bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge, attitudes and practices regarding children with ICU-acquired weakness in pediatric intensive care unit among chinese medical staff: a cross-sectional survey
Authors: Huang Di , Zhang Weiwei , Peng Weisi , Fan Yi , He Xin , Xing Ruirui , Yan XuDong , Zhou Sijia , Peng YueMing , Luo WeiXiang 
Published: May 2023

Abstract
Background
ICU-AW (Intensive Care Unit Acquired Weakness) is characterized by significant muscle weakness and can be caused by a variety of factors, including immobility, medication use, and underlying medical conditions.ICU-AW can affect critically ill children who have been hospitalized in the PICU for an extended period of time.The knowledge, attitude and practice level of ICU-AW of PICU medical staff directly affect the treatment of critically ill children with ICU-AW.The aim to this study was to explore the knowledge, attitudes, and practices of Chinese medical staff regarding critically ill children with intensive care unit-acquired weakness (ICU-AW) and related factors.

Methods
A Knowledge, Attitudes, and Practices (KAP) Questionnaire regarding critically ill children with ICU-AW was distributed to a stratified sample of 530 pediatric intensive care unit (PICU) healthcare workers. The questionnaire consisted of 31 items—with scores of 45, 40, and 40 for each dimension and a total score of 125.

Results
The mean total score of Chinese PICU healthcare workers for the KAP questionnaire regarding children with ICU-AW was 87.36 ± 14.241 (53–121), with mean total knowledge, attitudes, and practices scores of 30.35 ± 6.317, 30.46 ± 5.632, and 26.54 ± 6.454, respectively. The population distribution indicated that 50.56%, 46.04%, and 3.4% of healthcare workers had poor, average, and good scores, respectively. Multiple linear regression showed that gender, education, and hospital level classification influenced the KAP level of PICU healthcare workers regarding critically ill children with ICU-AW.

Conclusions
Overall, PICU healthcare workers in China have an average KAP level about ICU-AW, and the gender and education level of PICU healthcare workers, as well as the classification of hospitals where they work, predict the KAP status of healthcare workers regarding children with ICU-AW. Therefore, healthcare leaders should plan and develop specific training programs to improve the KAP level of PICU healthcare workers.
Identification of key genes and pathways in atherosclerosis using integrated bioinformatics analysis
Authors: Li Shihuan , Li Suqin , Li Qingjie , Zhou Qiaofeng , Liao Wenli , Yu Liangzhu , Ouyang Changhan , Xia Hongli , Liu Chao , Li Mincai 
Published: May 2023

Abstract
Background
Atherosclerosis (AS) is a chronic inflammatory disease that might induce severe cardiovascular events, such as myocardial infarction and cerebral infarction. These risk factors in the pathogenesis of AS remain uncertain and further research is needed. This study aims to explore the potential molecular mechanisms of AS by bioinformatics analyses.

Methods
GSE100927 gene expression profiles, including 69 AS samples and 35 healthy controls, were downloaded from Gene Expression Omnibus database and indenfied for key genes and pathways in AS.

Results
A total of 443 differentially expressed genes (DEGs) between control and AS were identified, including 323 down-regulated genes and 120 up-regulated genes. The Gene ontology terms enriched by the up-regulated DEGs were associated with the regulation of leukocyte activation, endocytic vesicle, and cytokine binding, while the down-regulated DEGs were associated with negative regulation of cell growth, extracellular matrix, and G protein-coupled receptor binding. KEGG pathway analysis showed that the up-regulated DEGs were enriched in Osteoclast differentiation and Phagosome, while the down-regulated DEGs were enriched in vascular smooth muscle contraction and cGMP-PKG signaling pathway. Using the modular analysis of Cytoscape, we identified 3 modules mainly involved in Leishmaniasis and Osteoclast differentiation. The GSEA analysis showed the up-regulated gene sets were enriched in the ribosome, ascorbated metabolism, and propanoate metabolism. The LASSO Cox regression analysis showed the top 3 genes were TNF, CX3CR1, and COL1R1. Finally, we found these immune cells were conferred significantly higher infiltrating density in the AS group.

