for volatile materials. The gravimetric yield of biochar at different temperatures ranged from 34.99 to 39.48%, while the yield on condensable gases ranged from 35.36 to 40.33% and the yield on non-condensable gases was around 23.54 to 25, 29%. The calorific value of biomass was 21,176 kj.kg− 1 and biochar up to 35,328a kj.kg− 1. The values found indicate that the residual biomass and biochar from the fruit's pericarp, showed high energy potent.
Quantifying Anthropogenic Interventions in Yamuna River Through River Flow Health Index and Geomorphic Analysis
Authors: Mohanty Maithili , Tare Vinod 
Published: April 2023

Abstract
The study deals with the flow alterations and planform adjustments due to the construction and operation of barrages in Yamuna River, India. The flow alterations are quantified using the River Flow Health Index on a 0–1 scale. The planform adjustments are analyzed using satellite-generated geomorphic maps. Results show that the magnitude and variability of flows are the most altered components during the construction phase. During post operation of Hathnikund barrages, the variability of flows associated with water withdrawal is the most altered component. Downstream of the barrage displayed an increase in fluvial bars and channel multiplicity and a decrease in channel area and width due to erratic construction activities, restricting floodplain connectivity. However, the river tends to return to the previous altered state during the post-Hathnikund barrage period. Withdrawal from the Hathnikund barrage to meet the water demand has left the channel dry during the year's lean season (2003, 2008, and 2013). Maintaining a minimum flow of 10m3/s during the lean season as ordered by the National Green Tribunal, India has reduced the channel belt in the Yamuna River (2018). These findings may help re-implement reservoir operating policies reducing downstream hydrological modifications, and aid in developing the river basin development plans.
Correlation between lymphotoxin-α concentrations and conjunctival goblet cell density in dry eye patients
Authors: Ke Lan , Wu Huanhuan , Shen Dan , Qi Mengying , Qiao Chen , Wang Haoyu , Zeng Qingyan 
Published: April 2023

Abstract
Purpose
To explore the relationship between the tear lymphotoxin-α (LT-α) concentration, conjunctival goblet cell density (GCD) and ophthalmic parameters in dry eye patients and the value of the LT-α concentration and conjunctival GCD in diagnosing dry eye.
Methods
Prospective case‒control study. Seventy-eight dry eye patients and twenty normal subjects were recruited. After completing the China Dry Eye Questionnaire, all subjects were examined in sequence with slit-lamp microscopy, tear LT-α concentration analysis, tear meniscus height measurement, the Schirmer I test and the conjunctival GCD examination using confocal microscopy.
Results
The conjunctival GCD (54.70 (24.38–126.50) cells/mm2) in the dry eye group was lower than that in the control group (125.80 (72.75–180.00) cells/mm2) (P = 0.011). The LT-α concentration(0.17(0.05–1.18) ng/ml) in the dry eye group was lower than that in the control group(0.30(0.13–1.32) ng/ml) without statistical significance (P = 0.366). And the LT-α concentrations were positively correlated with the tear film breakup time (FBUT) ( r = 0.262, p < 0.01). When LT-α < 1.47 ng/ml (81.6% subjects fell in this range), conjunctival GCD was positively correlated with the LT-α concentration (β = 63.92, P = 0.004). The area under the ROC curve (AUC) of LT-α concentration in the diagnosis of dry eye was 0.5657, the cutoff value was 0.11 ng/ml, the sensitivity was 41.03%, and the specificity was 80.00%. The AUC of conjunctival GCD in the diagnosis of dry eye was 0.6993, the cutoff value was 67.90 cells/mm2, the sensitivity was 59.15%, and the specificity was 82.35%.
Conclusion
The LT-α concentration is valuable in evaluating conjunctival GCD and tear film stability. The value of evaluating the conjunctival GCD using confocal microscopy in dry eye diagnosis is worthy of attention.
Gram classification of positive blood cultures is associated with mortality outcomes in septic acute kidney injury requiring continuous renal replacement therapy
Authors: Lee Jinwoo , Song Jeongin , Kim Seong Geun , Yun Donghwan , Kang Min Woo , Kim Dong Ki , Oh Kook-Hwan , Joo Kwon Wook , Kim Yon Su , Han Seung Seok , Park Jae Yoon , Kim Yong Chul 
Published: April 2023

