bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of the response to phosphodiesterase-5 inhibitors in pulmonary arterial hypertension: an analysis of the Spanish registry
Authors: Garcia Agustin R. , Blanco Isabel , Ramon Lluis , Pérez-Sagredo Jesús , Guerra-Ramos Francisco J. , Martín-Ontiyuelo Clara , Tura-Ceide Olga , Pastor-Pérez Francisco , Escribano-Subías Pilar , Barberà Joan A. 
Published: September 2023

Abstract
Background
Achieving and maintaining a low-risk profile is associated with favorable outcome in pulmonary arterial hypertension (PAH). The effects of treatment on risk profile are variable among patients.

Objective
To Identify variables that might predict the response to treatment with phosphodiesterase-5 inhibitors (PDE-5i) in PAH.

Methods
We carried out a cohort analysis of the Spanish PAH registry in 830 patients diagnosed with PAH that started PDE5i treatment and had > 1 year follow-up. 644 patients started PDE-5i either in mono- or add-on therapy and 186 started combined treatment with PDE-5i and endothelin receptor antagonist (ERA). Responders were considered when at 1 year they: (1) were alive; (2) did not present clinical worsening; and (3) improved European Society of Cardiology/European Respiratory Society (ESC/ERS) risk score or remained in low-risk. Univariate and multivariate logistic regression models were used to analyze variables associated with a favorable response.

Results
Two hundred and ten patients (33%) starting PDE-5i alone were classified as responders, irrespective of whether it was mono- or add-on therapy. In addition to known predictors of PAH outcome (low-risk at baseline, younger age), male sex and diagnosis of portopulmonary hypertension (PoPH) or HIV-PAH were independent predictors of favorable response to PDE-5i. Diffusing capacity for carbon monoxide (DLco) ≤ 40% of predicted was associated with an unfavorable response. When PDE-5i were used in upfront combination, 58% of patients were responders. In this group, diagnosis of idiopathic PAH (IPAH) was an independent predictor of favorable response, whereas connective tissue disease-PAH was associated with an unfavorable response.

Conclusion
Male sex and diagnosis of PoPH or HIV-PAH are predictors of favorable effect of PDE-5i on risk profile when used as mono- or add-on therapy. Patients with IPAH respond more favorably to PDE-5i when used in upfront combination. These results identify patient profiles that may respond favorably to PDE-5i in monotherapy and those who might benefit from alternative treatment strategies.
Generation of green electricity from sludge using photo-stimulated bacterial consortium as a sustainable technology
Authors: Othman Amal S. , Ahmed Nashwa A. , Elneklawi Mona S. , Hassan Mansour M. , El-Mongy Mahmoud Abd 
Published: September 2023

AbstractMicrobial fuel cell (MFC) is a bio-electrical energy generator that uses respiring microbes to transform organic matter present in sludge into electrical energy. The primary goal of this work was to introduce a new approach to the green electricity generation technology. In this context a total of 6 bacterial isolates were recovered from sludge samples collected from El-Sheikh Zayed water purification plant, Egypt, and screened for their electrogenic potential. The most promising isolates were identified according to 16S rRNA sequencing asEscherichia coliandEnterobacter cloacae, promising results were achieved on using them in consortium at optimized values of pH (7.5), temperature (30°C) and substrate (glucose/pyruvate 1%). Low level red laser (λ = 632.8nm, 8mW) was utilized to promote the electrogenic efficiency of the bacterial consortium, maximum growth was attained at 210 sec exposure interval. In an application of adding standard inoculum (107cfu/mL) of the photo-stimulated bacterial consortium to sludge based MFC a significant increase in the output potential difference values were recorded, the electricity generation was maintained by regular supply of external substrate. These results demonstrate the future development of the dual role of MFCs in renewable energy production and sludge recycling.
Construction and testing of Yarrowia lipolytica recombinant protein expression chassis cells based on the high-throughput screening and secretome
Authors: Yu Siqian , Zhang Ge , Liu Qi , Zhuang Yingping , Dai Zongjie , Xia Jianye 
Published: September 2023

Abstract
Background
In the recombinant protein market with broad economic value, the rapid development of synthetic biology has made it necessary to construct an efficient exocrine expression system for the different heterologous proteins. Yarrowia lipolytica possesses unique advantages in nascent protein transport and glycosylation modification, so it can serve as a potential protein expression platform. Although the Po1 series derived from W29 is often used for the expression of the various heterologous proteins, the ability of W29 to secrete proteins has not been verified and the Po1 series has been found to be not convenient for further gene editing.

