bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of renin angiotensin blockers on angiotensin converting enzyme 2 level in cardiovascular patients
Authors: Farid fahmy Sarah , El Derany Marwa Omar , Khorshid Hazem , Saleh Ayman , El-Demerdash Ebtehal 
Published: April 2023

Abstract
Background
Renin–angiotensin–aldosterone system (RAAS) is hypothesized to be in the center of COVID pathophysiology as the angiotensin converting enzyme 2 (ACE2) represents the main entrance of the virus, thus there is a need to address the effect of chronic use of RAAS blockers, as in case of treatment of cardiovascular diseases, on the expression of ACE2. Accordingly, this study aimed to clarify the effect of ACE inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) on ACE2 and to assess the correlation between ACE2 and several anthropometric and clinic-pathological factors.

Methods
A total of 40 healthy controls and 60 Egyptian patients suffering from chronic cardiovascular diseases were enrolled in this study. Patients were divided into 40 patients treated with ACEIs and 20 patients treated with ARBs. Serum ACE2 levels were assessed by ELISA.

Results
Assessment of serum ACE2 level in different groups showed a significant difference between ACEIs and healthy groups and ACEIs and ARBs group, while there was no difference between ARBs and healthy. Multivariate analysis using ACE2 level as constant and age, female sex, ACEIs use and myocardial infarction (MI) showed that there was a significant effect of female sex and ACEIs use on ACE2 level with no effect of age, MI and diabetes.

Conclusion
ACE2 levels varied between ACEIs and ARBs. It tends to be lower in ACEIs group and there is a strong positive association between ACE2 level and the female sex. This needs to be considered in Future studies to further understand the relationship between gender, sex hormones and ACE2 level.

Trial registration
Retrospectively registered ClinicalTrials.gov ID: NCT05418361 (June 2022).

Graphical abstract
Free trade as domestic, economic, and strategic issues: a big data analytics approach
Authors: Karim Moch Faisal , Rahutomo Reza , Manuaba Ida Bagus Kerthyayana , Purwandari Kartika , Mursitama Tirta Nugraha , Pardamean Bens 
Published: April 2023

AbstractThis article examines the engagement of domestic actors in public conversation surrounding free trade negotiations with a focus on the framing of these negotiations as economic, strategic or domestic issues. To analyse this topic, this article utilises the use of Twitter as a barometer of public sentiment toward the Regional Comprehensive Economic Partnership (RCEP). We employ topic classification and sentiment analysis to understand how RCEP is discussed in 345,015 tweets. Our findings show that the overall sentiment score towards RCEP is neutral. However, we find that when RCEP is discussed as a strategic issue, the sentiment is slightly more negative than when discussed as a domestic or economic issue. This article further suggests that discussion of RCEP is driven by the fear of China’s geopolitical ambitions, domestic protectionist agendas, and impact of RCEP on the domestic economy. This article contributes to the growing use of big data in understanding trade negotiations. Furthermore, it contributes to the study of free trade negotiation by examining how domestic political actors frame free trade negotiations.
KAGN:knowledge-powered attention and graph convolutional networks for social media rumor detection
Authors: Cui Wei , Shang Mingsheng 
Published: April 2023

AbstractRumor posts have received substantial attention with the rapid development of online and social media platforms. The automatic detection of rumor from posts has emerged as a major concern for the general public, the government, and social media platforms. Most existing methods focus on the linguistic and semantic aspects of posts content, while ignoring knowledge entities and concepts hidden within the article which facilitate rumor detection. To address these limitations, in this paper, we propose a novel end-to-end attention and graph-based neural network model (KAGN), which incorporates external knowledge from the knowledge graphs to detect rumor. Specifically, given the post's sparse and ambiguous semantics, we identify entity mentions in the post’s content and link them to entities and concepts in the knowledge graphs, which serve as complementary semantic information for the post text. To effectively inject external knowledge into textual representations, we develop a knowledge-aware attention mechanism to fuse local knowledge. Additionally, we construct a graph consisting of posts texts, entities, and concepts, which is fed to graph convolutional networks to explore long-range knowledge through graph structure. Our proposed model can therefore detect rumor by combining semantic-level and knowledge-level representations of posts. Extensive experiments on four publicly available real-world datasets show that KAGN outperforms or is comparable to other state-of-the-art methods, and also validate the effectiveness of knowledge.
Preparation and properties of cotton fabrics dyed by Aronia (Aronia melanocarpa) extract and chitosan
Authors: Hong Kyung Hwa 
Published: April 2023

