bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flavin fluorescence lifetime and autofluorescence optical redox ratio for improved visualization and classification of brain tumors
Authors: Reichert David , Wadiura Lisa I. , Erkkilae Mikael T. , Gesperger Johanna , Lang Alexandra , Roetzer-Pejrimovsky Thomas , Makolli Jessica , Woehrer Adelheid , Wilzbach Marco , Hauger Christoph , Kiesel Barbara , Andreana Marco , Unterhuber Angelika , Drexler Wolfgang , Widhalm Georg , Leitgeb Rainer A. 
Published: February 2023

PurposeModern techniques for improved tumor visualization have the aim to maximize the extent of resection during brain tumor surgery and thus improve patient prognosis. Optical imaging of autofluorescence is a powerful and non-invasive tool to monitor metabolic changes and transformation in brain tumors. Cellular redox ratios can be retrieved from fluorescence emitted by the coenzymes reduced nicotinamide adenine dinucleotide (phosphate) (NAD(P)H) and flavin adenine dinucleotide (FAD). Recent studies point out that the influence of flavin mononucleotide (FMN) has been underestimated.Experimental designFluorescence lifetime imaging and fluorescence spectroscopy were performed through a modified surgical microscope. We acquired 361 flavin fluorescence lifetime (500-580 nm) and fluorescence spectra (430-740 nm) data points on freshly excised different brain tumors: low-grade gliomas (N=17), high-grade gliomas (N=42), meningiomas (N=23), metastases (N=26) and specimens from the non-tumorous brain (N=3).ResultsProtein-bound FMN fluorescence in brain tumors did increase with a shift toward a more glycolytic metabolism (R=-0.87). This increased the average flavin fluorescence lifetime in tumor entities with respect to the non-tumorous brain. Further, these metrics were characteristic for the different tumor entities and showed promise for machine learning based brain tumor classification.ConclusionsOur results shed light on FMN fluorescence in metabolic imaging and outline the potential for supporting the neurosurgeon in visualizing and classifying brain tumor tissue during surgery.
Vasoactive-ventilation-renal score and outcomes in infants and children after cardiac surgery
Authors: Abhay Pota , Sharma Rajesh , Bhan Anil , Raina Manan , Vadhera Ananya , Akole Romel , Mir Firdoos Ahmad , Bajpai Pankaj , Misri Amit , Srivastava Swarnika , Prakash Ved , Mondal Tanmoy , Soundararajan Anvitha , Tibrewal Abhishek , Bansal Shyam Bihari , Sethi Sidharth Kumar 
Published: February 2023

IntroductionThere is a need to index important clinical characteristics in pediatric cardiac surgery that can be obtained early in the postoperative period and accurately predict postoperative outcomes.MethodologyA prospective cohort study was conducted in the pediatric cardiac ICU and ward on all children aged &lt;18 years undergoing cardiac surgery for congenital heart disease from September 2018 to October 2020. The vasoactive-ventilation-renal (VVR) score was analyzed to predict outcomes of cardiac surgeries with a comparison of postoperative variables.ResultsA total of 199 children underwent cardiac surgery during the study period. The median (interquartile range) age was 2 (0.8–5) years, and the median weight was 9.3 (6–16) kg. The most common diagnoses were ventricular septal defect (46.2%) and tetralogy of Fallot (37.2%). At the 48th h, area under the curve (AUC) (95% CI) values were higher for the VVR score than those for other clinical scores measured. Similarly, at the 48th h, AUC (95% CI) values were higher for the VVR score than those for the other clinical scores measured for the length of stay and mechanical ventilation.DiscussionThe VVR score at 48 h postoperation was found to best correlate with prolonged pediatric intensive care unit (PICU) stay, length of hospitalization, and ventilation duration, with the greatest AUC-receiver operating characteristic (0.715, 0.723, and 0.843, respectively). The 48-h VVR score correlates well with prolonged ICU, hospital stay, and ventilation.
Stable fitness during COVID-19: Results of serial testing in a cohort of youth with heart disease
Authors: Powell Adam W. , Mays Wayne A. , Wittekind Samuel G. , Chin Clifford , Knecht Sandra K. , Lang Sean M. , Opotowsky Alexander R. 
Published: February 2023