Results
A total of 246 Y. lipolytica strains were evaluated for their secretory capacity through performing high-throughput screening in 48-well plate. Thereafter, following two rounds of shake flask re-screening, a high-secreting protein starting strain DBVPG 5851 was obtained. Subsequently, combined with the extracellular protein types and relative abundance information provided by the secretome of the starting strain, available chassis cell for heterologous protein expression were preliminarily constructed, and it was observed that the most potential signal peptide was derived from YALI0D20680g.

Conclusions
This study offers a novel perspective on the diversification of Y. lipolytica host cells for the heterologous protein expression and provides significant basis for expanding the selection space of signal peptide tools in the future research.
Stigma and level of familiarity with opioid maintenance treatment (OMT) among specialist physicians in Israel
Authors: Lihi Rozner , Yael Delayahu , Silviu Brill , Anat Sason , Marsha Weinstein , Stacy Shoshan , Shaul Schreiber , Miriam Adelson , Einat Peles 
Published: September 2023

Abstract
Context
Opioid use disorder (OUD) poses significant public health problems that have increased dramatically, resulting in high rates of morbidity and mortality.

Objectives
To minimize the risk of an opioid epidemic in Israel and be prepared, we evaluated physicians’ objective knowledge, level of stigma, and approach to prescribing opioids, risk factors, and identification of patients with substance use disorder (SUD), as well as their knowledge about opioid maintenance treatment (OMT) for OUD.

Methods
Anonymous computerized questionnaires were distributed nationally to physicians by the Israel Medical Association. Knowledge, stigma, and approach were scored.

Results
Of only 249 responders, 58.6% prescribe opioids, 32.1% prescribe cannabis, and 18.5% daily encounter patients with SUD. Logistic regression found the high knowledge group had daily encounters with SUD (Odds Ratio (OR) = 3.5, 95% CI 1.7–7.1) and were familiar with OMT (OR = 10.1, 95% CI 3.5–29.0). The high stigma group was characterized by physicians who prescribe opioids (OR = 1.7, 95% CI 1.0–2.9), but who self-reported having limited knowledge regarding OMT (OR = 2, 95% CI 1.1–3.7). The high approach group was characterized by those who prescribe opioids (OR = 11.7, 95% CI 4.9–28), prescribe cannabis (OR = 2.1, 95% CI 1.0–4.3), self-report having limited knowledge regarding OMT (OR = 11.2, 95% CI 1.4–89) and self-report identifying SUD (OR = 32.5, 95% CI 4.1–260).

Conclusion
High stigma was most evident among physicians who prescribe opioids but, importantly, who had limited knowledge specifically regarding OMT. Gaps in knowledge and approach were observed. An educational intervention is highly recommended to reduce stigma and increase referrals of patients for OMT, the most effective treatment for opioid use disorder.
Prognostic factors affecting survival in patients with non-small cell lung cancer treated with salvage surgery after drug therapy: a multi-institutional retrospective study
Authors: Suzuki Shigeki , Asakura Keisuke , Okui Masayuki , Izawa Naoko , Sawafuji Makoto , Sakamaki Hiroyuki , Shigenobu Takao , Tajima Atsushi , Oka Naoyuki , Masai Kyohei , Kaseda Kaoru , Hishida Tomoyuki , Yasuda Hiroyuki , Fukunaga Koichi , Asamura Hisao 
Published: September 2023

Abstract
Background
The prevalence of salvage surgeries after drug therapy for non-small cell lung cancer (NSCLC) has risen, mainly due to recent progress in molecular-targeted drugs and immune checkpoint inhibitors for NSCLC. While the safety and effectiveness of salvage surgery after drug therapy for NSCLC have been studied, its indications remain unclear. We aimed to identify the prognostic factors affecting survival in patients with advanced-stage (stages III–IV) NSCLC treated with salvage surgery after drug therapy.

Methods
A retrospective investigation was conducted on patients who received salvage surgery after drug therapy at four hospitals between 2007 and 2020. Salvage surgery was defined as surgery after drug therapy for local progression, tumor conversion to resectable status, and discontinuation of prior drug therapy owing to serious complications.

