bluuebunny/crossref_metadata_2025_split huggingface dataset:
Echocardiography predictors of sustained sinus rhythm after cardioversion of supraventricular arrhythmia in patients with septic shock
Authors: Balik Martin , Maly Michal , Brozek Tomas , Rulisek Jan , Porizka Michal , Sachl Robert , Otahal Michal , Brestovansky Petr , Svobodova Eva , Flaksa Marek , Stach Zdenek , Horejsek Jan , Volny Lukas , Jurisinova Ivana , Novotny Adam , Trachta Pavel , Kunstyr Jan , Kopecky Petr , Tencer Tomas , Pazout Jaroslav , Duska Frantisek , Krajcova Adela , Waldauf Petr 
Published: June 2023

Abstract

Background
Supraventricular arrhythmias (SVA) are associated with two to five times worse survival in septic shock. The objective of the study was to propose echocardiography parameters that could predict the maintenance of sinus rhythm and the feasibility of the rhythm control approach.
Methods
Patients in septic shock with an onset of an SVA, a normal to moderately reduced LV systolic function (EF_LV˃̳35%) and on a continuous noradrenaline of less than 1.0 ug/kg.min were included. Echocardiography was performed at the arrhythmia onset, 1h and 4h post cardioversion on an infusion of propafenone or amiodarone. There were no limits to electric cardioversions. Arrhythmia recurrences were analysed in relation to a complex of echocardiography parameters.
Results
Out of the 209 patients enrolled into the trial, 173 were analysed in sinus rhythm at 1h and 187 at 4h post cardioversion. Heart rate decreased from a median of 130(111;147)/min to 85(78;96)/min at 1h, p˂0.001, accompanied by an increase of stroke volume from 50(42;60)ml to 66(58;78)ml at 1h,p˂0.001. The left atrial end-systolic diameter (LA_ESD 40(35;45)mm) and indexed biplanar volume (LAVI 31(26;39)ml/m2) did not change, the left atrial emptying fraction (36 (29;45)% at 4h, p = 0.005), trans-mitral A-wave (p = 0.002) and the A-wave velocity-time integral (Avti 7.7(6.1;9.4)cm at 4h,p˂0.001) were gradually increased. Pulmonary artery systolic pressure (PAPs) did not change, while the right ventricular systolic function parameters increased with cardioversion (all p˂0.001). Vasopressor dosage at the start of arrhythmia, at 1h and 4h post cardioversion showed significant reductions for noradrenaline (p < 0.001) and vasopressin (p < 0.001). The feasible predictors of arrhythmia recurrence were LA_EF at 4h with the cut- off 38.4%, AUC 0.69, p˂0.001, and Avti at 4h with the cut-off 6.8cm, AUC 0.65, p = 0.001. The elevated PAPs at 4h (p = 0.007) and enlarged LA_ESD at arrhythmia onset (p = 0.04) predicted only multiple recurrences (˃3). LAVI (p = 0.06) and arrhythmia history (p = 0.09) were not useful.
Conclusion
There is a period of atrial functional recovery after restoration of electrical sinus rhythm in patients with septic shock complicated by an SVA. The associations of LA_EF and Avti at 4 hours post-cardioversion with sustained sinus rhythm suggest potential parameters to guide the choice between rhythm and rate control strategies.
Trial registration
: ClinicalTrials.gov Identifier: NCT03029169
Enhancing Tube Feeding Method for Neurosurgery: The Application of Improved PICC Technique
Authors: Wu Huiwen , Qiu Yuru , Wang Yucui , Li Jiarong , Qiu Yihong 
Published: June 2023

Abstract
Background and purpose
Peripherally inserted central catheter (PICC) used in neurosurgical patients require changes in patients' head positions. However, such changes can worsen pressure on the brain tissue, lead to sudden acute brain herniation and respiratory arrest, resulting in a higher chance of patient death. This paper addresses the aforementioned problems by introducing a new PICC catheterization method.
Method
In a retrospective study, the records of patients with PICC from April 2020 to April 2023 were reviewed, and they were divided into three groups based on the methods employed. The first group as the conventional group, involved changing patients’ body positions during catheterization. The second group, as the intracavitary electrocardiographic (IECG) group, utilized intracavitary electrocardiographic monitoring and involved changing patients’ body positions during catheterization. The third group as the intracavitary electrocardiographic with improved body positioning (IECG-IBP) group, catheterization was performed with guidance from intracavitary electrocardiographs and without changing the patients’ body positions. The ECG changes among patients undergoing different catheter delivery methods were then compared, as well as the rate of catheter tip misplacement.
Result
The study encompassed a total of 354 cases. Our findings reveal distinct P wave amplitude percentages among the groups: 0% in the conventional group, 88.46% in the IECG group, and 91.78% in the IECG-IBP group. Furthermore, the following catheter tip misplacement rates were recorded: 11.54% for the conventional group, 5.39% for the IECG group, and 5.47% for the IECG-IBP group. Significantly notable differences were observed in these two key indicators between the conventional group and the IECG-IBP group. Notably, the IECG-IBP group demonstrated a more favorable outcome compared to the IECG group.
Conclusion
The study evidence that the PICC catheterization method, incorporating intracavitary electrocardiographic positioning technology and improved body positioning effectively mitigates the risk of induced sudden acute brain herniation and death in patients.
Could microcomputed tomography be a new method to distinguish between metastatic and non-metastatic lymph nodes in patients with non-small cell lung cancer as a decision support tool for pathological examination? A pilot study for method validation
Authors: CANGIR Ayten KAYI , ORHAN Kaan , GÜNEŞ Süleyman Gökalp , ÖZAKINCI Hilal , KAHYA Yusuf , KARASOY Duru , SAK Serpil 
Published: June 2023

