bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of a Focused Online Teaching Module on Airway Intervention: Can an Online Teaching Module Enable Knowledge Acquisition and Increased Confidence in Airway Management?
Authors: Briggs Blake , Kalra Sarathi , Masneri David , Husain Iltifat 
Published: September 2023

OBJECTIVE Teaching procedural skills via digital platforms is challenging. There is a paucity of literature on the feasibility of implementing an online asynchronous web-based learning (WBL) module for endotracheal intubation in Emergency Medicine. Learners completed a pre-test questionnaire prior to reviewing the module to assess their current knowledge. After completion of the online module, another assessment on airway management competency was completed. The purpose of our pilot study was to determine the feasibility of implementing an online airway module and investigate knowledge acquisition among learners who completed it. Additionally, we compared the relationship between pre-module confidence and knowledge between various training levels of those who completed the module. METHODS The study was IRB exempt. We conducted a quasi-experimental pre- and post-test study, where learners took a multiple-choice question-based test before watching content module, and after completion of modules, they went on to complete post-test questions. All responses were collected using Google survey and the data were collected over a period of 6 months. We performed descriptive statistics for the pre- and post-module. Frequency distribution was used for data summarization and chi-square test was used to assess the difference between variables. RESULTS We received 366 responses in the pre-test module and 105 in post-test module. Responses were summarized into 5 broad categories which assessed knowledge about airway technique, anatomical landmarks, formulas for selecting blade size, tube size, depth of tube, and case-based scenarios. All questions showed a higher percentage of correct answers in the post-assessment compared to the pre-assessment. CONCLUSION The results demonstrated that this WBL airway module resulted in significant knowledge acquisition, as well as increased confidence when approaching airway management. The study demonstrated that a WBL airway module is a feasible method of asynchronous education for healthcare providers in all levels of training.
Susceptibility Vessel Sign as a Predictor of Intracranial Large Vessel Occlusion
Authors: Raj Aiswarya , Valappil Ashraf V. , Johny Paul , Alapatt Paul J. , Abdurehiman K. P. , Sreevidya L. K. , Basheer Noufal 
Published: September 2023

Background The susceptibility vessel sign (SVS), which can be seen on susceptibility-weighted imaging (SWI), is typically described as a dark blooming artifact. Objective SVS, which can be seen on T2*-weighted gradient echo imaging, is typically described as a dark blooming artifact. The hypointense vessel’s diameter is thus larger on imaging than the opposing vessel’s diameter. We conducted a study to investigate the reliability of this sign on SWI in the principal intracranial arteries in 156 individuals with acute stroke and to assess the 3-month outcome using the modified Rankin Scale (mRS) in these patients. Results Among the 106 patients with large vessel occlusion (LVO) on magnetic resonance angiography (MRA), 73 patients demonstrated a positive SVS on magnetic resonance imaging (MRI), while 33 patients did not. Among the 50 patients without LVO, only 4 patients showed a false-positive SVS, while 46 patients showed a negative SVS. The sensitivity, specificity, positive predictive value, and negative predictive value of SVS as a screening tool were 67.05%, 90.7%, 93.65%, and 57.35% in anterior circulation LVO, and 77.8%, 100%, 100%, and 63.6% in posterior circulation LVO, respectively. The chi-square test showed p < .05, demonstrating a significant association. With a modified thrombolysis in cerebral infarction (mTICI) score of 2B or 3, 83.3% of SVS-positive patients had a successful recanalization, while 64.4% had an mRS score of less than 3. Interpretation SVS is a good screening tool for the presence of intracranial LVO, with good sensitivity, high specificity, and positive predictive value for LVO (posterior > anterior). SVS positivity may also indicate successful recanalization and a good 90-day mRS outcome.
CD5 B-Cell Predominant Primary Immunodeficiency: Part of the Spectrum of MAGT1 Deficiency
Authors: Rowane Marija J. , Stewart-Bates Benjamin C. , Doll Rayna J. , Meyerson Howard J. , Venglarcik John S. , Callahan Meghan , Fill Lauren , Saab Remie , Ochs Hans D. , Hostoffer Robert W. 
Published: September 2023

