bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic performance of the REDS score, SOFA score, NEWS2 score, and the red-flag, NICE high-risk, and SIRS criteria to predict survival at 180 days, in emergency department patients admitted with suspected sepsis – An observational cohort study
Authors: Sivayoham Narani , Hussain Adil N. , Sheerin Thomas , Dwivedi Prerak , Curpanen Danalakshmee , Rhodes Andrew 
Published: March 2023

BackgroundPatients admitted to hospital with sepsis are at persistent risk of poor outcome after discharge. Many tools are available to risk-stratify sepsis patients for in-hospital mortality. This study aimed to identify the best risk-stratification tool to prognosticate outcome 180 days after admission via the emergency department (ED) with suspected sepsis.MethodsA retrospective observational cohort study was performed of adult ED patients who were admitted after receiving intravenous antibiotics for the treatment of a suspected sepsis, between 1st March and 31st August 2019. The Risk-stratification of ED suspected Sepsis (REDS) score, SOFA score, Red-flag sepsis criteria met, NICE high-risk criteria met, the NEWS2 score and the SIRS criteria, were calculated for each patient. Death and survival at 180 days were noted. Patients were stratified in to high and low-risk groups as per accepted criteria for each risk-stratification tool. Kaplan–Meier curves were plotted for each tool and the log-rank test performed. The tools were compared using Cox-proportional hazard regression (CPHR). The tools were studied further in those without the following specified co-morbidities: Dementia, malignancy, Rockwood Frailty score of 6 or more, long-term oxygen therapy and previous do-not-resuscitate orders.ResultsOf the 1,057 patients studied 146 (13.8%) died at hospital discharge and 284 were known to have died within 180 days. Overall survival proportion was 74.4% at 180 days and 8.6% of the population was censored before 180 days. Only the REDS and SOFA scores identified less than 50% of the population as high-risk. All tools except the SIRS criteria, prognosticated for outcome at 180 days; Log-rank tests between high and low-risk groups were: REDS score p &lt; 0.0001, SOFA score p &lt; 0.0001, Red-flag criteria p = 0.001, NICE high-risk criteria p = 0.0001, NEWS2 score p = 0.003 and SIRS criteria p = 0.98. On CPHR, the REDS [Hazard ratio (HR) 2.54 (1.92–3.35)] and SOFA [HR 1.58 (1.24–2.03)] scores out-performed the other risk-stratification tools. In patients without the specified co-morbidities, only the REDS score and the SOFA score risk-stratified for outcome at 180 days.ConclusionIn this study, all the risk-stratification tools studied were found to prognosticate for outcome at 180 days, except the SIRS criteria. The REDS and SOFA scores outperformed the other tools.
Trophic diversification and parasitic invasion as ecological niche modulators for gut microbiota of whitefish
Authors: Kashinskaya Elena N. , Simonov Evgeniy P. , Poddubnaya Larisa G. , Vlasenko Pavel G. , Shokurova Anastasiya V. , Parshukov Aleksey N. , Andree Karl B. , Solovyev Mikhail M. 
Published: March 2023

IntroductionThe impact of parasites on gut microbiota of the host is well documented, but the role of the relationship between the parasite and the host in the formation of the microbiota is poorly understood. This study has focused on the influence that trophic behavior and resulting parasitism has on the structure of the microbiome.MethodsUsing 16S amplicon sequencing and newly developed methodological approaches, we characterize the gut microbiota of the sympatric pair of whitefish Coregonus lavaretus complex and the associated microbiota of cestodes parasitizing their intestine. The essence of the proposed approaches is, firstly, to use the method of successive washes of the microbiota from the cestode’s surfaces to analyze the degree of bacterial association to the tegument of the parasite. Secondly, to use a method combining the sampling of intestinal content and mucosa with the washout procedure from the mucosa to understand the real structure of the fish gut microbiota.Results and discussionOur results demonstrate that additional microbial community in the intestine are formed by the parasitic helminths that caused the restructuring of the microbiota in infected fish compared to those uninfected. Using the desorption method in Ringer’s solution, we have demonstrated that Proteocephalus sp. cestodes possess their own microbial community which is put together from “surface” bacteria, and bacteria which are weakly and strongly associated with the tegument, bacteria obtained after treatment of the tegument with detergent, and bacteria obtained after removal of the tegument from the cestodes.
Brain effective connectivity and functional connectivity as markers of lifespan vascular exposures in middle-aged adults: The Bogalusa Heart Study
Authors: Chuang Kai-Cheng , Ramakrishnapillai Sreekrishna , Madden Kaitlyn , St Amant Julia , McKlveen Kevin , Gwizdala Kathryn , Dhullipudi Ramasudhakar , Bazzano Lydia , Carmichael Owen 
Published: March 2023