AbstractNaturally occurring compounds can be utilized as coloring and finishing agents in environmentally friendly textile products. Aronia melanocarpa (Aronia) fruits (berries) are rich in bioactive compounds such as various form of polyphenolic compounds showing antibacterial and antioxidant, and thus numerous studies have been actively conducted on Aronia berry extract (AE) in recent years. However, most natural compounds including pigments exhibit inferior fixation and fastness when applied to cellulosic fibers. Therefore, in this study, coloring and functional compounds were extracted from Aronia berries and applied with or without chitosan to cotton fabrics to improve dyeability and functionality. The cotton fabrics were treated as follows: dyed with an AE single aqueous solution; dyed with an AE–chitosan mixture; and dyed with AE after being pretreated with a chitosan solution. Cotton fabrics dyed with AE and/or chitosan were investigated for their coloring properties and functionality, such as antibacterial properties and antioxidant capacity. It was proven that AE can be used to dye chitosan pretreated cotton fabrics, obtaining good color properties. Moreover, the cotton fabrics dyed with AE after chitosan pretreatment completely inhibited the growth of bacteria (> 99.9%) and exhibited antioxidant properties.
Fourteen days free-living evaluation of an open-source algorithm for counting steps in healthy adults with a large variation in physical activity level
Authors: Holm Ivar , Fridolfsson Jonatan , Börjesson Mats , Arvidsson Daniel 
Published: April 2023

AbstractBackgroundThe number of steps by an individual, has traditionally been assessed with a pedometer, but increasingly with an accelerometer. The ActiLife software (AL) is the most common way to process accelerometer data to steps, but it is not open source which could aid understanding of measurement errors. The aim of this study was to compare assessment of steps from the open-source algorithm part of the GGIR package and two closed algorithms, AL normal (n) and low frequency extension (lfe) algorithms to Yamax pedometer, as reference. Free-living in healthy adults with a wide range of activity level was studied.ResultsA total 46 participants divided by activity level into a low-medium active group and a high active group, wore both an accelerometer and a pedometer for 14 days. In total 614 complete days were analyzed. A significant correlation between Yamax and all three algorithms was shown but all comparisons were significantly different with paired t-tests except for ALn vs Yamax. The mean bias shows that ALn slightly overestimated steps in the low-medium active group and slightly underestimated steps in high active group. The mean percentage error (MAPE) was 17% and 9% respectively. The ALlfe overestimated steps by approximately 6700/day in both groups and the MAPE was 88% in the low-medium active group and 43% in the high active group. The open-source algorithm underestimated steps with a systematic error related to activity level. The MAPE was 28% in the low-medium active group and 48% in the high active group.ConclusionThe open-source algorithm captures steps fairly well in low-medium active individuals when comparing with Yamax pedometer, but did not show satisfactory results in more active individuals, indicating that it must be modified before implemented in population research. The AL algorithm without the low frequency extension measures similar number of steps as Yamax in free-living and is a useful alternative before a valid open-source algorithm is available.
Comparison of ovarian stimulation in follicular and luteal phases in an ovarian cycle (DuoStim) in patients with poor ovarian response
Authors: Naghshineh Elham , Aalami-harandi Rezvan , Heydari Nasrin , Shahabi Vahid , Borumandnia Nasrin , Salehi Safa 
Published: April 2023

Abstract
Background
Infertility is a global problem that refers to the absence of pregnancy after 12 months of intercourse without using contraception. Assisted reproductive techniques (ART) are a treatment technique for infertile patients. Poor ovarian response to stimulation (POR) is one of the challenges in the field of ART. POR refers to people in whom, despite appropriate ovarian stimulation, the number of oocytes retrieved is less than expected. Several ovarian stimulation protocols are applied in POR patients, but the best protocol is not defined. One of the protocols used in POR patients is the "double stimulation in the same ovarian cycle" (DuoStim) protocol. During the DuoStim protocol, both follicular and luteal phases of an ovarian cycle are stimulated. It allows us to retrieve oocytes twice in one ovarian cycle. In the current study, ovarian stimulation in follicular and luteal phases in an ovarian cycle in patients with the poor ovarian response is compared.