Conclusions
Our data showed the pathway of Osteoclast differentiation and Leishmaniasis was involved in the AS process and we developed a three-gene model base on the prognosis of AS. These findings clarified the gene regulatory network of AS and may provide a novel target for AS therapy.
Comparative study of optical coherence tomograph and histological images of eustachian tube nasopharyngeal region and adjacent structures in vivo and ex-vivo miniature pigs
Authors: Sun Xiao-Mei , Xiao Zhi-Wen , Luo Jia-Qi , Gu Qing-Yu , Zhang Hui-Qing , Li Bai-Ling , Zhuang Shi-Min , Zhang Guan-Ping 
Published: May 2023

Abstract
Objectives
Optical Coherence Tomograph (OCT) imaging technology can be used to examine, in vivo, the human ET. At present, it is impossible to achieve the OCT scanning vivo and ex vivo in the same individual human body, or study the consistency between OCT images and histological images of the eustachian tube nasopharyngeal region and adjacent structures. The aim of this study was to determine the consistency between OCT images and histological sections in vivo and ex vivo in miniature pigs.

Methods
OCT imaging was performed on five adult miniature pigs in vivo and ex vivo. The images of the eustachian tube OCT (ET-OCT), nasopharynx OCT (NP-OCT) and histological cross sections were further studied.

Results
All five miniature pigs achieved the OCT scan successfully, acquiring ET-OCT and NP-OCT images in vivo and ex vivo on both sides. The acquired ET OCT images closely matched the histological images, revealing details of the cartilage, submucosa, glands, and mucosa. The lower segment of the ET wall mucosa had an abundance of glands and submucosal tissues, with more low-signal areas appearing in the ex vivo images. The NP-OCT images of the nasopharynx matched the details of the mucosa and submucosal tissues. The ex-vivo OCT images showed thicker mucosa and more scattered slightly lower signal areas compared to the vivo OCT images.

Conclusions
ET-OCT images and NP-OCT images matched the histological structure of eustachian tube nasopharyngeal region structures in miniature pigs both in vivo and ex vivo. OCT images may be sensitive to changes in edema and ischemia status. There is a great potential for morphological assessment of inflammation, edema, injure, mucus gland status.
Molecular characteristics of clinical IMP-producing Klebsiella pneumoniae isolates: novel IMP-90 and integron In2147
Authors: Yang Liuyang , Zhang Guangcun , Zhao Qiang , Guo Ling , Yang Jiyong 
Published: May 2023

Abstract
Background
Since the first report of carbapenem-resistant Klebsiella pneumoniae isolates in China in 2007, the prevalence of CRKP and CRE has increased significantly. However, the molecular characteristics of IMP-producing Klebsiella pneumoniae (IMPKp) are rarely reported.

Methods
A total of 29 IMPKp isolates were collected from a Chinese tertiary hospital from 2011 to 2017. Clinical IMPKp were identified by VITEK®MS, and further analyzed by whole-genome DNA sequencing with HiSeq and PacBio RSII sequencer. Sequencing data were analyzed using CSI Phylogeny 1.4, Resfinder, PlasmidFinder and the MLST tool provided by the Centre for Genomic Epidemiology. The analysis results were visualized using iTOL editor v1_1. The open reading frames and pseudogenes were predicted using RAST 2.0 combined with BLASTP/BLASTN searches against the RefSeq database. The databases CARD, ResFinder, ISfinder, and INTEGRALL were performed for annotation of the resistance genes, mobile elements, and other features. The types of blaIMP in clinical isolates were determined by BIGSdb-Pasteur. Integrons were drawn by Snapgene, and the gene organization diagrams were drawn by Inkscape 0.48.1.

Results
Four novel ST type, including ST5422, ST5423, ST5426 and ST5427 were identified. The IMP-4 and IMP-1 were the dominant IMP type. The majority of blaIMP-carrying plasmids belonged to IncN and IncHI5. Two novel blaIMP-carrying integrons (In2146 and In2147) were uncovered. A novel variant blaIMP-90 presented in novel integron In2147 has been identified.

Conclusions
IMPKp showed low prevalence in China. Novel molecular characteristics of IMPKp have been identified. Continuous monitoring of IMPKp shall also be carried out in the future.
Altered endocannabinoidome bioactive lipid levels accompany reduced DNBS-induced colonic inflammation in germ-free mice
Authors: Venneri Tommaso , Giorgini Giada , Leblanc Nadine , Flamand Nicolas , Borrelli Francesca , Silvestri Cristoforo , Di Marzo Vincenzo 
Published: May 2023

Abstract
Background
Gut microbiota are involved in the onset and development of chronic intestinal inflammation. The recently described endocannabinoidome (eCBome), a diverse and complex system of bioactive lipid mediators, has been reported to play a role in various physio-pathological processes such as inflammation, immune responses and energy metabolism. The eCBome and the gut microbiome (miBIome) are closely linked and form the eCBome - miBIome axis, which may be of special relevance to colitis.