IntroductionEffective connectivity (EC), the causal influence that functional activity in a source brain location exerts over functional activity in a target brain location, has the potential to provide different information about brain network dynamics than functional connectivity (FC), which quantifies activity synchrony between locations. However, head-to-head comparisons between EC and FC from either task-based or resting-state functional MRI (fMRI) data are rare, especially in terms of how they associate with salient aspects of brain health.MethodsIn this study, 100 cognitively-healthy participants in the Bogalusa Heart Study aged 54.2 ± 4.3years completed Stroop task-based fMRI, resting-state fMRI. EC and FC among 24 regions of interest (ROIs) previously identified as involved in Stroop task execution (EC-task and FC-task) and among 33 default mode network ROIs (EC-rest and FC-rest) were calculated from task-based and resting-state fMRI using deep stacking networks and Pearson correlation. The EC and FC measures were thresholded to generate directed and undirected graphs, from which standard graph metrics were calculated. Linear regression models related graph metrics to demographic, cardiometabolic risk factors, and cognitive function measures.ResultsWomen and whites (compared to men and African Americans) had better EC-task metrics, and better EC-task metrics associated with lower blood pressure, white matter hyperintensity volume, and higher vocabulary score (maximum value of p = 0.043). Women had better FC-task metrics, and better FC-task metrics associated with APOE-ε4 3–3 genotype and better hemoglobin-A1c, white matter hyperintensity volume and digit span backwards score (maximum value of p = 0.047). Better EC rest metrics associated with lower age, non-drinker status, and better BMI, white matter hyperintensity volume, logical memory II total score, and word reading score (maximum value of p = 0.044). Women and non-drinkers had better FC-rest metrics (value of p = 0.004).DiscussionIn a diverse, cognitively healthy, middle-aged community sample, EC and FC based graph metrics from task-based fMRI data, and EC based graph metrics from resting-state fMRI data, were associated with recognized indicators of brain health in differing ways. Future studies of brain health should consider taking both task-based and resting-state fMRI scans and measuring both EC and FC analyses to get a more complete picture of functional networks relevant to brain health.
Case report: Delayed outflow obstruction of a DVA: A rare complication of brainstem cavernoma surgery
Authors: Agyemang Kevin , Gómez Rodríguez Rony , Rocha Marussi Victor Hugo , Marte Arias Sally Allinson , Feliciano Vilcahuaman Paitań Alexander , Campos Filho José Maria , Chaddad-Neto Feres 
Published: March 2023

IntroductionDevelopmental venous anomalies (DVAs) are considered variants of normal transmedullary veins. Their association with cavernous malformations is reported to increase the risk of hemorrhage. Expert consensus recommends meticulous planning with MR imaging, use of anatomical “safe zones”, intraoperative monitoring of long tracts and cranial nerve nuclei, and preservation of the DVA as key to avoiding complications in brainstem cavernoma microsurgery. Symptomatic outflow restriction of DVA is rare, with the few reported cases in the literature restricted to DVAs in the supratentorial compartment.CaseWe present a case report of the resection of a pontine cavernoma complicated by delayed outflow obstruction of the associated DVA. A female patient in her 20's presented with progressive left-sided hemisensory disturbance and mild hemiparesis. MRI revealed two pontine cavernomas associated with interconnected DVA and hematoma. The symptomatic cavernoma was resected via the infrafacial corridor. Despite the preservation of the DVA, the patient developed delayed deterioration secondary to venous hemorrhagic infarction. We discuss the imaging and surgical anatomy pertinent to brainstem cavernoma surgery, as well as the literature exploring the management of symptomatic infratentorial DVA occlusion.ConclusionDelayed symptomatic pontine venous congestive edema is extremely rare following cavernoma surgery. DVA outflow restriction from a post-operative cavity, intraoperative manipulation, and intrinsic hypercoagulability from COVID-10 infection are potential pathophysiological factors. Improved knowledge of DVAs, brainstem venous anatomy, and “safe entry zones” will further elucidate the etiology of and the efficacious treatment for this complication.
Results of treatment with alemtuzumab in a Spanish cohort of patients with multiple sclerosis in the real world: The RealMS study
Authors: Eichau Sara , López Ruiz Rocío , Ruíz de Arcos María , Ruiz-Peña Juan Luis , Navarro Guillermo , Calleja Miguel Ángel , Moreno-Amador José Luis , Dotor García-Soto Julio 
Published: March 2023

