bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact and usefulness of the transition to the new MAFLD classification for non-B, non-C HCC: a retrospective cohort study
Authors: Johira Yusuke , Nakahara Takashi , Kinami Takahiro , Yamasaki Shintaro , Kosaka Masanari , Shirane Yuki , Miura Ryoichi , Murakami Serami , Yano Shigeki , Amioka Kei , Naruto Kensuke , Ando Yuwa , Kosaka Yumi , Kodama Kenichiro , Uchikawa Shinsuke , Fujino Hatsue , Ono Atsushi , Murakami Eisuke , Okamoto Wataru , Yamauchi Masami , Kawaoka Tomokazu , Hayes C. Nelson , Tsuge Masataka , Imamura Michio , Aikata Hiroshi , Oka Shiro 
Published: June 2023

Abstract
Background
Metabolic dysfunction-associated fatty liver disease (MAFLD) represents a new classification system for fatty liver disease. In this study, we investigated the clinical characteristics of patients with MAFLD-hepatocellular carcinoma (HCC) in comparison with those with nonalcoholic fatty liver disease (NAFLD) and considered the validity and challenges of the new criteria.

Methods
This study included 237 untreated non-B, non-C HCC patients with hepatic steatosis. We examined the profile and laboratory findings of patients with MAFLD-HCC and NAFLD-HCC. We also classified MAFLD-HCC patients according to the factors on which the diagnosis was based and compared their clinical characteristics.

Results
A total of 222 (94%) and 101 (43%) patients were diagnosed with MAFLD and NAFLD, respectively. MAFLD-HCC patients were more likely to be male than NAFLD-HCC, but there were no significant differences in metabolic indices, noninvasive liver fibrosis score or HCC status. In a study of MAFLD-HCC patients by diagnostic factor, those with overweight only were younger and had advanced liver fibrosis histologically, and when limited to patients younger than 70 years, the majority were overweight. Redefinition of overweight as BMI ≥ 25 reduced the number of MAFLD-HCC patients by only 5, from 222 to 217.

Conclusions
MAFLD accounted for the majority of non-B, non-C HCC cases with hepatic steatosis. Examination of additional cases and revision of the detailed criteria is needed so that it can be used to efficiently select patients with fatty liver who are at high risk of developing HCC.
Prophylactic noninvasive respiratory support in the immediate postoperative period after cardiac surgery - a systematic review and network meta-analysis
Authors: Zhou Xiaoyang , Pan Jianneng , Wang Hua , Xu Zhaojun , Zhao Long , Chen Bixin 
Published: June 2023

Abstract
Background
Noninvasive respiratory support has been increasingly applied in the immediate postoperative period to prevent postoperative pulmonary complications (PPCs). However, the optimal approach remains uncertain. We sought to evaluate the comparative effectiveness of various noninvasive respiratory strategies used in the immediate postoperative period after cardiac surgery.

Methods
We conducted a frequentist random-effect network meta-analysis (NMA) of randomized controlled trials (RCTs) comparing the prophylactic use of noninvasive ventilation (NIV), continuous positive airway pressure (CPAP), high flow nasal cannula (HFNC), or postoperative usual care (PUC) in the immediate postoperative period after cardiac surgery. Databases were systematically searched through September 28, 2022. Study selection, data extraction, and quality assessment were performed in duplicate. The primary outcome was the incidence of PPCs.

Results
Sixteen RCTs enrolling 3011 patients were included. Compared with PUC, NIV significantly reduced the incidence of PPCs [relative risk (RR) 0.67, 95% confidence interval (CI): 0.49 to 0.93; absolute risk reduction (ARR) 7.6%, 95% CI: 1.6–11.8%; low certainty] and the incidence of atelectasis (RR 0.65, 95% CI: 0.45 to 0.93; ARR 19.3%, 95% CI: 3.9–30.4%; moderate certainty); however, prophylactic NIV was not associated with a decreased reintubation rate (RR 0.82, 95% CI: 0.29 to 2.34; low certainty) or reduced short-term mortality (RR 0.64, 95% CI: 0.16 to 2.52; very low certainty). As compared to PUC, the preventive use of CPAP (RR 0.85, 95% CI: 0.60 to 1.20; very low certainty) or HFNC (RR 0.74, 95% CI: 0.46 to 1.20; low certainty) had no significant beneficial effect on the incidence of PPCs, despite exhibiting a downward trend. Based on the surface under the cumulative ranking curve, the highest-ranked treatment for reducing the incidence of PPCs was NIV (83.0%), followed by HFNC (62.5%), CPAP (44.3%), and PUC (10.2%).