Methods
Colitis was induced in conventionally raised (CR), antibiotic-treated (ABX) and germ-free (GF) mice with dinitrobenzene sulfonic acid (DNBS). Inflammation was assessed by Disease Activity Index (DAI) score, body weight change, colon weight-length ratio, myeloperoxidase (MPO) activity and cytokine gene expression. Colonic eCBome lipid mediator concentrations were measured by HPLC-MS /MS.

Results
GF mice showed increased levels of anti-inflammatory eCBome lipids (LEA, OEA, DHEA and 13- HODE-EA) in the healthy state and higher MPO activity. DNBS elicited reduced inflammation in GF mice, having lower colon weight/length ratios and lower expression levels of Il1b, Il6, Tnfa and neutrophil markers compared to one or both of the other DNBS-treated groups. Il10 expression was also lower and the levels of several N-acyl ethanolamines and 13-HODE-EA levels were higher in DNBS-treated GF mice than in CR and ABX mice. The levels of these eCBome lipids negatively correlated with measures of colitis and inflammation.

Conclusions
These results suggest that the depletion of the gut microbiota and subsequent differential development of the gut immune system in GF mice is followed by a compensatory effect on eCBome lipid mediators, which may explain, in part, the observed lower susceptibility of GF mice to develop DNBS-induced colitis.
The financial need of feeding infants for the first six months of life in West Java Province of Indonesia and the implications of socioeconomic and mental health factors
Authors: Relaksana Riki , Akbar Adhadian , Sihaloho Estro Dariatno , Ferdian Dani , Siregar Adiatma YM 
Published: May 2023

Abstract
Background
In Indonesia, nearly half of all children aged less than six months were not exclusively breastfed in 2017. This study aimed to compare the cost of providing direct or indirect exclusive breastfeeding 0–6 months, partial exclusive breastfeeding and commercial milk formula only. This study also assessed the maternal socioeconomic and mental health factors to providing exclusive breastfeeding.

Methods
Data were collected in 2018 via a cross-sectional survey of 456 mothers in Bandung City and Purwakarta District, West Java Province, Indonesia, who had children aged less than six months. We used micro-costing to calculate the cost of productivity, equipment, supplies, and training of mothers when providing direct exclusive breastfeeding, indirect exclusive breastfeeding, partial exclusive breastfeeding (a mix of breastfeed and commercial milk formula), and infant formula/commercial milk formula only. Logistic regression was used to determine the impact of several independent variables, including mother’s level of depression, on exclusive breastfeeding.

Results
To provide direct exclusive breastfeeding, the cost per mother in the first six months is US$81.08, which is less expensive than indirect exclusive breastfeeding (US$171.15), partial exclusive breastfeeding (US$487.8) and commercial milk formula (US$494.9). We also found that education and age are associated with the decision to provide direct exclusive breastfeeding. Mothers who work will most likely provide indirect exclusive breastfeeding, commercial milk formula, or partial breastfeeding as opposed to direct exclusive breastfeeding. Finally, although severe depression symptoms have a positive relationship with the decision to provide commercial milk formula over direct exclusive breastfeeding, the evidence here is not strong.

Conclusions
The total cost of providing only commercial milk formula is 6-times higher than the cost of direct exclusive breastfeeding. The presence of severe depression symptoms is positively related to mothers opting for other feeding methods aside of direct exclusive breastfeeding and indirect exclusive breastfeeding. This study shows that direct exclusive breastfeeding is economically preferable to other methods, supports policies to reduce the time cost of exclusive breastfeeding (e.g., paid maternity leave and maternal cash transfers), and addresses the importance of mother’s mental health to ensure successful breastfeeding.
Survival time and prognostic factors in canine leishmaniosis in a non-endemic country treated with a two-phase protocol including initial allopurinol monotherapy
Authors: de Jong Marja Klazina , Rappoldt Aukje , Broere Femke , Piek Christine Jantine 
Published: May 2023

Abstract
Background
Leishmania infantum is an intracellular protozoan parasite which is endemic in countries of the Mediterranean Basin. Leishmaniosis is increasingly diagnosed in non-endemic areas due to the relocation of dogs from endemic areas and the travel of dogs to and from these areas. The prognosis of leishmaniosis in these dogs may differ from that of those in endemic areas. The aims of this study were (1) to determine the Kaplan–Meier estimated survival time for dogs with leishmaniosis in the Netherlands (a non-endemic country), (2) to determine if clinicopathological variables at the time of diagnosis predicted the survival of these dogs, and (3) to evaluate the effect of a two-phase therapy protocol of allopurinol monotherapy followed by meglumine antimoniate and/or miltefosine in the case of incomplete remission or relapse.