Results
Thirty-two patients received cytotoxic agents alone (n = 12 [38%]), tyrosine kinase inhibitors (TKIs; n = 16 [50%]), or immune checkpoint inhibitors (n = 4 [13%]) as prior drug therapy. In 11 (34%) and 21 (66%) patients, the clinical stage before treatment was III or IV, respectively. The median initial and preoperative serum carcinoembryonic antigen (CEA) levels were 10.2 (range, 0.5–1024) ng/mL and 4.2 (range, 0.6–92.5) ng/mL, respectively. Among the patients, 28 (88%) underwent lobectomy, 2 (6%) underwent segmentectomy, and 2 (6%) underwent wedge resection. Complete resection of the primary lesion was accomplished in 28 (88%) patients. Postoperative complications were documented in six (19%) patients. Mortality rates were 0% at 30 days and 3% at 90 days post-operation. The 5-year overall survival rate stood at 66%, while the 5-year progression-free survival rate was 21%. Multivariate analyses showed that prior TKI therapy and preoperative serum CEA level < 5 ng/mL were prognostic factors influencing overall survival (hazard ratio [95% confidence interval]: 0.06 [0.006–0.68] and 0.03 [0.002–0.41], respectively). The 5-year overall survival in the 11 patients with both favorable prognosticators was 100%.

Conclusions
In this study, prior TKI therapy and preoperative serum CEA level < 5 ng/mL were favorable prognostic factors for overall survival in patients with NSCLC treated with salvage surgery. Patients with these prognostic factors are considered good candidates for salvage surgery after drug therapy.
Uterine WNTS modulates fibronectin binding activity required for blastocyst attachment through the WNT/CA2+ signaling pathway in mice
Authors: Lou Yuefei , Pinel Laurie , Dufort Daniel 
Published: September 2023

AbstractAdhesion of the implanting blastocyst involves the interaction between integrin proteins expressed by trophoblast cells and components present in the basement membrane of the endometrial luminal epithelium. Although several factors regulating integrins and their adhesion to fibronectin are already known, we showed that Wnt signaling is involved in the regulation of blastocyst adhesion through the trafficking of integrins expressed by trophoblast cells. Localization of Itgα5β1 by immunofluorescence and FN-binding assays were conducted on peri-implantation blastocysts treated with either Wnt5a or Wnt7a proteins. Both Wnt5a and Wnt7a induced a translocation of Itgα5β1 at the surface of the blastocyst and an increase in FN-binding activity. We further demonstrated that uterine fluid is capable of inducing integrin translocation and this activity can be specifically inhibited by the Wnt inhibitor sFRP2. To identify the Wnt signaling pathway involved in this activity, blastocysts were incubated with inhibitors of either p38MAPK, PI3K pathway or CamKII prior to the addition of Wnts. Whereas inhibition of p38MAPK and PI3K had not effect, inhibition of CamKII reduced FN-binding activity induced by Wnts. Finally, we demonstrated that inhibition of Wnts by sFRP2 reduced the binding efficiency of the blastocyst to uterine epithelial cells. Our findings provide new insight into the mechanism that regulates integrin trafficking and FN-binding activity and identifies Wnts as a key player in blastocyst attachment to the uterine epithelium.
Assessing outcomes after thrombectomy with or without iliac vein stenting for young provoked DVT patients with iliac vein stenosis
Authors: Pu Hongji , Song Jumin , He Zhijun , Wang Fuyin , Hu Jiateng , Huang Sheng , Yin Minyi , Li Weimin , Liu Xiaobing , Lu Xinwu , Liu Guang 
Published: September 2023

Abstract
Background
This study aimed to assess the outcomes of thrombectomy with/without iliac vein stenting for young and transiently provoked DVT patients with iliac vein stenosis.

Methods
This is a retrospective analysis of a prospectively collected multicenter database. Acute, transiently provoked DVT patients between 18 and 45 years old with iliac vein stenosis were included. All patients underwent thrombectomy. Outcomes including the Villalta score, the VEINES-QOL score, and adverse events were evaluated.

Results
The data of 522 patients were collected of whom 75 were included, 58 underwent thrombectomy alone (nonstenting group) and 17 underwent thrombectomy and stenting (stenting group). Within 6 months, the Villalta score of patients in stenting group is lower than that of patients in nonstenting group (6 mo: 0.73 ± 0.77 vs. 1.41 ± 0.56, p = .0004), and the VEINES-QOL score of stenting group is higher than that of nonstenting group (6 mo: 89.00 ± 2.94 vs. 87.47 ± 3.72, p = .2141). At the following follow-ups, the Villalta score (12 mo: 0.56 ± 0.49 vs. 0.60 ± 0.58, p = .8266) and VEINES-QOL score (12 mo: 88.36 ± 2.29 vs. 88.31 ± 3.36, p = .9604) between the two groups are similar.