Abstract

Background:Patients with non-small cell lung cancer (NSCLC) wihtout lymph node (LN) metastases (pN0) have different survival rates even when the T status is similar. This may be because excised mediastinal and bronchial LNs are currently examined using a 2D method. Because, despite the rules of 2D pathological examination, unfortunately, not all of the removed LN can be sampled, and there may be metastatic foci in these remaining and unsampled LN tissues. Whereas, evaluation with micro-computed tomography (micro-CT) provides detailed information on internal structures of all these LNs as a whole and and without damaging the sample. We used quantitative micro-CT parameters to evaluate the metastasis status of LNs embedded in paraffin blocks.MethodsTwelve paraffin blocks and the corresponding whole slide images from eight NSCLC patients with pathological mediastinal LN metastases were used. The formalin-fixed paraffin-embedded (FFPE) LN blocks were subjected to micro-CT. Forty-seven regions of interest (ROIs) (17 metastatic foci, 11 normal lymphoid tissues, 10 adipose tissues, and 9 anthracofibrotic areas) were marked. Quantitative structural variables obtained via micro-CT analysis from tumoral and non-tumoral ROIs were analyzed.ResultsLinear density, connectivity, connectivity density, and closed porosity all differed significantly between tumoral and non-tumoral ROIs (kappa coefficients: 1, 0.90, 1, and 1, respectively). Receiver operating characteristic analysis showed that tumoral and non-tumoral ROIs differed in terms of thickness, linear density, connectivity, connectivity density, and percentage of closed porosity.ConclusionsQuantitative micro-CT parameters can distinguish between tumoral and non-tumoral areas in FFPE blocks of mediastinal LNs. These quantitative micro-CT parameters may facilitate the development of an artificial intelligence algorithm that can detect metastatic foci in the LN in FFPE LN blocks .
Management and restoration of degraded Agricultural Landscapes in the northwestern Ethiopian highlands: Good implications for climate change adaptive mechanism
Authors: Bitew Tadesse , Mekonnen Mulatie , Amare Tadele 
Published: June 2023

Abstract
Climate change is a pressing challenge globally, which needs adaptive strategies. This research was conducted to evaluate the role of soil and water conservation practices (SWCPs) as climate change adaptive strategies. The study was conducted in the northwest highland of Ethiopia that represents areas with high rainfall and high degradation. The effects of SWCPs were compared on cultivated farms and ex-closures. Sufficient soil samples and crop yield were collected to evaluate the performance of SWCPs to climate change adaptive mechanism. A total of 27 disturbed composite and 27 undisturbed soil samples at a depth of 0-20 cm were collected on cultivated land treated with different soil conservation practices along with 27 wheat yield samples. Similarly, 36 undisturbed soil samples at 0-15 and 15-30 cm were collected from ex-closure and adjacent grazing land. Collected data were subjected for the analysis of variance (ANOVA) for their significant differences followed by the mean separation for the treatments that showed significant difference using least significant difference (LSD). The result showed that SWCPs improved soil physico-chemical properties including soil organic carbon as well as wheat grain yield. Degraded grazing lands rehabilitated and resulted large stock of soil organic carbon by management interventions. Therefore, rehabilitation of degraded cultivated and grazing lands through SWCPs was found to improve soil properties, grain yield, and stock soil carbon and could be recommended as a climate change adaptive strategy.
LSTM neural network for pan-cancer classification &amp; marker gene discovery by symmetrical occlusion method
Authors: Zhao Xing , Wang Huating , Sun Hao 
Published: June 2023