Methods
The database of the Department of Clinical Sciences of Companion Animals of the Faculty of Veterinary Medicine, Utrecht University was investigated for leishmaniosis patients. Patient records were reviewed for signalment and clinicopathological data at the time of diagnosis. Only treatment-naive patients were included. Follow-up was performed during the study by phone contact and included treatment received and date and cause of death. Univariate analysis was performed using the Cox proportional hazards regression model.

Results
The estimated median Kaplan–Meier survival time was 6.4 years. In the univariate analysis, increases in monocyte, plasma urea and creatinine concentrations, and urine protein to creatinine ratio were all significantly associated with decreased survival time. The majority of patients only received allopurinol monotherapy.

Conclusions
Canine leishmaniosis patients in our study population in the Netherlands, which is non-endemic for the disease, had an estimated Kaplan–Meier median survival time of 6.4 years, which is comparable to the outcome of other reported therapy protocols. Increased plasma urea and creatinine concentrations and monocyte concentration were statistically associated with an increased risk of death. We conclude that initial allopurinol monotherapy for 3 months should be effective in more than half of canine leishmaniosis cases, provided there is adequate follow-up, and that meglumine antimoniate or miltefosine therapy should be started as the second phase of the protocol in cases where remission is incomplete or there is a relapse.

Graphical Abstract
Serum vitamin D levels and Sjogren’s syndrome: bi-directional Mendelian randomization analysis
Authors: Zhao Meng , Wei Feiran , Li Han , Wang Zemin , Wang Shuai , Liu Yangyang , Fei Gaoqiang , Ge You , Wei Pingmin 
Published: May 2023

Abstract
Background
Based on the results of existing observational studies, it can be found that the association between serum vitamin D levels and the risk of Sjogren’s syndrome (SS) in humans is still controversial. Based on this situation, this study aimed to assess the causal relationship between serum vitamin D levels and SS by using the Mendelian randomization (MR) approach.

Methods
In this study, genome-wide association studies (GWAS) summary statistics on serum vitamin D levels [sample size = 417,580 (UK Biobank)] and SS [sample size = 416,757 (cases = 2495, controls = 414,262) (FinnGen)] were used. The bi-directional MR analysis was then used to assess possible causal relationships. The major analysis method of MR was performed using inverse-variance weighted (IVW), supplemented by MR-Egger and the weighted median approaches. In addition, sensitivity analyses were used to ensure the stability of the results, including Cochran’s Q test, MR-PRESSO, MR-Egger intercept test, and the leave-one-out test.

Results
The MR suggested that no significant causal effects of serum 25(OH)D levels on SS risks were observed [odds ratio (OR) = 0.9824; 95% confidence interval (CI) = 0.7130 to 1.3538; P = 0.9137]. Similarly, no evidence supported the causal effects of SS on serum vitamin D levels (β: 0.0076, 95% CI: − 0.0031 to 0.0183; P = 0.1640).

Conclusion
This study found no obvious evidence that serum vitamin D level is causally associated with SS risks or vice versa. We call for larger sample size studies to further unravel the potential causal relationship and the exact mechanism.
Epigenetic effects of herbal medicine
Authors: Wu Yu-Yao , Xu Yan-Ming , Lau Andy T. Y. 
Published: May 2023