Conclusions
Current evidence suggest that the prophylactic use of NIV in the immediate postoperative period is probably the most effective noninvasive respiratory approach to prevent PPCs in patients undergoing cardiac surgery. Given the overall low certainty of the evidence, further high-quality research is warranted to better understand the relative benefits of each noninvasive ventilatory support.

Clinical Trial Registration
PROSPERO, https://www.crd.york.ac.uk/prospero/, registry number: CRD42022303904.
Care provider interaction and psychological well-being of persons living with dementia in long-term care: a longitudinal observational study
Authors: Lee Kyung Hee , Yang Eunjin , Lee Ji Yeon 
Published: June 2023

Abstract
Background
Although social interaction is important for dementia care and well-being of persons living with dementia, a limited number of studies have reported. This study aimed to examine whether the presence, type, and quality of social interaction is associated with psychological well-being among residents with dementia.

Methods
This study analyzed 258 videos of 30 participants living with dementia. Social interaction was assessed by quality, type, and presence of interaction. Psychological well-being was measured by positive and negative emotional expressions. A mixed model was used for data analysis since these repeatedly measured observation data were nested within subjects.

Results
Positive and neutral interactions were significantly associated with positive emotional expressions after controlling covariates, while negative interaction was significantly associated with negative emotional expressions. There was no significant relationship found between interaction presence or type and emotional expressions.

Conclusions
This study showed interaction quality is essential to promote psychological well-being in persons living with dementia regardless of presence or type of interaction. This study highlights the importance of positive care provider interactions in dementia care. Additionally, institutional efforts to create an environment to reduce negative interactions appears essential to improve the psychological well-being of persons living with dementia.

Trial registration
The study was reviewed and approved by the Yonsei University Institutional Review Board on October 16, 2020 (ref no: Y-2020-0158).
Left ventricular mass predicts cardiac reverse remodelling in patients treated with empagliflozin
Authors: Puar Pankaj , Hibino Makoto , Mazer C. David , Yan Andrew T. , Pandey Arjun K. , Quan Adrian , Teoh Hwee , Hess David A. , Verma Raj , Connelly Kim A. , Verma Subodh 
Published: June 2023

Abstract
Background
The cardiovascular (CV) benefits of sodium-glucose transport protein 2 inhibitors have been attributed, in part, to cardiac reverse remodelling. The EMPA-HEART CardioLink-6 study reported that sodium-glucose cotransporter-2 inhibition for 6 months with empagliflozin was associated with a significant reduction in left ventricular mass indexed to body surface area (LVMi). In this sub-analysis, we evaluated whether baseline LVMi may influence how empagliflozin affects cardiac reverse remodelling.

Methods
A total of 97 patients with type 2 diabetes and coronary artery disease were randomized to empagliflozin (10 mg/d) or matching placebo for 6 months. The study cohort was divided into those whose baseline LVMi was ≤ 60 g/m2 and those who had a baseline LVMi > 60 g/m2. Subgroup comparisons were conducted using a linear regression model adjusted for baseline values (ANCOVA) that included an interaction term between LVMi subgroup and treatment.

Results
Baseline LVMi was 53.3 g/m2 (49.2–57.2) and 69.7 g/m2 (64.2–76.1) for those with baseline ≤ 60 g/m2 (n = 54) and LVMi > 60 g/m2 (n = 43) respectively. The adjusted difference of LVMi regression between those randomized to empagliflozin and placebo were − 0.46 g/m2 (95% CI: −3.44, 2.52, p = 0.76) in the baseline LVMi ≤ 60 g/m2 subgroup and − 7.26 g/m2 (95% CI: −11.40, −3.12, p = 0.0011) in the baseline LVMi > 60 g/m2 subgroup (p-for-interaction = 0.007). No significant associations were found between baseline LVMi and 6-month change in LV end systolic volume-indexed (p-for-interaction = 0.086), LV end diastolic volume-indexed (p-for-interaction = 0.34), or LV ejection fraction (p-for-interaction = 0.15).

