bluuebunny/crossref_metadata_2025_split huggingface dataset:
Angiopoietin-2 is associated with capillary leak and predicts complications after cardiac surgery
Authors: Wollborn Jakob , Zhang Zilu , Gaa Julie , Gentner Moritz , Hausmann Christian , Saenger Felix , Weise Karina , Justice Samuel , Funk Jean-Luca , Staehle Hans Felix , Thomas Marie , Bruno Raphael R. , Saravi Babak , Friess Jan O. , Marx Markus , Buerkle Hartmut , Trummer Georg , Muehlschlegel Jochen D. , Reker Daniel , Goebel Ulrich , Ulbrich Felix 
Published: August 2023

Abstract
Background
Patients undergoing cardiac surgery are prone to numerous complications. Increased vascular permeability may be associated with morbidity and mortality due to hemodynamic instability, fluid overload, and edema formation. We hypothesized that markers of endothelial injury and inflammation are associated with capillary leak, ultimately increasing the risk of postoperative complications.

Methods
In this prospective, observational, multidisciplinary cohort study at our tertiary academic medical center, we recruited 405 cardiac surgery patients. Patients were assessed daily using body impedance electrical analysis, ultrasound, sublingual intravital microscopy, and analysis of serum biomarkers. Multivariable models, as well as machine learning, were used to study the association of angiopoietin-2 with extracellular water as well as common complications after cardiac surgery.

Results
The majority of patients underwent coronary artery bypass grafting, valvular, or aortic surgeries. Across the groups, extracellular water increased postoperatively (20 ± 6 preoperatively to 29 ± 7L on postoperative day 2; P < 0.001). Concomitantly, the levels of the biomarker angiopoietin-2 rose, showing a strong correlation based on the time points of measurements (r = 0.959, P = 0.041). Inflammatory (IL-6, IL-8, CRP) and endothelial biomarkers (VE-Cadherin, syndecan-1, ICAM-1) suggestive of capillary leak were increased. After controlling for common risk factors of edema formation, we found that an increase of 1 ng/mL in angiopoietin-2 was associated with a 0.24L increase in extracellular water (P < 0.001). Angiopoietin-2 showed increased odds for the development of acute kidney injury (OR 1.095 [95% CI 1.032, 1.169]; P = 0.004) and was furthermore associated with delayed extubation, longer time in the ICU, and a higher chance of prolonged dependence on vasoactive medication. Machine learning predicted postoperative complications when capillary leak was added to standard risk factors.

Conclusions
Capillary leak and subsequent edema formation are relevant problems after cardiac surgery. Levels of angiopoietin-2 in combination with extracellular water show promising potential to predict postoperative complications after cardiac surgery.
Trial registration number: German Clinical Trials Registry (DRKS No. 00017057), Date of registration 05/04/2019, www.drks.de

Graphical Abstract
Restoring gluconeogenesis by TEF inhibited proliferation and promoted apoptosis and immune surveillance in kidney renal clear cell carcinoma
Authors: Zhuang Wenyuan , Shi Xiaokai , Gao Shenglin , Qin Xihu 
Published: August 2023

Abstract
Background
Kidney renal clear cell carcinoma (KIRC) is the major histological subtype of kidney tumor which covers approximately 80% of the cases. Although various therapies have been developed, the clinical outcome remains unsatisfactory. Metabolic dysregulation is a key feature of KIRC, which impacts progression and prognosis of the disease. Therefore, understanding of the metabolic changes in KIRC is of great significance in improving the treatment outcomes.

Methods
The glycolysis/gluconeogenesis genes were analyzed in the KIRC transcriptome from the Cancer Genome Atlas (TCGA) by the different expression genes (DEGs) test and survival analysis. The gluconeogenesis-related miRNAs were identified by ImmuLncRNA. The expression levels of indicated genes and miRNAs were validated in KIRC tumor and adjunct tissues by QPCR. The effects of miR-4477b and PCK1 on cell proliferation and apoptosis were examined using the cell viability assay, cell apoptosis assay, and clone information. The interaction of miR-4477b with TEF was tested by the luciferase report gene assay. The different gluconeogenesis statuses of tumor cells and related signatures were investigated by single-cell RNA sequencing (scRNA-seq) analysis.

Results
The 11 gluconeogenesis genes were found to be suppressed in KIRC (referring as PGNGs), and the less suppression of PGNGs indicated better survival outcomes. Among the 11 PGNGs, we validated four rate-limiting enzyme genes in clinical tumor patients. Moreover, restoring gluconeogenesis by overexpressing PCK1 or TEF through miR-4477b inhibition significantly inhibited tumor cell proliferation, colony formation, and induced cell apoptosis in vitro. Independent single-cell RNA sequencing (scRNA-seq) data analysis revealed that the tumor cells had high levels of PGNG expression (PGNG + tumor cells) represented a phenotype of early stage of neoplasia and prompted immune surveillance.