Abstract
Sepsis is one of the most common causes of AKI in ICU patients, accounting for 15–20% of renal replacement therapy prescriptions. Herein, we aimed to investigate how bacterial blood culture results before CRRT correlate with mortality outcomes in patients with septic AKI requiring CRRT. The enrolled patients were divided into culture-negative, gram-positive, and gram-negative. Since the use of empirical antibiotics can affect culture-positive determination, information on antibiotic use was collected in chronological order. The primary outcome was in-hospital mortality after the initiation of CRRT. A total of 874 septic AKI patients requiring CRRT were classified into three groups: culture-negative, gram-positive cocci, and gram-negative rods. Their in-hospital mortality rates were 79.1%, 75.7%, and 61.9%, respectively (P = 0.002). In univariable Cox survival analysis performed after matching propensity scores, the gram-negative rod group was still associated with an approximately 37% reduction in mortality compared to the culture-negative group. The survival benefit of the gram-negative rod group during and after CRRT remained consistent across all subgroups, showing any P for interactions greater than 0.05. Culture-positive of gram-negative rods before CRRT initiation determine subsequent better clinical outcomes, such as lower mortality in patients undergoing CRRT due to septic AKI.
Neutrophil-to-Lymphocyte Ratio (NLR) Could Serve as a Potential Marker for Delirium and Delirium Duration in Geriatric Patients with Hip Fracture: A Retrospective Study
Authors: Zhao Shengjie , Sun Tiansheng , Zhang Jianzheng , Wang Yelai , Guo Yanhui , Wang Xiaowei 
Published: April 2023

Abstract
Purpose Postoperative delirium (POD) is an independent risk factor not only for mortality but also for institutionalization and dementia. The purpose of this study was to investigate the risk factors, which is related to the pathogenesis of POD, in geriatric patients with hip fracture.Methods 1,242 Eligible patients with hip fracture were enrolled. Receiver operating characteristic (ROC) curve was performed to identify the optimal cut point of NLR for POD. The relationship between NLR and POD occurrence, NLR and POD duration were analyzed by multivariable analysis.Results ROC curve showed that the optimal cut point of NLR for POD was NLR ≥ 7.6. Multivariate logistic regression analysis showed that NLR ≥ 7.6 (odds ratio [OR] 2.75, [95% confidence interval [CI] 1.51 to 5.02], p = 0.001), stroke (OR 1.05, [95% CI 1.02 to 1.09], p = 0.005), complications, general anesthesia, long length of stay were risk factors of POD, with the largest effect for NLR ≥ 7.6. NLR ≥ 7.6 (OR 0.59, [95% CI 0.209 to 0.886], p = 0.038), older age (OR 0.054, [95% CI 0.009 to 0.099], p = 0.019), previous stroke (OR 0.908, [95% CI 0.085 to 1.731], p = 0.031), and previous heart failure (OR 1.679, [95% CI 0.448 to 2.910], p = 0.008) suggested long POD duration.Conclusions NLR could be used as a potential marker for prediction of POD and POD duration in geriatric patients with hip fracture.
Autosomal dominant tubulointerstitial kidney disease cosegregating with COL4A4:p.G545A in Turkish Cypriot families with kidney failure
Authors: Ozdemir Fezile , Oygar D Deren , Behlul Ahmet , Ataç Salahi , Bardak Simge , Yükseliş Meral , Deltas Constantinos , Papagregoriou Gregory , Malatras Apostolos , Gale Daniel P , Gurkan Cemal , Neild Guy H 
Published: April 2023