Background Selective anti-polysaccharide antibody deficiency (SPAD) with CD5 B-cell predominance and autoimmune phenomena was identified in a male cohort first reported by Antall et al in 1999. The phenotypically likewise and genotypically identical X-linked immunodeficiency with magnesium defect, Epstein–Barr Virus infection, and neoplasia (XMEN) disease was defined as a novel primary immunodeficiency (PID) in 2011. Recent studies of the magnesium transporter 1 (MAGT1) gene mutation reveal glycosylation defects contributing to more phenotypic variance than the “XMEN” title pathologies. The updated title, “X-linked MAGT1 deficiency with increased susceptibility to EBV-infection and N-linked glycosylation defect,” was proposed in 2020. Objectives To reflect the patient population more accurately, a prospective classification update may consider MAGT1 glycobiological errors contributing to phenotypic variance but also pre-genetic testing era reports with CD5 B-cell predominance. Methods Patient 1 from Antall et al presented at 28 years of age for further immunological evaluation of his CD5/CD19 B-cell predominance diagnosed at 5 years old. Design Immune re-evaluation done through flow cytometry and next-generation sequencing. Results Flow cytometry B-cell phenotyping revealed persistent CD5+CD19+ (93%). Flow cytometric histogram quantified reduced activator CD16+CD56+ natural killer and CD8+ T-cell receptor, Group 2, Member D (NKG2D) glycoprotein expression. A c.923-1_934 deletion loss of function mutation was identified in the MAGT1 gene. Conclusion We suggest the novel PID XMEN, based on its CD5 B-cell predominance, had been discovered and reported over a decade earlier as CD5+ PID based on the MAGT1 mutation found in the same. We encourage consideration of combining these labels and recent findings to offer the most accurate classification of this disease.
High performance photocatalyst TiO2@UiO-66 applied to degradation of methyl orange
Authors: Yang Jingyi , Chang Xue , Wei Fang , Lv Zixiao , Liu Huiling , Li Zhan , Wu Wangsuo , Qian Lijuan 
Published: September 2023

AbstractMOFs have considerable adsorption capacity due to their huge specific surface area. They have the characteristics of photocatalysts for their organic ligands can absorb photons and produce electrons. In this paper, the photodegradation properties of TiO2 composites loaded with UiO-66 were investigated for the first time for MO. A series of TiO2@UiO-66 composites with different contents of TiO2 were prepared by a solvothermal method. The photocatalytic degradation of methyl orange (MO) was performed using a high-pressure mercury lamp as the UV light source. The effects of TiO2 loading, catalyst dosage, pH value, and MO concentration were investigated. The results showed that the degradation of MO by TiO2@UiO-66 could reach 97.59% with the addition of only a small amount of TiO2 (5 wt%). TiO2@UiO-66 exhibited significantly enhanced photoelectron transfer capability and inhibited efficient electron–hole recombination compared to pure TiO2 in MO degradation. The composite catalyst indicated good stability and reusability when they were recycled three times, and the photocatalytic reaction efficiencies were 92.54%, 88.76%, and 86.90%. The results provide a new option to design stable, high-efficiency MOF-based photocatalysts.
Comparative genomic analysis of two Arctic Pseudomonas strains reveals insights into the aerobic denitrification in cold environments
Authors: Hu Yong-Qiang , Zeng Yin-Xin , Du Yu , Zhao Wei , Li Hui-Rong , Han Wei , Hu Ting , Luo Wei 
Published: September 2023

AbstractBackgroundBiological denitrification has been commonly adopted for the removal of nitrogen from sewage effluents. However, due to the low temperature during winter, microorganisms in the wastewater biological treatment unit usually encounter problems such as slow cell growth and low enzymatic efficiency. Hence, the isolation and screening of cold-tolerant aerobic denitrifying bacteria (ADB) have recently drawn attention. In our previous study, twoPseudomonasstrains PMCC200344 and PMCC200367 isolated from Arctic soil demonstrated strong denitrification ability at low temperatures. The two Arctic strains show potential for biological nitrogen removal from sewage in cold environments. However, the genome sequences of these two organisms have not been reported thus far.ResultsHere, the basic characteristics and genetic diversity of strains PMCC200344 and PMCC200367 were described, together with the complete genomes and comparative genomic results. The genome ofPseudomonassp. PMCC200344 was composed of a circular chromosome of 6,478,166 bp with a G + C content of 58.60% and contained a total of 5,853 genes. The genome ofPseudomonassp. PMCC200367 was composed of a circular chromosome of 6,360,061 bp with a G + C content of 58.68% and contained 5,801 genes. Not only prophages but also genomic islands were identified in the twoPseudomonasstrains. No plasmids were observed. All genes of a complete set of denitrification pathways as well as various putative cold adaptation and heavy metal resistance genes in the genomes were identified and analyzed. These genes were usually detected on genomic islands in bacterial genomes.ConclusionsThese analytical results provide insights into the genomic basis of microbial denitrification in cold environments, indicating the potential of ArcticPseudomonasstrains in nitrogen removal from sewage effluents at low temperatures.
Monocyte to high-density lipoprotein ratio is associated with mortality in patients with coronary artery diseases
Authors: Pei Gaiqin , Liu Rui , Wang Lu , He Chengqi , Fu Chenying , Wei Quan 
Published: September 2023