BackgroundLittle is known about how sport and school restrictions early during the novel coronavirus 2019 (COVID-19) pandemic impacted exercise performance and body composition in youth with heart disease (HD).MethodsA retrospective chart review was performed on all patients with HD who had serial exercise testing and body composition via bioimpedance analysis performed within 12 months before and during the COVID-19 pandemic. Formal activity restriction was noted as present or absent. Analysis was performed with a paired t-test.ResultsThere were 33 patients (mean age 15.3 ± 3.4 years; 46% male) with serial testing completed (18 electrophysiologic diagnosis, 15 congenital HD). There was an increase in skeletal muscle mass (SMM) (24.1 ± 9.2–25.9 ± 9.1 kg, p &lt; 0.0001), weight (58.7 ± 21.5–63.9 ± 22 kg, p &lt; 0.0001), and body fat percentage (22.7 ± 9.4–24.7 ± 10.4%, p = 0.04). The results were similar when stratified by age &lt;18 years old (n = 27) or by sex (male 16, female 17), consistent with typical pubertal changes in this predominantly adolescent population. Absolute peak VO2 increased, but this was due to somatic growth and aging as evidenced by no change in % of predicted peak VO2. There remained no difference in predicted peak VO2 when excluding patients with pre-existing activity restrictions (n = 12). Review of similar serial testing in 65 patients in the 3 years before the pandemic demonstrated equivalent findings.ConclusionsThe COVID-19 pandemic and related lifestyle changes do not appear to have had substantial negative impacts on aerobic fitness or body composition in children and young adults with HD.
Assessing the risks of children with preoperative comorbidities undergoing comminuted fracture surgery
Authors: Cheng Kai-Yuan , Yang Chen-Yu , Liu Shih-Chia 
Published: February 2023

IntroductionComminuted fractures are characterized by bones broken in at least two places, destabilizing the bone and requiring surgery. Children whose bones are still developing and maturing tend to have a higher risk of sustaining comminuted fractures as the result of trauma. Trauma is a major cause of death in children and constitutes a major issue in orthopedics because of the unique properties of children's bones compared to adult bones and the associated complications.MethodsThis retrospective, cross-sectional study aimed to refine the association between comorbid disease and comminuted fractures in pediatric subjects using a large, national database. All data were extracted from the National Inpatient Sample (NIS) database from 2005 to 2018. Logistic regression analysis was used to evaluate associations between comorbidities and comminuted fracture surgery and between various comorbidities and LOS or unfavorable discharge.ResultsA total of 2,356,483 patients diagnosed with comminuted fractures were selected initially, of whom 101,032 patients aged younger than 18 years who underwent surgery for comminuted fractures were included. Study results suggest that patients with any comorbidities undergoing orthopedic surgery for comminuted fracture appear to have longer LOS and a higher proportion of discharge to long-term care facilities.DiscussionAlmost all comorbidities were significantly associated with poor in-hospital outcomes and longer LOS. The analysis of comminuted fractures in children may provide useful information to help first responders and medical personnel evaluate and manage comminuted fractures appropriately.
Case report: Emapalumab for active disease control prior to hematopoietic stem cell transplantation in refractory systemic juvenile idiopathic arthritis complicated by macrophage activation syndrome
Authors: Chellapandian Deepak , Milojevic Diana 
Published: February 2023