Abstract
Chronic kidney disease (CKD) is a global health priority with over 850 million people affected. The starting point for improving outcome must be to diagnose the primary renal disease and in low and middle income countries ‘unknown aetiology’ accounts for the majority of diagnoses. In Cyprus, familial kidney disease is very common. Using next-generation sequencing, we found that a common polymorphism (COL4A4:p.G545A), hitherto considered to be benign or hypomorphic, was present in 5 of 53 Turkish Cypriot families with kidney disease and a glomerular phenotype (at least one person with haematuria and/or proteinuria). Therefore, we tested 49 further families with kidney disease using a restriction fragment length polymorphism assay. From this total of 102 families, we showed that this variant was present in 12 of 85 families (14%) with some evidence of glomerular disease and none of 17 with chronic kidney disease lacking these features. Co-segregation analyses indicated that the variant co-segregated with disease more than would be expected by chance. These families have an autosomal dominantly inherited susceptibility to kidney disease associated with variable and intermittent microscopic haematuria, proteinuria < 1 g/day until the eGFR falls below 30 ml/min. End-stage kidney disease occurred in 17% of those affected at a median of 66 years. The presentation is more characteristic of a tubulointerstitial kidney disease and represents a tubular phenotype of Alport spectrum nephropathy.
Heritable microbiome variation is correlated with source environment in locally adapted maize varieties
Authors: Yu Peng , He Xiaoming , Wang Danning , Jiang Yong , Li Meng , McLaughlin Chloee , Marcon Caroline , Guo Li , Baer Marcel , Delgado-Baquerizo Manuel , Moya Yudelsy Tandron , von Wirén Nicolaus , Deichmann Marion , Schaaf Gabriel , Piepho Hans-Peter , Yang Zhikai , Yang Jinliang , Yim Bunlong , Smalla Kornelia , Hüging Hubert , Sawers Ruairidh , Reif Jochen , Hochholdinger Frank , Chen Xinping , de Vries Franciska , Goormachtig Sofie 
Published: April 2023

Abstract
Beneficial interactions with microorganisms are pivotal for crop performance and resilience. However, it remains unclear how heritable the microbiome is with respect to the host plant genotype and to what extent host genetic mechanisms can modulate plant-microbe interactions in the face of environmental stress. Here, we surveyed 3,168 root and rhizosphere microbiome samples from 129 accessions of locally adapted Zea mays, sourced from diverse habitats and grown under control and different stress conditions. We quantified treatment and host genotype effects on the microbiome. Plant genotype and source environment were predictive of microbiome abundance. Genome wide association analysis identified host genetic variants linked to both rhizosphere microbiome abundance and source environment. We identified transposon insertions in a candidate gene linked to both the abundance of a keystone microbe Massilia and source total soil nitrogen, finding specific Massilia alone can contribute to root development, biomass production and nitrogen resilience. We conclude that locally adapted maize varieties exert patterns of genetic control on their root and rhizosphere microbiomes that follow variation in their home environments, consistent with a role in tolerance to prevailing stress.
the incidence rate and prognostic factors of heart failure-related adverse events in hypertrophic cardiomyopathy: A systematic review and meta-analysis
Authors: Jiang Maoning , Mu Tingting , Sun Youhai , Wang Xiaojun , Deng Aiyun 
Published: April 2023

Abstract
Introduction heart failure is a common comorbidities of hypertrophic cardiomyopathy（HCM）, The mortality and hospitalization rates of heart failure-related in patients with HCM is constantly increasing，However, Prognosis and risk assessment of heart failure-related adverse events（HF-RAEs）in patients with HCM is controversial. Therefore, this study aimed to systematically review and conduct a meta-analysis of the incidence rate and predictors of HF-RAEs in patients with HCM.
Methods PubMed, Embase, Web of science, and Cochrane library were searched to identify studies that compared the incidence rate and predictors of HF-RAEs in patients with HCM. The outcomes of interest included the incidence rate and predictors of HF-RAEs, such as sex, atrial fibrillation, hypertension, left ventricular ejection fraction (LVEF), left atrial diameter.
Results fourteen studies comprising 6,903 patients were included. The pooled results showed a higher incidence (11%) of HF-RAEs in patients with HCM. Some clinical and imaging parameters, such as male gender (HR = 1.963, 95% CI (1.354, 2.847)), atrial fibrillation（HR=2.60,95%CI（1.87,3.61））, left atrial diameter (HR = 1.06, 95% CI (1.04, 1.07)) ,and LVEF (HR=0.96,95%CI(0.95,0.97)) could be used as predictors of the occurrence of HF-RAEs in patients with HCM, while hypertension (HR=1.47,95%CI (0.99,2.20) could not.
Conclusion Patients with HCM have a higher incidence of HF-RAEs. Clinical indicators, as well as imaging parameters could predict the risk of HF-RAEs in patients with HCM. These risk factors should be closely monitored to effectively prevent the occurrence of HF-RAEs in HCM.
The incidence of complication in the perioperative period of rotational atherectomy in patients with acute coronary syndrome: A retrospective study of low-speed versus high-speed
Authors: WU JIAWEI , QIU GUANGQUAN , LI HUI , HU HAO , MA LIKUN 
Published: April 2023