Abstract
Background
Whether the monocyte to high-density lipoprotein ratio (MHR) is associated with the prognosis of coronary artery disease (CAD) is inconclusive.

Methods
Patients with CAD were enrolled and their data were collected. Blood was sampled within 24 h after admission. Multivariate Cox regression analysis was performed to determine the relationship between the MHR and all-cause mortality as well as complications during hospitalization.

Results
We included 5371 patients in our cohort study. Among them, 114 (2.12%) patients died in hospital. MHR was independently associated with all-cause mortality (hazard ratio [HR], 1.81; 95% confidence interval [CI] 1.35, 2.42), cardiovascular mortality (1.69; 1.17, 2.45) and non-cardiovascular mortality (2.04; 1.27, 3.28). This association was only observed in patients with hypertension (P for interaction = 0.003). Patients with higher MHR levels also have a higher risk of complications, including infection, pneumonia, electrolyte disturbance, gastrointestinal bleeding, multiple organ dysfunction syndrome, and disturbance of consciousness. The receiver operating characteristic (ROC) analysis showed that the MHR had higher prognostic values than monocytes and high-density lipoprotein.

Conclusion
MHR was an independent predictor of all-cause mortality and in-hospital complications in patients with CAD, especially in patients with hypertension.
Evaluation of left ventricular dysfunction by three-dimensional speckle-tracking echocardiography and bioinformatics analysis of circulating exosomal miRNA in obese patients
Authors: Wan Fuxin , Ma Xin , Wang Jiana , An Zhaohui , Xue Jiewen , Wang Qin 
Published: September 2023

Abstract
Background
Obesity is an independent risk factor for cardiovascular disease and affects the human population. This study aimed to evaluate left ventricular (LV) dysfunction in obese patients with three-dimensional speckle-tracking echocardiography (3D-STE) and investigate the possible related mechanisms at the exosomal miRNA level.

Methods
In total, 43 participants (16 obese patients and 27 healthy volunteers) were enrolled. All subjects underwent full conventional echocardiography as well as 3D-STE. Characterization and high-throughput sequencing for the isolated circulating exosomes and the differentially expressed miRNAs (DEMs) were screened for target gene prediction and enrichment analysis.

Results
Obese patients had significantly lower global longitudinal strain (GLS) (-20.80%±3.10% vs. -14.77%±2.05%, P < 0.001), global circumferential strain (GCS) (-31.63%±3.89% vs. -25.35%±5.66%, P = 0.001), global radial strain (GRS) (43.21%±4.89% vs. 33.38%±3.47%, P < 0.001), and indexed LV end-diastolic volume (LVEDV) [38.07mL/m2 (27.82mL/m2–9.57mL/m2) vs. 24.79mL/m2 (21.97mL/m2–30.73mL/m2), P = 0.002] than healthy controls. GLS (ρ = 0.610, P < 0.001), GCS (ρ = 0.424, P = 0.005), and GRS (ρ = -0.656, P < 0.001) indicated a moderate relationship with body mass index (BMI). In obese patients, 33 exosomal miRNAs were up-regulated and 26 exosomal miRNAs were down-regulated when compared to healthy controls (P < 0.05). These DEMs possibly contribute to obesity-associated LV dysfunction through the PI3K-Akt signaling pathway. Important miRNAs, including miR-101-3p, miR-140-3p, and miR-99a-5p, have clinical utility in predicting early obesity-related myocardial injury.