Conclusions
Our study suggests that the deficiency of gluconeogenesis is a key metabolic feature of KIRC, and restoring gluconeogenesis could effectively inhibit the proliferation and progression of KIRC cells.
Concerns over colour durability in the nineteenth-century industrial revolution: insights from John Ruskin’s teaching collection
Authors: Ghigo Tea , Occhipinti Michele , Beeby Andrew , Domoney Kelly , Bone Daniel 
Published: August 2023

Abstract
The numerous new pigments that gradually became available to artists during the nineteenth-century Colour Revolution were received with contrasting attitudes. The initial enthusiasm for new chromatic possibilities was soon nuanced by concerns about the stability and performance of industrial materials. This study focuses on the work of John Ruskin, the famous art critic of Victorian England, whose artistic production was as impressive as his penmanship. Archival research into nineteenth-century literature is combined with material analyses with macro-XRF, XRD and FORS on a group of watercolours by Ruskin preserved at the Ashmolean Museum to determine his attitude towards pigment stability. The results show that he was very concerned with colour durability and chose his materials carefully, using the treatise Chromatography by the chemist George Field (first edition 1835) as guidance. The material analyses also provided new insight into the composition of specific pigments, revealing the use of a hitherto unreported cobalt-based blue.
A systematic review of demographic and background factors associated with the development of children’s aquatic competence
Authors: Duke Charlotte , Calverley Hannah , Petrass Lauren , Peters Jacqui , Moncrieff Kate , Konjarski Loretta , Matthews Bernadette 
Published: August 2023

Abstract
Background
Globally, drowning is a leading cause of unintentional injury and death among children. Teaching aquatic competencies (swimming skills and water safety knowledge) to children has been proposed as a prevention strategy. In Australia, however, many children are not meeting standard aquatic competency benchmarks. Exploration of the connection between demographic and background factors and aquatic competencies could provide insight into why differences in acquisition of aquatic knowledge and skills occur.

Main body
A systematic literature review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was performed to identify studies that reported on the association between demographic and background factors and aquatic competencies. Nine databases were searched for English language peer-reviewed studies published since 2000. Fourteen studies fulfilled all inclusion criteria. Studies were quasi-experimental or cross-sectional in design, which is considered quality level III-2 or IV, respectively, on the National Health and Medical Research Council Evidence Hierarchy. Study quality was moderate, and risk of bias was high. While aquatic competencies can be taught, this review found that factors including age, gender, geographic residence, medical conditions/disabilities, socioeconomic status, and swimming frequency were significantly associated with the demonstration and/or acquisition of aquatic competencies.

Conclusion
This review provides insight into demographic and background factors that are significantly associated with the development of aquatic competence. Whilst further investigation is required to increase the evidence base, these findings may assist in tailoring swimming and water safety programs to accommodate those at-risk of not achieving age-appropriate aquatic competencies.
Differentiating brain metastasis from glioblastoma by time-dependent diffusion MRI
Authors: Kamimura Kiyohisa , Kamimura Yoshiki , Nakano Tsubasa , Hasegawa Tomohito , Nakajo Masanori , Yamada Chihiro , Akune Kentaro , Ejima Fumitaka , Ayukawa Takuro , Ito Soichiro , Nagano Hiroaki , Takumi Koji , Nakajo Masatoyo , Uchida Hiroyuki , Tabata Kazuhiro , Iwanaga Takashi , Imai Hiroshi , Feiweier Thorsten , Yoshiura Takashi 
Published: August 2023

Abstract
Background
This study was designed to investigate the use of time-dependent diffusion magnetic resonance imaging (MRI) parameters in distinguishing between glioblastomas and brain metastases.

Methods
A retrospective study was conducted involving 65 patients with glioblastomas and 27 patients with metastases using a diffusion-weighted imaging sequence with oscillating gradient spin-echo (OGSE, 50 Hz) and a conventional pulsed gradient spin-echo (PGSE, 0 Hz) sequence. In addition to apparent diffusion coefficient (ADC) maps from two sequences (ADC50Hz and ADC0Hz), we generated maps of the ADC change (cADC): ADC50Hz − ADC0Hz and the relative ADC change (rcADC): (ADC50Hz − ADC0Hz)/ ADC0Hz × 100 (%).