Abstract
Background The safety and efficacy of rotational atherectomy (RA) in acute coronary syndrome (ACS) patients treated with different rotational speeds remain unclear.Methods This was an observational retrospective registry. Between February 2017 and January 2022, a total of 283 ACS patients were treated with RA. The patients were divided into two groups: the low-speed group (130,000-150,000rpm,182 cases) and the high-speed group (160,000-220,000rpm,101 cases) according to the maximum RA speed. The primary outcome was the occurrence of hypotension, vasospasm, dissection, slow flow, perforation, bradyarrhythmia, burr entrapment, rotawire fracture during RA, as well as the incidence of heart failure, stent thrombosis, and cardiac death during hospitalization.Results Patients in the low-speed RA group experienced a higher incidence of vasospasm during RA operation (15.4% versus 6.9%, p = 0.040), whereas the incidence of slow blood flow was higher in the high-speed RA group (16.5% versus 27.7%, p = 0.031). There was no significant difference in other complications between the two groups. Moreover, logistic regression analysis identified rotational speed (160,000-220,000rpm) as a predictor of slow flow during RA operation (OR = 1.900, 95%CI:1.006–3.588, p = 0.048). For every 10,000 rpm increase in rotational speed, the risk of slow flow increased by 27% (OR = 1.273, 95% CI: 1.047–1.547, p = 0.015).Conclusion ACS patients treated with a lower RA speed (130,000-150,000 rpm) had a higher risk of vasospasm, while in patients where higher speeds were used (160,000-220,000 rpm ), a higher incidence of slow flow was identified. High rotational speed (160,000-220,000 rpm) is an independent risk factor for slow flow during RA in ACS patients.
Inflammation and digestive reflux in the pancreatic stump after pancreaticoduodenectomy
Authors: Wang Tiegong , Tian Liang , Zhang Xiaoling , Xu Yanfeng , Che Yanxu , Zhang Lei , Zhao Xiulei , Kong Deshuai , Luo Yi 
Published: April 2023

Abstract
Background and Objectives:
Postoperative pancreatic fistula (POPF) contributes to significant morbidity and mortality after pancreaticoduodenectomy (PD). However, the underlying mechanisms of POPF remain unclear. This study is to explore the pathology in the pancreatic stump and elucidates the mechanisms of POPF following PD.
Methods:
Pathological analysis and 16S rRNA gene sequencing were performed on the specimens obtained from the two patients who accepted complete pancreatectomy for grade C POPF after PD. In addition, a retrospective radiological analysis was conducted on a cohort of 125 consecutive patients who underwent PD to evaluate the inflammatory response in the pancreatic stump.
Results:
The presence of gradient inflammation and acinar-duct metaplasia (ADM) in the pancreatic stumps is ubiquitous. The incidence of apoptosis is markedly reduced in the pancreatic stump. Moreover, a significant accumulation of neutrophil-dominated inflammatory cells is detected in the ductal system. Notably, the ADM-formed duct is the site where the neutrophils transmigrate through the ductal wall. Additionally, the microbial evidence indicates that gut microbes migrate from the digestive tract. Radiological analysis proves that a gradient of pancreatitis exists in all cases after PD and reaches peak on the fourth postoperative day.
Conclusions:
Inflammation and digestive reflux exist in the pancreatic stump after PD. The underlying mechanisms of POPF are the high biochemical activity of the pancreas, mechanical injury, and digestive reflux.