Results
Twenty-six infertile patients with poor ovarian enrolled. They had a mean ± standard deviation age of 36.3 ± 3.15 years. The duration of follicular phase stimulation (FPS) was shorter than luteal phase stimulation (LPS) (pvalue = 0.003). The total dose of gonadotropin was significantly lower in FPS than in LPS (pvalue = 0.013). Significantly fewer total oocytes were retrieved after FPS than after LPS (pvalue = 0.001).

Conclusion
This study supports the putative benefits of LPS in infertile women with POR. Utilizing the DuoStim strategy in people with poor ovarian response caused more oocytes to be retrieved.
Trial registration: irct.ir identifier: IRCT20221001056068N1, 11/22/2022, https://www.irct.ir/trial/66187.
Identification of novel functional brain proteins for treatment-resistant schizophrenia: Based on a proteome-wide association study
Authors: Wei Wenming , Zhang Huijie , Cheng Bolun , Qin Xiaoyue , He Dan , Zhang Na , Zhao Yijing , Cai Qingqing , Shi Sirong , Chu Xiaoge , Wen Yan , Liu Huan , Jia Yumeng , Zhang Feng 
Published: April 2023

Abstract

Objective
Genetic approaches are increasingly advantageous in characterizing treatment-resistant schizophrenia (TRS). We aimed to identify TRS-associated functional brain proteins, providing a potential pathway for improving psychiatric classification and developing better-tailored therapeutic targets.

Methods
TRS-related proteome-wide association studies (PWAS) were conducted on genome-wide association studies (GWAS) from CLOZUK and the Psychiatric Genomics Consortium (PGC), which provided TRS individuals (n = 10,501) and non-TRS individuals (n = 20,325), respectively. The reference datasets for the human brain proteome were obtained from ROS/MAP and Banner, with 8,356 and 11,518 proteins collected, respectively. We then performed colocalization analysis and functional enrichment analysis to further explore the biological functions of the proteins identified by PWAS.

Results
In PWAS, two statistically significant proteins were identified using the ROS/MAP and then replicated using the Banner reference dataset, including CPT2 (PPWAS-ROS/MAP = 4.15 × 10−2 and PPWAS-Banner = 3.38 × 10−3) and APOL2 (PPWAS-ROS/MAP = 4.49 × 10−3 and PPWAS-Banner = 8.26 × 10−3). Colocalization analysis identified three variants that were causally related to protein expression in the human brain, including CCDC91 (PP4 = 0.981), PRDX1 (PP4 = 0.894), and WARS2 (PP4 = 0.757). We extended PWAS results from gene-based analysis to pathway-based analysis, identifying 14 gene ontology (GO) terms and the only candidate pathway for TRS, metabolic pathways (all P < 0.05).

Conclusions
Our results identified two protein biomarkers, and cautiously support that the pathological mechanism of TRS is linked to lipid oxidation and inflammation, where mitochondria-related functions may play a role.
Outcomes of Older Adults With AML Treated in Community Versus Academic Centers: An Analysis of Alliance Trials
Authors: Bhatt Vijaya Raj , Ulrich Angela M. , Uy Geoffrey L. , Stone Richard M. , Stock Wendy , Ojelabi Michael O. , Yin Jun , Kohlschmidt Jessica , Eisfeld Ann-Kathrin , Baer Maria R. , Chow Selina , Klepin Heidi , Le-Rademacher Jennifer , Jatoi Aminah 
Published: April 2023