Results
The mean and the fifth and 95th percentile values of each parameter in enhancing and peritumoral regions were compared between glioblastomas and metastases. The area under the receiver operating characteristic curve (AUC) values of the best discriminating indices were compared. In enhancing regions, none of the indices of ADC0Hz and ADC50Hz showed significant differences between metastases and glioblastomas. The mean cADC and rcADC values of metastases were significantly higher than those of glioblastomas (0.24 ± 0.12 × 10−3mm2/s vs. 0.14 ± 0.03 × 10−3mm2/s and 23.3 ± 9.4% vs. 14.0 ± 4.7%; all p < 0.01). In peritumoral regions, no significant difference in all ADC indices was observed between metastases and glioblastomas. The AUC values for the mean cADC (0.877) and rcADC (0.819) values in enhancing regions were significantly higher than those for ADC0Hz5th (0.595; all p < 0.001).

Conclusions
The time-dependent diffusion MRI parameters may be useful for differentiating brain metastases from glioblastomas.
Stakeholder engagement in the development of an upper extremity outcome measure for children with rare musculoskeletal conditions
Authors: Elfassy Caroline , Wagner Lisa , Higgins Johanne , Montpetit Kathleen , Snider Laurie , Dahan-Oliel Noémi 
Published: August 2023

Abstract
Background
Upper extremity (UE) involvement is prevalent in 73% of individuals with arthrogryposis multiplex congenita (AMC), yet no AMC-specific outcome measure exists. When developing a measure specific to a population with a rare musculoskeletal condition, clinicians’ and patients’ perspectives and involvement is a crucial and necessary step. This study sought to determine the most clinically useful items for an outcome measure of UE function for children with AMC as defined by caregivers and clinicians.

Methods
To ensure the perspectives and needs of caregivers of children with AMC and clinicians were considered in the development of the UE measure for AMC, a Nominal Group technique (NGT) with caregivers of children with AMC (phase 1) followed by a three-round survey with clinicians (phase 2) were carried out.

Results
Phase 1: Eleven individuals participated in the nominal group technique and identified 32 items. The most important items were Picking up an object (n = 11), Eating (n = 10), Reaching mouth (n = 10), Getting out of bed (n = 10). Phase 2: Invitations to participate to an online survey was sent to 47 experts in the field of AMC, 20 participants completed round 1, 15 completed round 2 and 13 completed round 3. Throughout the survey, participants were asked about movement required to screen the UE, essential domains to be included in the measure, establishing a scoring guide and identifying tasks associated with joint motion and position.

Conclusion
A preliminary version of an UE AMC-specific outcome measure was developed with the help of caregivers’ perspectives and expert opinions.
Cognitive perspectives on maintaining physicians’ medical expertise: IV. Best practices and open questions in using testing to enhance learning and retention
Authors: Fraundorf Scott H. , Caddick Zachary A. , Nokes-Malach Timothy J. , Rottman Benjamin M. 
Published: August 2023

AbstractAlthough tests and assessments—such as those used to maintain a physician’s Board certification—are often viewed merely as tools for decision-making about one’s performance level, strong evidence now indicates that the experience of being tested is a powerful learning experience in its own right: The act of retrieving targeted information from memory strengthens the ability to use it again in the future, known as the testing effect. We review meta-analytic evidence for the learning benefits of testing, including in the domain of medicine, and discuss theoretical accounts of its mechanism(s). We also review key moderators—including the timing, frequency, order, and format of testing and the content of feedback—and what they indicate about how to most effectively use testing for learning. We also identify open questions for the optimal use of testing, such as the timing of feedback and the sequencing of complex knowledge domains. Lastly, we consider how to facilitate adoption of this powerful study strategy by physicians and other learners.
Sternomental displacement and neck circumference: a new look for the neck as a difficult airway predictor in obese surgical patients—a cohort study
Authors: Gorgy Antony , Ahmed Abeer , Atef Mohamed , Mekawy Nevan , Sami Wael , Nagy Heba 
Published: August 2023

Abstract
Background
Sternomental displacement (SMDD) is a surrogate indicator for cervical spine (C-spine) mobility. SMDD revealed good potential to predict difficult airway, but its validity in obese patients is not evident. Therefore, this study assessed the performance of SMDD with neck circumference (NC) in predicting difficult airway in obese surgical patients. The study involved 135 adult patients with body mass index (BMI) ≥ 35 kg/m2 scheduled for elective surgeries under general anesthesia with endotracheal tubes (ETT) inserted using Macintosh laryngoscopes. The airway was assessed using SMDD, NC, and modified Mallampati test (MMT). Difficult laryngoscopy view (DLV) was defined as Cormack–Lehane (C-L) grade ≥ 3. The accuracy of the SMDD in predicting DLV was set as the primary endpoint, while the accuracy of the SMDD compared to that of NC, MMT, and NC/SMDD ratio in predicting difficult airway was set as the secondary endpoint.