Conclusions
Patients with higher LVMi at baseline experienced greater LVM regression with empagliflozin.
Intratumoural microbiota: from theory to clinical application
Authors: Ji Hao , Jiang Zhengting , Wei Chen , Ma Yichao , Zhao Jiahao , Wang Fei , Zhao Bin , Wang Daorong , Tang Dong 
Published: June 2023

AbstractCancer is a major cause of high morbidity and mortality worldwide. Several environmental, genetic and lifestyle factors are associated with the development of cancer in humans and result in suboptimal treatment. The human microbiota has been implicated in the pathophysiological process of cancer and has been used as a diagnostic, prognostic and risk assessment tool in cancer management. Notably, both extratumoural and intratumoural microbiota are important components of the tumor microenvironment, subtly influencing tumorigenesis, progression, treatment and prognosis. The potential oncogenic mechanisms of action of the intratumoural microbiota include induction of DNA damage, influence on cell signaling pathways and impairment of immune responses. Some naturally occurring or genetically engineered microorganisms can specifically accumulate and replicate in tumors and then initiate various anti-tumor programs, ultimately promoting the therapeutic effect of tumor microbiota and reducing the toxic and side effects of conventional tumor treatments, which may be conducive to the pursuit of accurate cancer treatment. In this review, we summarise evidence revealing the impact of the intratumoural microbiota on cancer occurrence and progress and potential therapeutic and diagnostic applications, which may be a promising novel strategy to inhibit tumor development and enhance therapeutic efficacy.
Downregulation of connexin 43-based gap junctions underlies propofol-induced excessive relaxation in hypertensive vascular smooth muscle cells
Authors: Zeng Weiqi , Deng Zhizhao , Gao Yingxin , Sun Guoliang , Li Xianlong , Yuan Dongdong 
Published: June 2023

Abstract
Background
Postinduction hypotension caused by propofol remains a non-negligible problem for anesthesiologists, and is especially severe in chronic hypertensive patients with long-term vasoconstriction and decreased vascular elasticity. The functional change in gap junctions composed of Cx43 (Cx43-GJs) is reported as the biological basis of synchronized contraction or relaxation of blood vessels. Thus, we investigated the role of Cx43-GJs in propofol-induced dramatic blood pressure fluctuations in chronic hypertensive patients, and their internal mechanisms.

Methods
Human umbilical artery smooth muscle cells (HUASMCs) were pretreated with long-term angiotensin II (Ang II), with or without propofol, to simulate the contraction and relaxation of normal and hypertensive VSMCs during anesthesia induction. The levels of F-actin polymerization and MLC2 phosphorylation were used as indicators to observe the contraction and relaxation of HUASMCs. Different specific activators, inhibitors and siRNAs were used to explore the role of Cx43-GJs and Ca2+ as well as the RhoA/ LIMK2/cofilin and RhoA/MLCK signaling pathways in the contraction and relaxation of normal and hypertensive HUASMCs.

Results
Both F-actin polymerization and MLC2 phosphorylation were significantly enhanced in Ang II-pretreated HUASMCs, along with higher expression of Cx43 protein and stronger function of Cx43-GJs than in normal HUASMCs. However, with propofol administration, similar to Gap26 and Cx43-siRNA, the function of Cx43-GJs in Ang II-pretreated HUASMCs was inhibited compared with that in normal HUASMCs, accompanied by a larger decrease in intracellular Ca2+ and the RhoA/LIMK2/cofilin and RhoA/MLCK signaling pathways. Eventually F-actin polymerization and MLC2 phosphorylation were more dramatically decreased. However, these effects could be reversed by RA with enhanced Cx43-GJ function.

Conclusion
Long-term exposure to Ang II significantly enhanced the expression of the Cx43 protein and function of Cx43-GJs in HUASMCs, resulting in the accumulation of intracellular Ca2+ and the activation of its downstream RhoA/LIMK2/cofilin and RhoA/MLCK signaling pathways, which maintained HUASMCs in a state of excessive-contraction. With inhibition of Cx43-GJs by propofol in Ang II-pretreated HUASMCs, intracellular Ca2+ and its downstream signaling pathways were dramatically inhibited, which ultimately excessively relaxed HUASMCs. This is the reason why the blood pressure fluctuation of patients with chronic hypertension was more severe after receiving propofol induction.
Kounis syndrome in a patient following AstraZeneca coronavirus disease 2019 vaccination: a case report
Authors: Farook A. M. , Priyankara D. 
Published: June 2023

Abstract
Introduction and importance
Kounis syndrome, also known as allergic angina syndrome, is defined as the occurrence of an acute coronary syndrome concomitantly with a hypersensitivity reaction. It is a very important diagnosis and missing it may be fatal to the patient. This is a medical emergency, and immediate treatment should be initiated. The treatment of Kounis syndrome is challenging because treatment of either acute coronary syndrome and hypersensitivity reaction can lead to the worsening of the other injury. This case is the first reported case of Kounis syndrome following coronavirus disease 2019 vaccination in Sri Lanka according to our knowledge.