Abstract
RNA-Seq has been widely used for capturing the transcriptome profile of clinical samples. The quantitative measurement of RNA expression level provided by RNA-Seq is an ideal replacement for conventional cancer diagnosis of microscope examination with a more sensitive & automated approach. Accurate classification of the status and the tissue of origin of a clinical sample is crucial for the cancer diagnosis and helps clinicians to determine the appropriate treatment strategy. However, existing studies often use maker genes that exhibits statistical difference between healthy and cancer samples, neglecting genes with low expression level differences. To conduct pan-cancer classification, this paper employed normalized read count for gene expression level normalization. A baseline LSTM neural network was trained using RNA-Seq data containing a complete list of genes to distinguish 28 classes of samples with different origins and statuses. Most importantly, this paper introduces a novel maker gene discovery method named “Symmetrical Occlusion” (SO), which works in conjunction with the trained LSTM network by mimicking the “gain of function” and “loss of function” of genes to evaluate the importance of the gene in pan-cancer classification. This is achieved by calculating the change in the prediction score of the LSTM network. Furthermore, a new neural network would be trained using dataset containing only genes of high importance to achieve better classification performance with fewer genes. The baseline LSTM neural network achieves a validation accuracy of 96.59% in pan-cancer classification. After employing occlusion and selecting the top 33% of genes ranked by their importance, the accuracy of the second LSTM neural network with the same architecture is later improved to 98.30% with 67% fewer genes than the baseline. Our method successfully discovered many marker genes which are not differentially expressed. Compared with the existing methods, our neural network has more comprehensive prediction classes, and outperformed others in terms of classification performance, including metastasized cancer classification. In addition, our method may also be applied to marker gene discovery as well as novel cell type detection using single-cell RNA-Seq.
High-efficiency approximation of non-local dispersion model for light interaction with metallic nanostructures by modified two-grid method
Authors: Wang Mei , Yao Changhui 
Published: June 2023

Abstract
In this paper, we design a modified two-grid method (MTGM) for the Maxwell’s system by adding one correction on the coarse mesh, called postprocessing technique, to the classical two-grid method (TGM), which makes MTGM run smoothing for the edge element like Lagrange elements. The considered Maxwell’s system describes the non-local dispersion model for light interaction with metallic nanostructures. The main contributions of this paper have three parts. Firstly, we give the integral expansion formulas in order to set up supercloseness in the first step of MTGM. Secondly, we take a group of superconvergent solutions on the coarse mesh into the second step as the correction values. Such an algorithm overcomes the difficulties that the edge element can not be applied to the numerical electromagnetic system by TGM directly. Thirdly, we employ the Crank-Nicolson fully discrete scheme to obtain a convergent rate O(τ2 +h+H2) by using the lowest mixed N´ed´elec − Raviart − Thomas finite element, where τ is the time mesh size, and H, h is the course mesh size and fine mesh size in space, respectively. In the end, we present two numerical examples to verify our algorithm, which demonstrates that the MTGM can save about 30% CPU time.
Impact of Sodium-glucose Cotransporter 2 Inhibitors on Echocardiography-derived Total Atrial Conduction Time
Authors: TAŞTAN ERCAN , BESKİSİZ SONGÜL 
Published: June 2023

Abstract
Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors constitute a new class of glucose-lowering agents. A large number of clinical trials have demonstrated that SGLT2 inhibitors improve the cardiovascular outcomes of type 2 diabetes mellitus (T2DM). Structural changes (increased fibrosis and hypertrophy) and electrical remodeling of the atria are among the myocardial changes induced by DM. Studies have shown that SGLT2 inhibitors reduce oxidative stress and improve mitochondrial function, thus reducing atrial fibrosis and hypertrophy. Echocardiography-derived total atrial conduction time (TACT) is a marker of atrial remodeling. TACT is calculated as the time delay between the onset of the P wave on an electrocardiogram and the peak A′ wave obtained from tissue Doppler imaging (PA-TDI duration). The aim of the present study was to investigate whether SGLT2 inhibitors reduce the TACTs of T2DM patients.
Methods: This prospective, single-center pilot study was performed to evaluate the effects of additional treatment with SGLT2 inhibitors on the TACTs of T2DM patients. Between March 2022 and December 2022, 107 T2DM outpatients who had inadequately controlled were consecutively recruited from Gazi Yaşargil Training and Research Hospital, Diyarbakir, Turkey. All participants were evaluated at baseline and six months after commencing treatment with SGLT2 inhibitors. TACT was calculated as the mean time across six different regions between the onset of the P wave in lead II of an ECG and the peak A′ wave obtained from tissue Doppler imaging .
Results: A total of 107 T2DM patients were included in the study. Among them, 57 were on dapagliflozin, and 50 were on empagliflozin. A univariate correlation analysis showed that the mean PA-TDI was correlated with Δ BMI (r = 0.094, p = 0.044) and Δ lateral E/e′ ratio (r = 0,312, p = 0.001). A multiple regression analysis revealed that Δ BMI and Δ lateral E/e′ ratio (p = 0.026 and p = 0.001, respectively) were inversely related to the mean PA-TDI duration. These findings remained after adjusting the Δ mean PA-TDI value for age and sex.
Conclusion: This study showed for the first time that SGLT2 inhibitors can reduce TACT, likely by improving diastolic parameters and atrial remodeling and decreasing BMI.
Elevated expression of N-myc downstream regulated gene 1 protein promotes neovascularization and tumor progression in glioblastomas
Authors: Sugita Yasuo , Furuta Takuya , Takahashi Kenji , Higaki Koichi , Shioga Taro , Murakami Yuichi , Kuwano Michihiko , Ono Mayumi , Abe Hideyuki , Akiba Jun , Morioka Motohiro 
Published: June 2023