BackgroundAlemtuzumab (ALZ) is a humanized monoclonal antibody approved for the treatment of patients with highly active relapsing-remitting multiple sclerosis (RRMS) administered in two annual courses. The objective of this study was to describe the effectiveness and safety data of ALZ and to report the health resource utilization in patients receiving this treatment.MethodsIn this retrospective, non-interventional study, information was retrieved from patients' medical charts at one center in Spain. Included patients were ≥18 years old, and ALZ treatment was initiated between 1 March 2015 and 31 March 2019, according to routine clinical practice and local labeling.ResultsOf 123 patients, 78% were women. The mean (standard deviation, SD) age of patients at diagnosis was 40.3 (9.1) years, and the mean time since diagnosis was 13.8 (7.3) years. Patients were previously treated with a median (interquartile range; IQR) number of two (2.0–3.0) disease-modifying treatments (DMTs). Patients were treated with ALZ for a mean (SD) of 29.7 (13.8) months. ALZ reduced the annualized relapse rate (ARR) (1.5 before vs. 0.05 after;p&lt; 0.001) and improved the median EDSS (4.63 before vs. 4.00 after;p&lt; 0.001). Most (90.2%) patients were relapse-free while receiving ALZ. The mean number of gadolinium-enhancing [Gd+] T1 lesions was reduced (1.7 before vs. 0.1 after;p&lt; 0.001), and the mean number of T2 hyperintense lesions was maintained (35.7 before vs. 35.4 after;p= 0.392). A total of 27 (21.9%) patients reported 29 autoimmune diseases: hyperthyroidism (12), hypothyroidism (11), idiopathic thrombocytopenic purpura (ITP) (3), alopecia areata (1), chronic urticaria (1), and vitiligo (1). The mean number of health resources (outpatient visits, emergency room visits, hospital admissions, and tests performed in the hospital) used while patients were treated with ALZ progressively decreased from year 1 to year 4, except for a slight increase at year 2 of outpatient visits.ConclusionThe ReaLMS study provides real-world evidence that ALZ can promote clinical and magnetic resonance imaging disease remission, as well as disability improvement in patients with MS, despite several prior DMT failures. The ALZ safety profile was consistent with data available from clinical trials and other real-world studies. Healthcare resource use was reduced throughout the treatment period.
Research on brain functions related to visual information processing and body coordination function of pilots based on the low-frequency amplitude method
Authors: Xu Kaijun , Liu Rui , Chen Xipeng , Chen Xi , Yang Yong , Wang Quanchuan , Yang Jiazhong 
Published: March 2023

ObjectiveResearch on the differences in physiological and psychological mechanisms of practitioners in different occupations is a current hot spot, such as pilots. This study explores the frequency-dependent changes of pilots’ low-frequency amplitudes in the classical frequency band and sub-frequency band between pilots and general occupations. The goal of the current work is to provide objective brain images for the selection and evaluation of outstanding pilots.MethodsTwenty-six pilots and 23 age-, sex-, and education-matched healthy controls were included in this study. Then the mean low-frequency amplitude (mALFF) of the classical frequency band and sub-frequency band was calculated. The two-sample t-test was performed on SPM12 to analyze the differences between the flight group and control group in the classic frequency band. To explore the main effects and the inter-band effects of the mean low-frequency amplitude (mALFF), the mixed design analysis of variance was applied in the sub-frequency bands.ResultsCompared with the control group, left cuneiform lobe and the right cerebellum six area of pilots show significant difference in the classic frequency band. And the main effect results in the sub-frequency bands show that the area with higher mALFF in the flight group is located on the left middle occipital gyrus, the left cuneiform lobe, the right superior occipital gyrus, the right superior gyrus, and the left lateral central lobule. However, the area where the value of mALFF decreased is mainly located on the left rectangular cleft with surrounding cortex and the right dorsolateral superior frontal gyrus. Besides, compared with the slow-4 frequency band, the mALFF of the left middle orbital middle frontal gyrus of the slow-5 frequency band was increased, while the mALFF value of the left putamen, left fusiform gyrus, and right thalamus was decreased. The sensitivity of the slow-5 frequency band and the slow-4 frequency band to the pilots’ different brain areas was also different. Also, the different brain areas in the classic frequency band and the sub-frequency band were significantly correlated with pilots’ flight hours.ConclusionOur findings showed that the left cuneiform brain area and the right cerebellum of pilots changed significantly during resting state. And there was a positive correlation between the mALFF value of those brain area and flight hours. The comparative analysis of sub-frequency bands found that the slow-5 band could elucidate a wider range of different brain regions, providing new ideas for exploring the brain mechanisms of pilots.
Integrating conservation agriculture with intensive crop diversification in the maize-based organic system: Impact on sustaining food and nutritional security
Authors: Ansari Meraj Alam , Ravisankar N. , Ansari Majhrool Hak , Babu Subhash , Layek Jayanta , Panwar A. S. 
Published: March 2023