Case presentation
We discuss a 54-year-old female Sri Lankan patient who developed Kounis syndrome following Oxford AstraZeneca COVID-19 vaccination. The patient initially developed anaphylaxis following the AstraZeneca COVID-19 vaccine and subsequently developed acute coronary syndrome secondary to anaphylaxis. The patient was treated appropriately and eventually recovered from her condition.

Conclusion
This syndrome should be suspected when there is a concurrent acute coronary syndrome with allergic reactions. This is an often under- or misdiagnosed condition, and physicians should be educated about it. Caregivers should be aware of its pathophysiology, as treatment of either of the two may worsen the other injury.
Global analysis of the biosynthetic chemical space of marine prokaryotes
Authors: Wei Bin , Hu Gang-Ao , Zhou Zhen-Yi , Yu Wen-Chao , Du Ao-Qi , Yang Cai-Ling , Yu Yan-Lei , Chen Jian-Wei , Zhang Hua-Wei , Wu Qihao , Xuan Qi , Xu Xue-Wei , Wang Hong 
Published: June 2023

Abstract
Background
Marine prokaryotes are a rich source of novel bioactive secondary metabolites for drug discovery. Recent genome mining studies have revealed their great potential to bio-synthesize novel secondary metabolites. However, the exact biosynthetic chemical space encoded by the marine prokaryotes has yet to be systematically evaluated.

Results
We first investigated the secondary metabolic potential of marine prokaryotes by analyzing the diversity and novelty of the biosynthetic gene clusters (BGCs) in 7541 prokaryotic genomes from cultivated and single cells, along with 26,363 newly assembled medium-to-high-quality genomes from marine environmental samples. To quantitatively evaluate the unexplored biosynthetic chemical space of marine prokaryotes, the clustering thresholds for constructing the biosynthetic gene cluster and molecular networks were optimized to reach a similar level of the chemical similarity between the gene cluster family (GCF)-encoded metabolites and molecular family (MF) scaffolds using the MIBiG database. The global genome mining analysis demonstrated that the predicted 70,011 BGCs were organized into 24,536 mostly new (99.5%) GCFs, while the reported marine prokaryotic natural products were only classified into 778 MFs at the optimized clustering thresholds. The number of MF scaffolds is only 3.2% of the number of GCF-encoded scaffolds, suggesting that at least 96.8% of the secondary metabolic potential in marine prokaryotes is untapped. The unexplored biosynthetic chemical space of marine prokaryotes was illustrated by the 88 potential novel antimicrobial peptides encoded by ribosomally synthesized and post-translationally modified peptide BGCs. Furthermore, a sea-water-derived Aquimarina strain was selected to illustrate the diverse biosynthetic chemical space through untargeted metabolomics and genomics approaches, which identified the potential biosynthetic pathways of a group of novel polyketides and two known compounds (didemnilactone B and macrolactin A 15-ketone).

Conclusions
The present bioinformatics and cheminformatics analyses highlight the promising potential to explore the biosynthetic chemical diversity of marine prokaryotes and provide valuable knowledge for the targeted discovery and biosynthesis of novel marine prokaryotic natural products.
Learner-oriented assessment matters: testing the effects of academic buoyancy, reflective thinking, and learner enjoyment in self-assessment and test-taking anxiety management of the EFL learners
Authors: Nurjamin Asep , Salazar-Espinoza David-Eli , Saenko Natalya , Bina Elia 
Published: June 2023

AbstractStudents may better keep tabs on their own development by engaging in self-assessment (S-A), academic buoyancy (AB) construction, and reflective thinking (RT). Although S-A, AB, and RT have been known for a long time, very little is known regarding their potential effects on test-taking anxiety (TTA) and learner enjoyment (LE). Therefore, this study aimed to present a framework depicting the dynamic interaction of AB, RT, LE, S-A, and TTA. Specifically, 394 EFL students from Turkey were given the Academic Buoyancy Scale (ABS), the Reflective Thinking Questionnaire (RTQ), the Test-Taking Anxiety Scale (TTAS), the Core of Self-Assessment Questionnaire (CSAQ), and the Foreign Language Enjoyment Scale (FLES). Higher levels of S-A, AB, RT, and LE were associated with more S-A and less TTA among EFL students, as shown by confirmatory factor analysis (CFA) and structural equation modeling (SEM). The findings of this research have important implications for the development of S-A, AB, and RT practices and the introduction of learning-oriented evaluation in educational settings.
Pathways of opportunity in STEM: comparative investigation of degree attainment across different demographic groups at a large research institution
Authors: Costello Robin A. , Salehi Shima , Ballen Cissy J. , Burkholder Eric 
Published: June 2023