IntroductionMacrophage activation syndrome (MAS), a secondary form of hemophagocytic lymphohistiocytosis, is a serious life-threatening complication associated with systemic juvenile idiopathic arthritis (sJIA). MAS is characterized by fever, hepatosplenomegaly, liver dysfunction, cytopenias, coagulation abnormalities, and hyperferritinemia and may progress to multiple organ failure and death. Overproduction of interferon-gamma is a major driver of hyperinflammation in murine models of MAS and primary hemophagocytic lymphohistiocytosis. A subset of patients with sJIA may develop progressive interstitial lung disease, which is often difficult to manage. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) can potentially be a curative immunomodulatory strategy for patients with sJIA refractory to conventional therapy and/or complicated by MAS. The use of emapalumab (anti-interferon gamma antibody) for the active control of MAS in refractory cases of sJIA and associated lung disease has not been reported. Herein we report a patient with refractory sJIA complicated by recurrent MAS and lung disease that was managed with emapalumab and ultimately followed by an allo-HSCT, which resulted in permanent correction of the underlying immune dysregulation and improvement of lung disease.Case ReportWe present a 4-year-old girl with sJIA complicated by recurrent MAS and progressive interstitial lung disease. She developed a progressively worsening disease that was refractory to glucocorticoids, anakinra, methotrexate, tocilizumab, and canakinumab. She had a chronic elevation of serum inflammatory markers, notably soluble interleukin-18, and CXC chemokine ligand 9 (CXCL9). Emapalumab, initiated at 6 mg/kg (1 dose) and continued at 3 mg/kg twice weekly for a total of 4 weeks, resulted in MAS remission along with normalization of inflammatory markers. The patient received a matched sibling donor allo-HSCT after a reduced-intensity conditioning regimen with fludarabine/melphalan/thiotepa and alemtuzumab, along with tacrolimus and mycophenolate mofetil for graft-vs.-host disease prophylaxis. At 20 months following her transplant, she has maintained a full donor engraftment with complete donor-derived immune reconstitution. She had complete resolution of sJIA symptoms including marked improvement in her lung disease along with normalization of serum interleukin-18 and CXCL9 levels.ConclusionThe use of emapalumab followed by allo-HSCT could help achieve a complete response in refractory cases of sJIA complicated by MAS who have failed standard treatment.
Brucea javanica oil alleviates intestinal mucosal injury induced by chemotherapeutic agent 5-fluorouracil in mice
Authors: Zheng Xinghan , Mai Liting , Xu Ying , Wu Minghui , Chen Li , Chen Baoyi , Su Ziren , Chen Jiannan , Chen Hongying , Lai Zhengquan , Xie Youliang 
Published: February 2023

Background:Brucea javanica (L.) Merr, has a long history to be an anti-dysentery medicine for thousand of years, which is commonly called “Ya-Dan-Zi” in Chinese. The common liquid preparation of its seed, B. javanica oil (BJO) exerts anti-inflammatory action in gastrointestinal diseases and is popularly used as an antitumor adjuvant in Asia. However, there is no report that BJO has the potential to treat 5-Fluorouracil (5-FU)-induced chemotherapeutic intestinal mucosal injury (CIM).Aim of the study: To test the hypothesis that BJO has potential intestinal protection on intestinal mucosal injury caused by 5-FU in mice and to explore the mechanisms.Materials and methods: Kunming mice (half male and female), were randomly divided into six groups: normal group, 5-FU group (5-FU, 60 mg/kg), LO group (loperamide, 4.0 mg/kg), BJO group (0.125, 0.25, 0.50 g/kg). CIM was induced by intraperitoneal injection of 5-FU at a dose of 60 mg/kg/day for 5 days (from day 1 to day 5). BJO and LO were given orally 30 min prior to 5-FU administration for 7 days (from day 1 to day 7). The ameliorative effects of BJO were assessed by body weight, diarrhea assessment, and H&amp;E staining of the intestine. Furthermore, the changes in oxidative stress level, inflammatory level, intestinal epithelial cell apoptosis, and proliferation, as well as the amount of intestinal tight junction proteins were evaluated. Finally, the involvements of the Nrf2/HO-1 pathway were tested by western blot.Results: BJO effectively alleviated 5-FU-induced CIM, as represented by the improvement of body weight, diarrhea syndrome, and histopathological changes in the ileum. BJO not only attenuated oxidative stress by upregulating SOD and downregulating MDA in the serum, but also reduced the intestinal level of COX-2 and inflammatory cytokines, and repressed CXCL1/2 and NLRP3 inflammasome activation. Moreover, BJO ameliorated 5-FU-induced epithelial apoptosis as evidenced by the downregulation of Bax and caspase-3 and the upregulation of Bcl-2, but enhanced mucosal epithelial cell proliferation as implied by the increase of crypt-localized proliferating cell nuclear antigen (PCNA) level. Furthermore, BJO contributed to the mucosal barrier by raising the level of tight junction proteins (ZO-1, occludin, and claudin-1). Mechanistically, these anti-intestinal mucositis pharmacological effects of BJO were relevant for the activation of Nrf2/HO-1 in the intestinal tissues.Conclusion: The present study provides new insights into the protective effects of BJO against CIM and suggests that BJO deserves to be applied as a potential therapeutic agent for the prevention of CIM.
A central amygdala input to the dorsal vagal complex controls gastric motility in mice under restraint stress
Authors: Wang Hao , Liu Wen-Jian , Wang Xi-Yang , Chen Xiao-Qi , Cai Rong-Lin , Zhang Meng-Ting , Wang Hai-Tao , He Guang-Wei , Zhang Zhi , Shen Guo-Ming 
Published: February 2023