IntroductionDeveloping an intensive sustainable model and feeding a rising population are worldwide challenges. The task is much more daunting in the North Eastern Himalayas, where, low productive maize (Zea mays)- fallow is the main production system in the upland. To increase farm productivity, nutritional security, and energy dietary returns while maintaining environmental sustainability and economic viability, short-duration crops must be included in the maize–fallow system.MethodsA field study was conducted in sandy clay loam soil with a randomized complete block design with three replications for three continuous years (2018–2021) under organic management with two crop management practices, viz., (i) conservation agriculture and (ii) conventional agriculture, and six crop diversification options, viz., (i) maize–sweet corn (Zea mays saccharata)–vegetable pea (Pisum sativa) (M-SC-VP), (ii) maize–sweet corn-mustard (Brassica juncea) (M-SC-M), (iii) maize–sweet corn–lentil (Lens culinaris) (M-SC-L), (iv) maize–sweet corn–vegetable broad bean (Vicia faba) (M-SC-VB), (v) maize (local)–vegetable pea (M-VP), and (vi) maize (local)–fallow (M-F).ResultsThe results showed that, the average system productivity was 5.3% lower for conventional agriculture than conservation agriculture. System carbohydrate, protein, fat, dietary fiber, and dietary energy were ~6.9, 6.8, 7.8, 6.7, and 7%, higher in conservation agriculture than in conventional agriculture, respectively. Similarly, system macronutrients (Ca, Mg, P, and K) and system micronutrients yield (Fe, Mn, Zn, and Cu) were, 5.2–8% and 6.9–7.4% higher in conservation agriculture than in conventional agriculture, respectively. On average, over the years, crop diversification with M-SC-VP/M-SC-VB intensive crop rotation had higher system productivity (158%), production efficiency (157%), net returns (benefit–cost ratio) (44%), and dietary net energy returns (16.6%) than the local maize–vegetable pea system. Similarly, the M-SC-VP/M-SC-VB system improved the nutritional security by improving Ca, Mg, P, K, Fe, Mn, Zn, and Cu yield by 35.5–135.7% than the local M-VP system.DiscussionConservation agriculture with M-SC-VP/M-SC-VB rotation showed significantly (p &lt; 0.05) higher productivity, carbohydrate yield, protein yield, fat yield, and dietary fiber production. It is concluded that conservation agriculture improved soil health and performed better than conventional agriculture in maize-based intensive cropping systems. Overall results indicate that crop diversification with M-SC-VP/M-SC-VB can potentially increase calorie and protein consumption and farm profitability.
Genetic polymorphisms in CYP4F2 may be associated with lung cancer risk among females and no-smoking Chinese population
Authors: Shi Hongyang , Zhang Yonghong , Wang Yu , Fang Ping , Liu Yun 
Published: March 2023

BackgroundOur study aimed to explore the potential association of CYP4F2 gene polymorphisms with lung cancer (LC) risk.MethodsThe five variants in CYP4F2 were genotyped using Agena MassARRAY in 507 cases and 505 controls. Genetic models and haplotypes based on logistic regression analysis were used to evaluate the potential association between CYP4F2 polymorphisms and LC susceptibility.ResultsThis study observed that rs12459936 was linked to an increased risk of LC in no-smoking participants (allele: OR = 1.38, p = 0.035; homozygote: OR = 2.00, p = 0.035; additive: OR = 1.40, p = 0.034) and females (allele: OR = 1.64, p = 0.002; homozygote: OR = 2.57, p = 0.006; heterozygous: OR = 2.56, p = 0.001; dominant: OR = 2.56, p &lt; 0.002; additive: OR = 1.67, p = 0.002). Adversely, there was a significantly decreased LC risk for rs3093110 in no-smoking participants (heterozygous: OR = 0.56, p = 0.027; dominant: OR = 0.58, p = 0.035), rs3093193 (allele: OR = 0.66, p = 0.016; homozygote: OR = 0.33, p = 0.011; recessive: OR = 0.38, p = 0.021; additive: OR = 0.64, p = 0.014), rs3093144 (recessive: OR = 0.20, p = 0.045), and rs3093110 (allele: OR = 0.54, p = 0.010; heterozygous: OR = 0.50, p = 0.014; dominant: OR = 0.49, p = 0.010; additive: OR = 0.54, p = 0.011) in females.ConclusionsThe study demonstrated that CYP4F2 variants were associated with LC susceptibility, with evidence suggesting that this connection may be affected by gender and smoking status.
Clinical updates on gliomas and implications of the 5th edition of the WHO classification of central nervous system tumors
Authors: Guo Xiaopeng , Shi Yixin , Liu Delin , Li Yilin , Chen Wenlin , Wang Yaning , Wang Yuekun , Xing Hao , Xia Yu , Li Junlin , Wu Jiaming , Liang Tingyu , Wang Hai , Liu Qianshu , Jin Shanmu , Qu Tian , Guo Siying , Li Huanzhang , Yang Tianrui , Zhang Kun , Wang Yu , Ma Wenbin 
Published: March 2023