Conclusions
The global strain obtained from 3D-STE can sensitively detect the decrease in LV myocardial function in obese patients. Key miRNAs and pathways provide a new theoretical basis and targets of action for studying obesity-induced LV dysfunction.

Trial registration
In accordance with the World Health Organization (WHO) definition of a clinical trial, this study does not include human health-related interventions. This study was carried out at the General Hospital of Ningxia Medical University after obtaining institutional ethical approval (KYLL-2022-0556) and written informed consent from all participants.
Fatal BK polyomavirus-associated pneumonia: report of two cases with literature review
Authors: Wang Yuchen , Fang Yiling , Yan Ziyan , Xia Renfei , Zeng Wenli , Deng Wenfeng , Xu Jian , Feng Xiaoqin , Peng Jie , Miao Yun 
Published: September 2023

Abstract
Background
In immunocompromised populations, such as patients with AIDS and recipients of solid organ and hematopoietic stem cell transplants, BK polyomavirus (BKPyV) can reactivate and cause several diseases, which can lead to death in their severe forms. Unlike hemorrhagic cystitis and BKPyV-associated nephropathy, BKPyV-associated pneumonia is rare, with only seven known cases worldwide. However, the disease can rapidly progress with extremely high mortality.

Case presentation
Herein, we report two cases of BKPyV-associated pneumonia following hematopoietic stem cell transplantation. Both patients had consistent infectious pneumonia and graft-versus-host disease after stem cell transplantation. The diagnosis of BKPyV-associated pneumonia was confirmed by metagenomic next-generation sequencing and polymerase chain reaction after the sudden worsening of the pulmonary infection signs and symptoms concomitant with renal dysfunction and systemic immune weakening. Both patients eventually died of systemic multi-organ failure caused by severe pneumonia.

Conclusions
Currently, BKPyV reactivation cannot be effectively prevented. Immunocompromised patients must actively manage their primary lung infections, pay close attention to pulmonary signs and imaging changes. Especially during and after steroid pulse therapy or immunosuppressive therapy for graft versus host diseases, BKPyV load in blood/urine needs to be regularly measured, and the immunosuppressive intensity should be adjusted properly after the BKPyV reactivation diagnosis. Clinical trials of new antiviral drugs and therapies for BKPyV are urgently needed.
Strengthening antimicrobial resistance surveillance systems: a scoping review
Authors: Do Phu Cong , Assefa Yibeltal Alemu , Batikawai Suliasi Mekerusa , Reid Simon Andrew 
Published: September 2023

Abstract
Background
Antimicrobial resistance (AMR) is an emerging global public health crisis. Surveillance is a fundamental component in the monitoring and evaluation of AMR mitigation endeavours. The primary aim of the scoping review is to identify successes, barriers, and gaps in implementing AMR surveillance systems and utilising data from them.

Methods
PubMed, Web of Science, SCOPUS, and EMBASE databases were searched systematically to identify literature pertaining to implementation, monitoring, and evaluation of AMR surveillance systems. A thematic analysis was conducted where themes within the literature were inductively grouped based on the described content.

Results
The systematic search yielded 639 journal articles for screening. Following deduplication and screening, 46 articles were determined to be appropriate for inclusion. Generally, most studies focused on human AMR surveillance (n = 38, 82.6%). Regionally, there was equal focus on low- and middle-income countries (n = 7, 15.2%) and trans-national contexts (n = 7, 14.5%). All included articles (n = 46, 100.0%) discussed barriers to either implementing or utilising AMR surveillance systems. From the scoping review, 6 themes emerged: capacity for surveillance, data infrastructure, policy, representativeness, stakeholder engagement, and sustainability. Data infrastructure was most frequently discussed as problematic in evaluation of surveillance systems (n = 36, 75.0%). The most frequent success to surveillance system implementation was stakeholder engagement (n = 30, 65.2%).

Conclusions
Experiences of AMR surveillance systems are diverse across contexts. There is a distinct separation of experiences between systems with emerging surveillance systems and those with established systems. Surveillance systems require extensive refinement to become representative and meet surveillance objectives.
75% radiation dose reduction using deep learning reconstruction on low-dose chest CT
Authors: Jo Gyeong Deok , Ahn Chulkyun , Hong Jung Hee , Kim Da Som , Park Jongsoo , Kim Hyungjin , Kim Jong Hyo , Goo Jin Mo , Nam Ju Gang 
Published: September 2023

Abstract
Objective
Few studies have explored the clinical feasibility of using deep-learning reconstruction to reduce the radiation dose of CT. We aimed to compare the image quality and lung nodule detectability between chest CT using a quarter of the low dose (QLD) reconstructed with vendor-agnostic deep-learning image reconstruction (DLIR) and conventional low-dose (LD) CT reconstructed with iterative reconstruction (IR).