AbstractEpigenetic memory is essential for life that governs the predefined functional features of cells. Recent evidence has indicated that the epigenetic modification provides a potential link to gene expression changes that may be involved in the development of various chronic diseases, and targeting the epigenome becomes a plausible method for treating diseases. Traditional herbal medicine has gradually entered the vision of researchers due to its low toxicity and its effectiveness in treating diseases. As a matter of fact, researchers found that the possessed epigenetic modification capacity of herbal medicine had the ability to combat the progression of the disease, such as various types of cancer, diabetes, inflammation, amnesia, liver fibrosis, asthma, and hypertension-induced renal injury. Studies on the epigenetic effects of herbal medicine will provide valuable insights into the molecular mechanisms of human diseases, which may lead to new therapeutic approaches and diagnoses. Thus, this review summarized the impact of herbal medicine and its bioactive components on disease epigenome as examples of how utilization of epigenetic plasticity could be useful as the basis for the future development of targeted therapies in chronic diseases.
Upregulated expression of Notch1/4 - JAG-1/DLL-1 detected in allergic rhinitis
Authors: Hjalmarsson Eric , Petro Marianne , Georén Susanna Kumlien , Winqvist Ola , Cardell Lars Olaf 
Published: May 2023

Abstract
Background
Allergic rhinitis (AR) is a chronic disease with high prevalence. There are currently many treatments available. However, despite an often good therapeutic response, many patients still report impairment in quality of life (QoL) during the pollen season. A skewed T helper (Th)2 polarization is a well-acknowledged pathologic feature of AR. In animal models, local notch signaling in peripheral tissue seems crucial for Th2 cell differentiation and the development of AR. However, the involvement of Notch signaling in Th2 cell differentiation and the development of AR in humans remains unknown. Hence, the present study investigated the human expression of Notch receptors on CD4+ T-cells in nasal mucosa and blood. Correspondingly Notch ligand expression was assessed on nasal epithelial cells and neutrophils.

Methodology
Nasal brush and blood samples from 18 patients with pollen-induced AR and 22 healthy controls were collected outside the pollen season. Notch 1–4 and Jagged-1,2 and Delta-like ligand 1,3–4 was analyzed using flow cytometry.

Results
The fraction of CD4+Notch1+ and CD4+Notch4+ T-cells was higher in AR patients than in healthy control patients. Further, the expression levels of the Notch ligands JAG-1 and DLL-1 were increased in nasal epithelial cells from AR patients compared to healthy control patients. In addition, AR patients displayed higher expression of JAG-1 on neutrophils both in the nasal mucosa and in peripheral blood.

Conclusion
The present study is the first to demonstrate increased activity in the Notch1/4 - JAG-1/DLL-1 pathways among allergic individuals. Further propagating the importance of Notch signalling in AR and blocking JAG-1 and DLL-1-induced Notch signalling by nasal epithelial cells and Neutrophils are potential targets to reduce allergic airway inflammation.
CT volume analysis in living donor liver transplantation: accuracy of three different approaches
Authors: Kalshabay Yerkezhan , Zholdybay Zhamilya , Di Martino Michele , Medeubekov Ulykbek , Baiguissova Dinara , Ainakulova Akmaral , Doskhanov Maksat , Baimakhanov Bolatbek 
Published: May 2023

Abstract
Objectives
The aim of this retrospective study is to compare and evaluate accuracy of three different approaches of liver volume quantification in living donor transplantations.

Methods
This is a single-center, retrospective study of 60 donors. The total and right lobe liver volumes were analyzed in the portal-venous phase by two independent radiologists who estimated the volumes using manual, semi-automated and automated segmentation methods. The measured right lobe liver volume was compared to the real weight of the graft after back-table examinations.

Results
The mean estimated overall liver volume was 1164.4 ± 137.0 mL for manual, 1277.4 ± 190.4 mL for semi-automated and 1240.1 ± 108.5 mL for automated segmentation. The mean estimated right lobe volume was 762.0 ± 122.4 mL for manual, 792.9 ± 139.9 mL for semi-automated and 765.4 ± 132.7 mL for automated segmentation. The mean graft weight was 711.2 ± 142.9 g. The manual method better correlated with the graft weight (r = 0.730) in comparison with the semi-automated (r = 0.685) and the automated (r = 0.699) methods (p < 0.001). The mean error ratio in volume estimation by each application was 12.7 ± 16.6% for manual, 17.1 ± 17.3% for semi-automated, 14.7 ± 16.8% for automated methods. There was a statistically significant difference between the mean error ratio of the manual and the semi-automated segmentations (p = 0.017), and no statistically significant difference between the manual and the automated applications (p = 0.199).

Conclusion
Volume analysis application better correlates with graft weight, but there is no obvious difference between correlation coefficients of all three methods. All three modalities had an error ratio, of which the semi-automated method showed the highest value.

Critical relevance statement
Volume analysis application was more accurate, but there is no drastic difference between correlation coefficients of all three methods.

Graphical abstract