Graphical AbstractWe identified that CeA GABAergic neurons project into the DVC, and proposed that activation of the GABAergic projections from CeA to DVC may be responsible for restrained stress (RS)-induced gastric motility disorder (GMD).
Changes in blood pressure and arterial stiffness monitored using the cardio–ankle vascular index during hemodialysis
Authors: Sato Shuji , Shimizu Kazuhiro , Takahashi Mao , Masai Motoyuki , Nagakawa Osamu , Uchino Junji , Suzuki Toshihiro , Sato Yuka , Iwai Noriko , Shirai Kohji 
Published: February 2023

During hemodialysis (HD), blood pressure (BP) changes are frequently observed. However, the mechanism of BP changes during HD has not been fully clarified. The cardio–ankle vascular index (CAVI) reflects the arterial stiffness of the arterial tree from the origin of the aorta to the ankle independent from BP during measurement. Additionally, CAVI reflects functional stiffness in addition to structural stiffness. We aimed to clarify the role of CAVI in regulating the BP system during HD. We included 10 patients undergoing 4-hour HD (total 57 HD sessions). Changes in the CAVI and various hemodynamic parameters were evaluated during each session. During HD, BP decreased and CAVI significantly increased (CAVI, median [interquartile range]; 9.1 [8.4–9.8] [0 min] to 9.6 [9.2–10.2] [240 min], p &lt; 0.05). Changes in CAVI from 0 min to 240 min were significantly correlated with water removal rate (WRR) (r = −0.42, p = 0.002). Changes in CAVI at each measurement point were negatively correlated with ΔBP (Δsystolic BPeach MP, r = −0.23, p &lt; 0.0001; Δdiastolic BPeach MP, r = −0.12, p = 0.029). Whereas one patient exhibited a simultaneous decrease in BP and CAVI during the initial 60 min of HD. Arterial stiffness monitored with CAVI generally increased during HD. CAVI elevation is associated with decreased WWR and BP. An increase in CAVI during HD may reflect the contraction of smooth muscle cells and play an important role in BP maintenance. Hence, measuring CAVI during HD may distinguish the cause of BP changes.
Bacillus lipopeptide-mediated biocontrol of peanut stem rot caused by Athelia rolfsii
Authors: Korangi Alleluya Virginie , Argüelles Arias Anthony , Ribeiro Bianca , De Coninck Barbara , Helmus Catherine , Delaplace Pierre , Ongena Marc 
Published: February 2023

IntroductionPeanut (Arachis hypogaea L.) is a widespread oilseed crop of high agricultural importance in tropical and subtropical areas. It plays a major role in the food supply in the Democratic Republic of Congo (DRC). However, one major constraint in the production of this plant is the stem rot (white mold or southern blight) disease caused by Athelia rolfsii which is so far controlled mainly using chemicals. Considering the harmful effect of chemical pesticides, the implementation of eco-friendly alternatives such as biological control is required for disease management in a more sustainable agriculture in the DRC as in the other developing countries concerned. Bacillus velezensis is among the rhizobacteria best described for its plant protective effect notably due to the production of a wide range of bioactive secondary metabolites. In this work, we wanted to evaluate the potential of B. velezensis strain GA1 at reducing A. rolfsii infection and to unravel the molecular basis of the protective effect.Results and discussionUpon growth under the nutritional conditions dictated by peanut root exudation, the bacterium efficiently produces the three types of lipopeptides surfactin, iturin and fengycin known for their antagonistic activities against a wide range of fungal phytopathogens. By testing a range of GA1 mutants specifically repressed in the production of those metabolites, we point out an important role for iturin and another unidentified compound in the antagonistic activity against the pathogen. Biocontrol experiments performed in greenhouse further revealed the efficacy of B. velezensis to reduce peanut disease caused by A. rolfsii both via direct antagonism against the fungus and by stimulating systemic resistance in the host plant. As treatment with pure surfactin yielded a similar level of protection, we postulate that this lipopeptide acts as main elicitor of peanut resistance against A. rolfsii infection.
Exploring island syndromes: Variable matrix permeability in Phalaenopsis pulcherrima (Orchidaceae), a specialist lithophyte of tropical Asian inselbergs
Authors: Zhang Zhe , Li Jihong , Suddee Somran , Bouamanivong Somsanith , Averyanov Leonid V. , Gale Stephan W. 
Published: February 2023