BackgroundThe 5th edition of the World Health Organization (WHO) classification of central nervous system tumors incorporated specific molecular alterations into the categorization of gliomas. The major revision of the classification scheme effectuates significant changes in the diagnosis and management of glioma. This study aimed to depict the clinical, molecular, and prognostic characteristics of glioma and its subtypes according to the current WHO classification.MethodsPatients who underwent surgery for glioma at Peking Union Medical College Hospital during 11 years were re-examined for tumor genetic alterations using next-generation sequencing, polymerase chain reaction-based assay, and fluorescence in situ hybridization methods and enrolled in the analysis.ResultsThe enrolled 452 gliomas were reclassified into adult-type diffuse glioma (ntotal=373; astrocytoma, n=78; oligodendroglioma, n=104; glioblastoma, n=191), pediatric-type diffuse glioma (ntotal=23; low-grade, n=8; high-grade, n=15), circumscribed astrocytic glioma (n=20), and glioneuronal and neuronal tumor (n=36). The composition, definition, and incidence of adult- and pediatric-type gliomas changed significantly between the 4th and the 5th editions of the classification. The clinical, radiological, molecular, and survival characteristics of each subtype of glioma were identified. Alterations in CDK4/6, CIC, FGFR2/3/4, FUBP1, KIT, MET, NF1, PEG3, RB1, and NTRK2 were additional factors correlated with the survival of different subtypes of gliomas.ConclusionsThe updated WHO classification based on histology and molecular alterations has updated our understanding of the clinical, radiological, molecular, survival, and prognostic characteristics of varied subtypes of gliomas and provided accurate guidance for diagnosis and potential prognosis for patients.
Discovery of BAR502, as potent steroidal antagonist of leukemia inhibitory factor receptor for the treatment of pancreatic adenocarcinoma
Authors: Di Giorgio Cristina , Bellini Rachele , Lupia Antonio , Massa Carmen , Bordoni Martina , Marchianò Silvia , Rosselli Rosalinda , Sepe Valentina , Rapacciuolo Pasquale , Moraca Federica , Morretta Elva , Ricci Patrizia , Urbani Ginevra , Monti Maria Chiara , Biagioli Michele , Distrutti Eleonora , Catalanotti Bruno , Zampella Angela , Fiorucci Stefano 
Published: March 2023

IntroductionThe leukemia inhibitory factor (LIF), is a cytokine belonging to IL-6 family, whose overexpression correlate with poor prognosis in cancer patients, including pancreatic ductal adenocarcinoma (PDAC). LIF signaling is mediate by its binding to the heterodimeric LIF receptor (LIFR) complex formed by the LIFR receptor and Gp130, leading to JAK1/STAT3 activation. Bile acids are steroid that modulates the expression/activity of membrane and nuclear receptors, including the Farnesoid-X-Receptor (FXR) and G Protein Bile Acid Activated Receptor (GPBAR1).MethodsHerein we have investigated whether ligands to FXR and GPBAR1 modulate LIF/LIFR pathway in PDAC cells and whether these receptors are expressed in human neoplastic tissues. ResultsThe transcriptome analysis of a cohort of PDCA patients revealed that expression of LIF and LIFR is increased in the neoplastic tissue in comparison to paired non-neoplastic tissues. By in vitro assay we found that both primary and secondary bile acids exert a weak antagonistic effect on LIF/LIFR signaling. In contrast, BAR502 a non-bile acid steroidal dual FXR and GPBAR1 ligand, potently inhibits binding of LIF to LIFR with an IC50 of 3.8 µM.DiscussionBAR502 reverses the pattern LIF-induced in a FXR and GPBAR1 independent manner, suggesting a potential role for BAR502 in the treatment of LIFR overexpressing-PDAC.