Results
The DLV cases were 28 of 135 (20.7%), with a mean BMI of 41.1 ± 3.3 kg/m2. SMDD  < 5cm and NC > 43 cm could predict DLV with an area under the receiver operating characteristic curve (AUROC) of 0.97 and 0.83 respectively. SMDD and NC had a good negative correlation (r =  − 0.6; 95% CI = 0.7 to 0.4; p = 0.0001). The NC/SMDD ratio had the best prediction for DLV (AUROC of 0.98 at a cut-off value  > 7.8).

Conclusions
In obese surgical patients, SMDD and NC/SMDD ratios are excellent predictors for DLV when the cut-off values are  < 5cm and  > 7.8, respectively.

Trial registration
ClinicalTrials.gov, NCT04524546. Registered in August 2020.
Combining ability and gene action studies for yield and fibre traits in Gossypium arboreum using Griffings numerical and Haymans graphical approach
Authors: SUKRUTHA Bhimireddy , RAJESWARI Sivakami , PREMALATHA N. , BOOPATHI Narayana Manikanda , THIRUKUMARAN K. , MANIVANNAN A. 
Published: August 2023

Abstract
Background
For the purpose of utilising hybrid vigour to produce possible hybrids with a suitable level of stability, the knowledge of gene activity and combining ability is a crucial prerequisite before choosing desirable parents. The present study was carried out with six parents crossed in full diallel fashion and generated 30 F1 hybrids. These hybrids were evaluated in two replications in Randomized Block Design at Department of Cotton, TNAU for combining ability and gene action. Diallel analysis was carried out according to Griffing’s method-I (parents + F1 + reciprocals) and model-I and Hayman’s graphical approach by using INDOSTAT software.

Results
Analysis of variance for combining ability indicated that mean square values of GCA, SCA and reciprocals were highly significant for all the traits except for the uniformity index. RG763 and K12 showed highly positively significant GCA effects for most of the yield traits while PA838 and K12 for fibre quality traits, so they were found as best general combiners. PAIG379 × K12 and PDB29 × K12 for yield traits, and PDB29 × PA838, RG763 × PA838, and CNA1007 × RG763 cross combinations for fibre quality traits could be recommended for future breeding programms.

Conclusion
The results of both Griffing’s and Hayman’s approaches showed that non-additive gene action predominates as SCA variance was bigger than GCA variance, so heterosis breeding is thought to be a more fruitful option for enhancing GCA of many traits.
Telmisartan versus EnalapRil In heart failure with redUced ejection fraction patients with Moderately impaired kidney Functions; randomized controlled trial: “TRIUMF trial”
Authors: Samir Ahmad , Aboel-Naga Salma , Shehata Ahmed , Abdelhamid Magdy 
Published: August 2023

Abstract
Background
When heart failure with reduced ejection fraction (HFrEF) and chronic kidney disease (CKD) co-exist, Renin angiotensin-aldosterone system inhibitors (RAASi) are often underutilized for the fear of worsening renal function (WRF). Telmisartan is a RAASi characteristic for a favorable renal profile, although data on its utility in HFrEF is limited. This study aimed to compare efficacy and tolerability of Telmisartan versus Enalapril in patients with HFrEF and CKD.

Results
This study randomized 107 patients with HFrEF and CKD to either Telmisartan (10–80 mg) or Enalapril (5–40 mg) daily. The achieved RAASi dose, dose reductions (DR) or dis-continuation (DC), death/Heart failure rehospitalization (HFH), NYHA class and 6MWT were compared at 3- and 6-months. At 3- and 6-months, 93.5% versus 68.6% and 95.2% versus 72.9% were maintaining ≥ 50% of the target dose in the Telmisartan- versus Enalapril-group, respectively. Despite the higher achieved dose by 3- and 6-months, Telmisartan versus Enalapril was associated with less WRF (6.4% vs. 22.9%, p = 0.022 and 7.3% vs. 13.6%, p = 0.28) and fewer episodes of DR-DC (31.9% vs. 55.1%, p = 0.018 and 35.7% vs. 56.5%, p = 0.041), respectively. By the end of the study, there were 5 deaths in each group, yet, HFH occurred in 34.1% versus 55.3%, p = 0.035, and NYHA class changed by − 1 [− 2, 0] versus 0 [− 1, 1], p = 0.017 in Telmisartan- versus Enalapril patients, respectively. Within-group results showed improvement in 6MWT in Telmisartan-, and increase in diuretic requirements in Enalapril-group.