Materials and methods
We retrospectively collected 100 patients (median age, 61 years [IQR, 53–70 years]) who received LDCT using a dual-source scanner, where total radiation was split into a 1:3 ratio. QLD CT was generated using a quarter dose and reconstructed with DLIR (QLD-DLIR), while LDCT images were generated using a full dose and reconstructed with IR (LD-IR). Three thoracic radiologists reviewed subjective noise, spatial resolution, and overall image quality, and image noise was measured in five areas. The radiologists were also asked to detect all Lung-RADS category 3 or 4 nodules, and their performance was evaluated using area under the jackknife free-response receiver operating characteristic curve (AUFROC).

Results
The median effective dose was 0.16 (IQR, 0.14–0.18) mSv for QLD CT and 0.65 (IQR, 0.57–0.71) mSv for LDCT. The radiologists’ evaluations showed no significant differences in subjective noise (QLD-DLIR vs. LD-IR, lung-window setting; 3.23 ± 0.19 vs. 3.27 ± 0.22; P = .11), spatial resolution (3.14 ± 0.28 vs. 3.16 ± 0.27; P = .12), and overall image quality (3.14 ± 0.21 vs. 3.17 ± 0.17; P = .15). QLD-DLIR demonstrated lower measured noise than LD-IR in most areas (P < .001 for all). No significant difference was found between QLD-DLIR and LD-IR for the sensitivity (76.4% vs. 72.2%; P = .35) or the AUFROCs (0.77 vs. 0.78; P = .68) in detecting Lung-RADS category 3 or 4 nodules. Under a noninferiority limit of -0.1, QLD-DLIR showed noninferior detection performance (95% CI for AUFROC difference, -0.04 to 0.06).

Conclusion
QLD-DLIR images showed comparable image quality and noninferior nodule detectability relative to LD-IR images.
Differentiating tumour progression from pseudoprogression in glioblastoma patients: a monoexponential, biexponential, and stretched-exponential model-based DWI study
Authors: Liao Dan , Liu Yuan-Cheng , Liu Jiang-Yong , Wang Di , Liu Xin-Feng 
Published: September 2023

Abstract
Background
To investigate the diagnostic performance of parameters derived from monoexponential, biexponential, and stretched-exponential diffusion-weighted imaging models in differentiating tumour progression from pseudoprogression in glioblastoma patients.

Methods
Forty patients with pathologically confirmed glioblastoma exhibiting enhancing lesions after completion of chemoradiation therapy were enrolled in the study, which were then classified as tumour progression and pseudoprogression. All patients underwent conventional and multi-b diffusion-weighted MRI. The apparent diffusion coefficient (ADC) from a monoexponential model, the true diffusion coefficient (D), pseudodiffusion coefficient (D*) and perfusion fraction (f) from a biexponential model, and the distributed diffusion coefficient (DDC) and intravoxel heterogeneity index (α) from a stretched-exponential model were compared between tumour progression and pseudoprogression groups. Receiver operating characteristic curves (ROC) analysis was used to investigate the diagnostic performance of different DWI parameters. Interclass correlation coefficient (ICC) was used to evaluate the consistency of measurements.

Results
The values of ADC, D, DDC, and α values were lower in tumour progression patients than that in pseudoprogression patients (p < 0.05). The values of D* and f were higher in tumour progression patients than that in pseudoprogression patients (p < 0.05). Diagnostic accuracy for differentiating tumour progression from pseudoprogression was highest for α(AUC = 0.94) than that for ADC (AUC = 0.91), D (AUC = 0.92), D* (AUC = 0.81), f (AUC = 0.75), and DDC (AUC = 0.88).

Conclusions
Multi-b DWI is a promising method for differentiating tumour progression from pseudoprogression with high diagnostic accuracy. In addition, the α derived from stretched-exponential model is the most promising DWI parameter for the prediction of tumour progression in glioblastoma patients.