IntroductionPlants confined to island-like habitats are hypothesised to possess a suite of functional traits that promote on-spot persistence and recruitment, but this may come at the cost of broad-based colonising potential. Ecological functions that define this island syndrome are expected to generate a characteristic genetic signature. Here we examine genetic structuring in the orchid Phalaenopsis pulcherrima, a specialist lithophyte of tropical Asian inselbergs, both at the scale of individual outcrops and across much of its range in Indochina and on Hainan Island, to infer patterns of gene flow in the context of an exploration of island syndrome traits.MethodsWe sampled 323 individuals occurring in 20 populations on 15 widely scattered inselbergs, and quantified genetic diversity, isolation-by-distance and genetic structuring using 14 microsatellite markers. To incorporate a temporal dimension, we inferred historical demography and estimated direction of gene flow using Bayesian approaches.ResultsWe uncovered high genotypic diversity, high heterozygosity and low rates of inbreeding, as well as strong evidence for the occurrence of two genetic clusters, one comprising the populations of Hainan Island and the other those of mainland Indochina. Connectivity was greater within, rather than between the two clusters, with the former unequivocally supported as ancestral.DiscussionDespite a strong capacity for on-spot persistence conferred by clonality, incomplete self-sterility and an ability to utilize multiple magnet species for pollination, our data reveal that P. pulcherrima also possesses traits that promote landscape-scale gene flow, including deceptive pollination and wind-borne seed dispersal, generating an ecological profile that neither fully conforms to, nor fully contradicts, a putative island syndrome. A terrestrial matrix is shown to be significantly more permeable than open water, with the direction of historic gene flow indicating that island populations can serve as refugia for postglacial colonisation of continental landmasses by effective dispersers.
Anxiety in a regular day of work: A 24 hour psychophysiological investigation in young dentists with gender comparison
Authors: Queirolo Luca , Bacci Christian , Roccon Andrea , Zanette Gastone , Mucignat Carla 
Published: February 2023

Introduction and aimDentistry is a highly demanding profession with a strong mental and physical involvement, possibly generating anxiety. Very few studies assessed psychophysiological activity in dentists, while none tried to relate it with gender during a routine working day. This study aims at evaluating correlations between gender, psychophysiological indexes, and psychological variables.Materials and methodsData were acquired at the Dental Clinic of the University of Padua on 20 healthy young dentists (10 M-10F) during a 24 h period of a working day. Physiological variables (measured with E4 Empatica) were electrodermal activity (EDA), heart rate variability (HRV) and heart rate (HR). Participants anxiety was measured through a self-reported scale on patient-relationship anxiety and through the Generalized Anxiety Disorder-7 Questionnaire (GAD-7).Results5 (3F, 2 M) participants over 20 had a GAD-7 score ≥ 10. Female gender, in comparison to Male, was associated with higher perceived patient relationship anxiety (p = 0.002) and lower HRV (p-adj = 0.022). The gender Male, although being associated with lower level of self-reported anxiety (p = 0.002), showed an equal number of subjects with a GAD-7 score ≥ 10 (p = 0.371). No interaction between gender and EDA was found, nor an effect of GAD score on EDA, HRV and HR values. Higher values of EDA were found during sleep time; a difference between sleep time and working time EDA (p = 0.037) and a difference between sleep time and daytime (p = 0.0045). A different HR between sleep and all daytime (p &lt; 0.001) was also highlighted.Conclusion25% of dentists fell within generalized anxiety disorder diagnosis, compared to a maximum of 8.6% in the general population. A possible general biomarker of excessive stress response was measured: a shift of circadian sympathetic activity was found in dentists; a higher activity during sleep in comparison to working time and daytime. The Female gender was associated with higher perceived patient-approach anxiety, lower parasympathetic activity, and a comparable sympathetic activity to the Male gender, thus fostering a possible vulnerability to excessive stress. This study underlines the need to empower the psychological approach to stress and patient-relationship in dentistry.