Conclusions
In patients with HFrEF and CKD, Telmisartan was better tolerated to uptitrate, caused less WRF, less HFH and showed better functional improvement compared to Enalapril.
Clinical trial registration This study was prospectively registered on clinicaltrials.gov, with registration number (NCT04736329).
Arterial spin-labeled magnetic resonance perfusion imaging in prediction of pediatric brain tumors grading: inter-observer agreement
Authors: Elmansy Maha Mohammed Hassan , Zaki Samia Mounir , Elbakry Magda Ali Hany , Abdelwahab Rihame Mohamed 
Published: August 2023

Abstract
Background
Pediatric brain tumors are a major concern with many variable management options. Arterial spin-labeled magnetic resonance perfusion imaging is a relatively new and noninvasive technique that can help in predicting tumor grades and provide us with physiological data about the tumors which significantly aids in all stages of tumor care, including diagnosis, therapy, and follow-up.

Aim of the study
To determine agreement between independent observers in the assessment and prediction of brain tumor grading in pediatrics by arterial spin-labeled (ASL) magnetic resonance perfusion imaging.

Methods
Thirty-two patients (21 boys and 11 girls; mean age of (10.28 ± 4.31) years) with brain tumors were evaluated by ASL MRI perfusion. Image analysis was performed by two reviewers for quantifying absolute and relative tumoral blood flow (aTBF and rTBF) as well as qualitative assessment of the tumors in ASL color map images.

Results
The inter-observer agreement for the mean aTBF and the mean rTBF values of the studied lesions was almost perfect (inter-class correlation coefficient (ICC) = 0.978, 0.997). There was substantial agreement between both observers for the qualitative assessment of the studied lesions in color ASL images (Kappa = 0.779, with % of agreement = 87.0%). The mean aTBF for grade I tumors was (24.64 ± 3.45 ml/100 g/min), for grade II tumors it was (33.81 ± 3.59 ml/100 g/min), while for high-grade tumors (grade III and IV tumors) it was (75.60 ± 20.0 ml/100 g/min) with (p < 0.001). The mean rTBF of grade I, II, and III/IV tumors was (1.01 ± 0.17); (1.07 ± 0.31); and (3.12 ± 0.24) with (p < 0.001).

Conclusions
Arterial spin-labeled perfusion MRI can help in the challenge of prediction of brain tumor grading in pediatrics with accurate quantitative and semi-quantitative measurements of perfusion parameters of the tumors as well as qualitative and visual assessment of the tumors.
Applying machine learning methods to predict operative mortality after tricuspid valve surgery
Authors: Arafat Amr A. , Alamro Sultan , AlRasheed Maha M. , Adam Adam I. , Ismail Huda , Pragliola Claudio , Albabtain Monirah A. 
Published: August 2023

Abstract
Background
EuroSCORE stratifies surgical risk in cardiac surgery; however, it is not explicitly for tricuspid valve surgery. Therefore, we aimed to apply machine learning (ML) methods to predict operative mortality after tricuspid valve surgery and compare the predictive ability of these models to EuroSCORE.
This retrospective analysis included 1161 consecutive patients who underwent tricuspid valve surgery at a single center from 2009 to 2021. The study outcome was operative mortality (n=112), defined as mortality occurring within 30 days of surgery or the same hospital admission. Random forest, LASSO, elastic net, and logistic regression were used to identify predictors of operative mortality.

Results
EuroSCORE was significantly higher in patients who had operative mortality [8.52 (4.745–20.035) vs.4.11 (2.29–6.995), P<0.001] [AUC=0.73]. Random forest identified eight variables predicting operative mortality with an accuracy of 92% in the test set (age≥70 years, heart failure, emergency surgery, chronic kidney disease grade IV, diabetes mellitus, tricuspid valve replacement, hypertension, and redo surgery). The classification error rate in the training data was 9%, and in the testing data, it was 4.8%. Logistic regression identified eight variables with an AUC of 0.76. LASSO identified 13 variables with an AUC of 0.78, and elastic net identified 17 variables (AUC=0.795). The AUCs of the elastic net (P=0.048) and random forest (P<0.001) models were significantly higher than that of EuroSCORE.

Conclusions
ML effectively predicted TV surgery mortality more accurately than the traditional risk-scoring method. Incorporating ML in cardiac surgery risk scoring with comprehensive inclusion of all possible variables is recommended.