Abstract
Background
We used an opportunity gap framework to analyze the pathways through which students enter into and depart from science, technology, engineering, and mathematics (STEM) degrees in an R1 higher education institution and to better understand the demographic disparities in STEM degree attainment.

Results
We found disparities in 6-year STEM graduation rates on the basis of gender, race/ethnicity, and parental education level. Using mediation analysis, we showed that the gender disparity in STEM degree attainment was explained by disparities in aspiration: a gender disparity in students’ intent to pursue STEM at the beginning of college; women were less likely to graduate with STEM degrees because they were less likely to intend to pursue STEM degrees. However, disparities in STEM degree attainment across race/ethnicities and parental education level were largely explained by disparities in attrition: persons excluded because of their ethnicity or race (PEERs) and first generation students were less likely to graduate with STEM degrees due to fewer academic opportunities provided prior to college (estimated using college entrance exams scores) and more academic challenges during college as captured by first year GPAs.

Conclusions
Our results reinforce the idea that patterns of departure from STEM pathways differ among marginalized groups. To promote and retain students in STEM, it is critical that we understand these differing patterns and consider structural efforts to support students at different stages in their education.
Gender and the return migration process: Gulf returnees in Ghana
Authors: Rahman Md Mizanur , Salisu Mohammed 
Published: June 2023

AbstractLabour migration in the context of South-South migration is generally conceived as a multidimensional process that comprises three distinct subprocesses: emigration, immigration, and return migration. There is growing consensus that return migration is the least understood of these three subprocesses. In a similar vein, a gendered analysis has become more integral to migration scholarship today; yet one area where gender matters but has not been thoroughly studied is the return migration process. This paper explores how gender shapes the return migration experiences by reflecting on four transnational sites of return migration such as migrants’ socio-demographic features, working and living conditions in the Gulf, remittance control and use, and finally return and reintegration. Empirically, this research draws on the experiences of selected Gulf male and female return migrants in Accra, Ghana. The study reports that the gender dimension of returnees’ experiences constitutes an avenue of migration research that has the potential to produce a more nuanced understanding of gendered migration scholarship in the Global South.
Predictive value of retinal oximetry, optical coherence tomography angiography and microperimetry in patients with treatment-naïve branch retinal vein occlusion
Authors: Frederiksen Katrine Hartmund , Pedersen Frederik Nørregaard , Vergmann Anna Stage , Yang Dawei , Laugesen Caroline Schmidt , Vestergaard Jesper Pindbo , Sørensen Torben Lykke , Cheung Carol Y , Kawasaki Ryo , Peto Tunde , Grauslund Jakob 
Published: June 2023

AbstractVascular endothelial growth factor inhibitors have substantially improved the visual outcomes in patients with macular edema (ME) caused by branch retinal vein occlusion (BRVO), but treatment outcomes are highly variable and early prediction of expected clinical outcome would be important for individualized treatment.As non-invasive metabolic, structural and functional retinal markers might act as early predictors of clinical outcomes, we performed a 12-month, prospective study aimed to evaluate if baseline retinal oximetry, optical coherence tomography angiography (OCT-A) or microperimetry were able to predict need of treatment, structural or functional outcome in patients with ME caused by treatment-näive BRVO.We evaluated 41 eyes of 41 patients with a mean age of 69.6 years and 56% females. We found a strong tendency towards a higher retinal arteriolar oxygen saturation in patients without a need of additional aflibercept treatment after the loading phase (99.8% vs. 92.3%, adjusted odds ratio 0.80 (95% confidence interval 0.64-1.00), adjusted p = 0.058), but otherwise, retinal oximetry, OCT-A or microperimetry were not able to predict need of treatment, structural nor functional outcomes. (Trial registration: clinicaltrials.gov, S-20,170,084. Registered 24 August 2014, https://clinicaltrials.gov/ct2/show/NCT03651011)