PURPOSE: Clinical trials are important for managing older patients with AML. We investigated differences in outcomes of older patients with AML on the basis of whether patients participated in intensive chemotherapy trials at community versus academic cancer centers. METHODS: We used data from the Alliance for Clinical Trials in Oncology phase III trials that enrolled patients age ≥ 60 years with newly diagnosed AML between 1998 and 2002 in the Cancer and Leukemia Group B (CALGB) 9720 trial and between 2004 and 2006 in the CALGB 10201 trial. Centers funded by the NCI Community Oncology Research Program were identified as community cancer centers; others were designated as academic cancer centers. Logistic regression models and Cox proportional hazards models were used to compare 1-month mortality and overall survival (OS) by center type. RESULTS: Seventeen percent of the 1,170 patients were enrolled in clinical trials in community cancer centers. The study results demonstrated comparable rates of grade ≥3 adverse events (97% v 93%), 1-month mortality (19.1% v 16.1%), and OS (43.9% v 35.7% at 1 year) between community versus academic cancer centers, respectively. After adjusting for covariates, 1-month mortality (odds ratio, 1.40; 95% CI, 0.92 to 2.12; P = .11) and OS (hazard ratio, 1.04; 95% CI, 0.88 to 1.22; P = .67) were not statistically different among patients treated in community versus academic cancer centers. CONCLUSION: An older patient population, who have complex health care needs, can be successfully treated on intensive chemotherapy trials in select community cancer centers with outcomes comparable with that achieved at academic cancer centers.
Association of Opioid Administration During General Anesthesia and Survival for Severely Injured Trauma Patients: A Preplanned Secondary Analysis of the PROPPR Study
Authors: Levy Dominique T. , Livingston Colleen E. , Saroukhani Sepideh , Fox Erin E. , Wade Charles E. , Holcomb John B. , Gumbert Sam D. , Galvagno Samuel M. , Kaslow Olga Y. , Pittet Jean-Francois , Pivalizza Evan G. 
Published: April 2023

BACKGROUND:
There is a lack of reported clinical outcomes after opioid use in acute trauma patients undergoing anesthesia. Data from the Pragmatic, Randomized, Optimal Platelet and Plasma Ratios (PROPPR) study were analyzed to examine opioid dose and mortality. We hypothesized that higher dose opioids during anesthesia were associated with lower mortality in severely injured patients.

METHODS:
PROPPR examined blood component ratios in 680 bleeding trauma patients at 12 level 1 trauma centers in North America. Subjects undergoing anesthesia for an emergency procedure were identified, and opioid dose was calculated (morphine milligram equivalents [MMEs])/h. After separation of those who received no opioid (group 1), remaining subjects were divided into 4 groups of equal size with low to high opioid dose ranges. A generalized linear mixed model was used to assess impact of opioid dose on mortality (primary outcome, at 6 hours, 24 hours, and 30 days) and secondary morbidity outcomes, controlling for injury type, severity, and shock index as fixed effect factors and site as a random effect factor.

RESULTS:
Of 680 subjects, 579 had an emergent procedure requiring anesthesia, and 526 had complete anesthesia data. Patients who received any opioid had lower mortality at 6 hours (odds ratios [ORs], 0.02–0.04; [confidence intervals {CIs}, 0.003–0.1]), 24 hours (ORs, 0.01–0.03; [CIs, 0.003–0.09]), and 30 days (ORs, 0.04–0.08; [CIs, 0.01–0.18]) compared to those who received none (all P < .001) after adjusting for fixed effect factors. The lower mortality at 30 days in any opioid dose group persisted after analysis of those patients who survived >24 hours (P < .001). Adjusted analyses demonstrated an association with higher ventilator-associated pneumonia (VAP) incidence in the lowest opioid dose group compared to no opioid (P = .02), and lung complications were lower in the third opioid dose group compared to no opioid in those surviving 24 hours (P = .03). There were no other consistent associations of opioid dose with other morbidity outcomes.

CONCLUSIONS:
These results suggest that opioid administration during general anesthesia for severely injured patients is associated with improved survival, although the no-opioid group was more severely injured and hemodynamically unstable. Since this was a preplanned post hoc analysis and opioid dose not randomized, prospective studies are required. These findings from a large, multi-institutional study may be relevant to clinical practice.
Patients Undergoing Elective Inpatient Major Therapeutic Procedures in Florida Had No Significant Change in Hospital Mortality or Mortality-Related Comorbidities Between 2007 and 2019
Authors: Epstein Richard H. , Dexter Franklin , Fahy Brenda G. 
Published: April 2023

BACKGROUND:
In a recent study, rapid response team implementation at 1 hospital was associated with only a 0.1% reduction in inpatient mortality from 2005 to 2018, characterized in the accompanying editorial as a “tepid” improvement. The editorialist postulated that an increase in the degree of illness of hospitalized patients might have masked a larger reduction that otherwise might have occurred. Impressions of greater patient acuity during the studied period might have been an artifact of efforts to document more comorbidities and complications, possibly facilitated by the change in diagnosis coding from the International Classification of Diseases, Ninth Revision (ICD-9) to the Tenth Revision (ICD-10).