Conclusion
The stenting group had better efficacy within 6 months after intervention, while there was no significant difference in the symptom, signs, and quality of life between two groups after 6 months within a 2-year follow-up.

Trial registration
This study was registered in the Chinese Clinical Trial Registry (Registration Number: ChiCTR2200056073).
Prospective association between an obesogenic dietary pattern in early adolescence and metabolomics derived and traditional cardiometabolic risk scores in adolescents and young adults from the ALSPAC cohort
Authors: Solsona Eduard Martínez , Johnson Laura , Northstone Kate , Buckland Genevieve 
Published: September 2023

Abstract
Background
Dietary intake during early life may be a modifying factor for cardiometabolic risk (CMR). Metabolomic profiling may enable more precise identification of CMR in adolescence than traditional CMR scores. We aim to assess and compare the prospective associations between an obesogenic dietary pattern (DP) score at age 13 years with a novel vs. traditional CMR score in adolescence and young adulthood in the Avon Longitudinal Study of Parents and Children (ALSPAC).

Methods
Study participants were ALSPAC children with diet diary data at age 13. The obesogenic DP z-score, characterized by high energy-density, high % of energy from total fat and free sugars, and low fibre density, was previously derived using reduced rank regression. CMR scores were calculated by combining novel metabolites or traditional risk factors (fat mass index, insulin resistance, mean arterial blood pressure, triacylglycerol, HDL and LDL cholesterol) at age 15 (n = 1808), 17 (n = 1629), and 24 years (n = 1760). Multivariable linear regression models estimated associations of DP z-score with log-transformed CMR z-scores.

Results
Compared to the lowest tertile, the highest DP z-score tertile at age 13 was associated with an increase in the metabolomics CMR z-score at age 15 (β = 0.20, 95% CI 0.09, 0.32, p trend < 0.001) and at age 17 (β = 0.22, 95% CI 0.10, 0.34, p trend < 0.001), and with the traditional CMR z-score at age 15 (β = 0.15, 95% CI 0.05, 0.24, p trend 0.020). There was no evidence of an association at age 17 for the traditional CMR z-score (β = 0.07, 95% CI -0.03, 0.16, p trend 0.137) or for both scores at age 24.

Conclusions
An obesogenic DP was associated with greater CMR in adolescents. Stronger associations were observed with a novel metabolite CMR score compared to traditional risk factors. There may be benefits from modifying diet during adolescence for CMR health, which should be prioritized for further research in trials.
From quality to clarity: evaluating the effectiveness of online ınformation related to septic arthritis
Authors: Golgelioglu Fatih , Canbaz Sebati Baser 
Published: September 2023

Abstract
Background
The aim of this study was to assess the content, readability, and quality of online resources on septic arthritis, a crucial orthopedic condition necessitating immediate diagnosis and treatment to avert serious complications, with a particular focus on the relevance to individuals from the general public.

Methods
Two search terms (“septic arthritis” and “joint infection”) were input into three different search engines on the Internet (Google, Yahoo, and Bing) and 60 websites were evaluated, with the top 20 results in each search engine. The websites underwent categorization based on their type, and their content and quality were assessed utilizing the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark, the Global Quality Score (GQS), and the Information Value Score (IVS). The readability of the text was assessed through the utilization of the Flesch Kincaid Grade Level (FKGL) and the Flesch Reading Ease Score (FKRS). The presence or absence of the Health on Net (HON) code was evaluated on each website.

Results
The DISCERN, JAMA, GQS, FKGL, and IVS scores of the academic category were found to be substantially greater when compared with the physician, medical, and commercial categories. But at the same time, academic sites had high readability scores. Websites with HON code had significantly higher average FKGL, FCRS, DISCERN, JAMA, GQS, and IVS scores than those without.