METHODS:
We used inpatient data from every nonfederal hospital in Florida from the last quarter of 2007 through 2019. We studied hospitalizations for major therapeutic surgical procedures with lengths of stay ≥2 days. Using logistic regression with clustering by the Clinical Classification Software (CCS) code of the primary surgical procedure, we evaluated the trends for decreased mortality, changes in the prevalence of Medicare Severity Diagnosis Related Groups (MS-DRG) with complications or comorbidities (CC) or major complications or major comorbidities (MCC), and changes in the van Walraven index (vWI), a measure of patient comorbidities associated with increased inpatient mortality. Also incorporated in the modeling was the change from ICD-9 to ICD-10.

RESULTS:
There were 3,151,107 hospitalizations comprising 130 distinct CCS codes and 453 MS-DRG groups among 213 hospitals. Despite a progressive increase of 4.1% per year in the odds of a CC or MCC (P = .001), there were no significant changes in the marginal estimates of in-house mortality over time (net estimated decrease, 0.036%; 99% confidence interval [CI], −0.168% to 0.097%; P = .49). There was also absence of a significantly greater fraction of discharges with vWI >0 attributable to the year of the study (odds ratio, 1.017 per year; 99% CI, 0.995–1.041). The changes in MS-DRG to those with CC or MCC were not increased significantly from either the ICD-10 coding change or the number of years after the change.

CONCLUSIONS:
Consistent with the previous study, there was at most a small decrease in the mortality rate over a 12-year period. We found no reliable evidence that patients undergoing elective inpatient surgical procedures were any sicker in 2019 than in 2007. There were substantively more comorbidities and complications documented over time, but this was unrelated to the change to ICD-10 coding.
Clinical Performance of Decision Support Systems in Anesthesia, Intensive Care, and Emergency Medicine: A Systematic Review and Meta-Analysis
Authors: Harutyunyan Robert , Jeffries Sean D. , Ramírez-GarcíaLuna Jose L. , Hemmerling Thomas M. 
Published: April 2023

BACKGROUND:
Medical technology is expanding at an alarming rate, with its integration into health care often reflected by the constant evolution of best practices. This rapid expansion of available treatment modalities, when coupled with progressively increasing amounts of consequential data for health care professionals to manage, creates an environment where complex and timely decision-making without the aid of technology is inconceivable. Decision support systems (DSSs) were, therefore, developed as a means of supporting the clinical duties of health care professionals through immediate point-of-care referencing. The integration of DSS can be especially useful in critical care medicine, where the combination of complex pathologies, the multitude of parameters, and the general state of patients require swift informed decision-making. The systematic review and meta-analysis were performed to evaluate DSS outcomes compared to the standard of care (SOC) in critical care medicine.

METHODS:
This systematic review and subsequent meta-analysis were performed after the EQUATOR networks Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). We systematically explored PubMed, Ovid, Central, and Scopus for randomized controlled trials (RCTs) from January 2000 to December 2021. The primary outcome of this study was to evaluate whether DSS is more effective than SOC practice in critical care medicine within the following disciplines: anesthesia, emergency department (ED), and intensive care unit (ICU). A random-effects model was used to estimate the effect of DSS performance, with 95% confidence intervals (CIs) in both continuous and dichotomous results. Outcome-based, department-specific, and study-design subgroup analyses were performed.

RESULTS:
A total of 34 RCTs were included for analysis. In total, 68,102 participants received DSS intervention, while 111,515 received SOC. Analysis of the continuous (standardized mean difference [SMD], −0.66; 95% CI [−1.01 to −0.30]; P < .01) and binary outcomes (odds ratio [OR], 0.64; 95% CI, [0.44–0.91]; P < .01) was statistically significant and suggests that health interventions are marginally improved with DSS integration in comparison to SOC in critical care medicine. Subgroup analysis in anesthesia (SMD, −0.89; 95% CI, [−1.71 to −0.07]; P < .01) and ICU (SMD, −0.63; 95% CI [−1.14 to −0.12]; P < .01) were deemed statistically supportive of DSS in improving outcome, with evidence being indeterminate in the field of emergency medicine (SMD, −0.24; 95% CI, [−0.71 to 0.23]; P < .01).

CONCLUSIONS:
DSSs were associated with a beneficial impact in critical care medicine on a continuous and binary scale; however, the ED subgroup was found to be inconclusive. Additional RCTs are required to determine the effectiveness of DSS in critical care medicine.