Conclusion
The quality of websites giving information on septic arthritis was variable and not optimal. Although the content of the academic group was of higher quality, it could be difficult to understand. One of the key responsibilities of healthcare professionals should be to provide high quality and comprehensible information concerning joint infections on reputable academic platforms, thereby facilitating patients in attaining a fundamental level of health literacy.
Modified posterior osteotomy for osteoporotic vertebral collapse with neurological dysfunction in thoracolumbar spine: a preliminary study
Authors: Long Zhisheng , Gong Feipeng , Xiong Long , Wen Jiabin , Chen Gang 
Published: September 2023

Abstract
Objective
The risk of osteoporotic vertebral collapse (OVC) associated with delayed neurological dysfunction (DND) is substantial, and performing surgery for this condition in elderly patients presents challenges. The focus of the current research is on simplifying surgical procedures while maintaining their effectiveness. This study was designed to contribute clinical data supporting the use of modified posterior osteotomy for treating thoracolumbar OVC with DND. The study compares perioperative clinical parameters, imaging data characteristics, and changes in efficacy outcome indicators to provide evidence for the advancement of this technique.

Methods
A total of 12 patients diagnosed with osteoporotic vertebral collapse and neurological dysfunction were included in the study. All patients underwent modified posterior osteotomy. Data regarding perioperative and radiological parameters as well as complications such as surgery duration, blood loss, ASIA grade, VAS, ODI, regional kyphosis angle (RKA), anterior vertebral height ratio (AVHr), and spinal canal clearance ratio (SCCr), were collected retrospectively. These parameters were then analysed to evaluate the clinical efficacy and safety of the modified posterior osteotomy technique.

Results
A total of 12 patients were included in the study, with a mean age of 65.5 ± 9.7 years. The average follow-up period was 29.4 ± 5.0 months. The mean operative blood loss was 483.3 ± 142.0 ml, and the average operative time was 3.7 ± 0.7 h. The visual analogue scale (VAS) score decreased from a preoperative value of 5.8 ± 0.7 to a final follow-up value of 1.3 ± 0.8 (P < 0.05), indicating a significant improvement in pain. The ODI decreased from 65.2 ± 6.0 before surgery to 20.5 ± 7.0, indicating a decrease in disability, and the postoperative neurological function showed a significant improvement. Correction of the RKA was observed, with the angle changing from 35.8 ± 10.8° before surgery to 20.0 ± 3.5° after surgery and to 22.5 ± 3.1° at the final follow-up. Similarly, correction of the AVHr was observed, with the height changing from 39.3 ± 18.0 to 63.0 ± 14.3 after surgery and to 53.9 ± 8.9 at the final follow-up. Correction of the SCCr was also observed, with the ratio changing from 54.9 ± 5.4 to 68.1 ± 5.3 after surgery and to 68.68 ± 6.76 at the final follow-up.

Conclusions
Posterior modified osteotomy is an effective treatment for thoracolumbar osteoporotic fractures with OVC combined with DND. It can significantly preserve vertebral height, increase vertebral canal volume, correct kyphotic angle, and improve postoperative neurological function. The simplified osteotomy also offers advantages in terms of operating time, blood loss, postoperative VAS score, and improvement in lumbar function.
Preoperative high-intensity strength training combined with balance training can improve early outcomes after total knee arthroplasty
Authors: Sun Jian-ning , Shan Yu-zhou , Wu Li-xia , Li Ning , Xu Fei-hu , Kong Xiang-ru , Zhang Bei 
Published: September 2023

Abstract
Background
To investigate the effect of preoperative high-intensity strength training combined with balance training on the knee function of end-stage knee osteoarthritis (KOA) patients after total knee arthroplasty (TKA).

Methods
A prospective study was conducted on end-stage KOA patients awaiting TKA. The patients were divided into an experimental group and a control group according to whether they received a preoperative training intervention. The differences in knee flexor–extensor strength, knee range of motion (ROM), timed up and go (TUG) test result, stair ascend/descend test result, Knee Society score (KSS) and Berg balance scale (BBS) score were assessed in both groups at baseline (T1), before operation (T2), 3 months after operation (T3), and 1 year after operation (T4).

Results
After high-intensity strength training and balance training, the knee flexor–extensor strength, TUG test result, stair ascend/descend test result, and KSS were all significantly improved at T2 in the experimental group over the control group. At T3, the knee ROM, knee flexor–extensor strength, TUG test result, BBS score, and KSS clinical and functional scores were all significantly superior in the experimental group. The experimental group enjoyed a superiority in KSS clinical and functional scores until T4. Group × time and between-group interactions were found in all assessment indicators in both groups (p < 0.01).

Conclusion
Preoperative high-intensity strength training combined with balance training can enhance the knee flexor–extensor strength and balance of patients with end-stage KOA in the short term and help improve early outcomes after KOA.
Trial registration ChiCTR2000032857, 2020-05-13.