Abstract
Aim
The N-myc downstream regulated gene 1 (NDRG1) is a member of the NDRG family, of which four members (NDRG1, NDRG2, NDRG3, NDRG4) have been identified. NDRG1 is repressed by c-MYC and N-MYC proto-oncogenes. NDRG1 is translated into a 43 kDa protein that is associated with the regulation of cellular stress responses, proliferation and differentiation. In this study, we aimed to clarify the relationship between progression of glioblastoma (GB) IDH-wildtype and NDRG1 expression in tumor cells.
Methods
We assessed the expression of NRDG1 in 42 GBs using immunostaining, and evaluated its prognostic significance. NDRG1 expression of GBs was evaluated using Histoscore, which showed high and low scores in 25 and 17 cases, respectively. Additionally, expression of NRDG1 mRNA was confirmed in frozen tissue specimens from seven GB cases and a GB cell line, respectively.
Results
NDRG1 positive cells were strongly expressed in Ki-67 labeled proliferating tumor cells and CD105 positive microvessels around the pseudopalisade. Statistical analyses showed lower survival rates in the high-score group than the low-score group (p < 0.01).
Conclusion
This study indicated that overexpression of NDRG1 was related to the progression and angiogenesis of GBs.
Anatomical and Morphological Changes in Scots Pine and Siberian Larch Needles Under Impact of Emissions From a Large Aluminum Enterprise
Authors: Kalugina Olga Vladimirovna , Mikhailova Tatiana Alekseevna , Afanasyeva Larisa Vladimirovna 
Published: June 2023

Abstract
Species-specific anatomical and morphological changes of Scots pine and Siberian larch needles were studied at different levels pollution by aluminum smelter emissions. Anatomical parameters were found to change non-linearly in polluted needles as a result of pathological exposure to pollutants. In pine, negative anatomical changes include the following: reduction of the cross-sectional area of needles, central cylinder and conductive bundles, reduction of the thickness of the external tissues and mesophyll, reduction of resin channels and a decrease in their diameter. At a critical level of pollution, when the content of pollutants in pine needles reaches maximum values, certain changes in anatomical parameters in the remaining green needles are presumably adaptive. In larch needles at low, moderate and high levels of needles pollution, the anatomical changes found can be classed as adaptive – this is an increase in needles mass, thickness and width, thickness of the epidermis, mesophyll, cross-sectional area of needles. Larch needles, even at a critical pollution level, show no significant anatomical abnormalities. Negative morphological changes of pine include a decrease in the size of needles and shoots, their mass and the number of needles on shoots, in larch – a decrease in the length of needles and shoots, the number of brachiblasts. The results obtained suggest that indicators of the development of pathological processes in both pine and larch exposed to pollution are changes in the number of visual and morphological parameters of tree needles and shoots. Both showed a high level of correlation with the content of pollutants in the needles.
Knowledge, perception and Quality of Life assessment of Chikungunya Infected patients in Dhaka, Bangladesh
Authors: SIAM Mohammad Kawsar SHARIF , Tanni Farah Naz , Shohan Mohammad Umer Sharif 
Published: June 2023

Abstract

During mid-2017, a major outbreak occurred in Bangladesh especially in Dhaka city. Before this outbreak, the people of Bangladesh did not have adequate knowledge about the Chikungunya infection virus. Throughout our study, we wanted to find the level of knowledge of the patients. Additionally, we wanted to see what sort of impact chikungunya put on the quality of life (QoL) of these patients. The cross-sectional study consisted of 50 (100% participation in follow up) healthcare background and 98 non-healthcare (91.84% participation in follow up). Preparation of the questionnaire was done after proper analysis. The questionnaire was validated applying reliability scale. The value of Cronbach alpha is found more than 0.5 that validated the questionnaire. In the cross-sectional study, we compared the knowledge and perception by using different statistical analysis tools and models. Also, in the follow-up study, statistical analysis was done to find out the impacts on QoL using a systemic methodology. 51.35% of patients who participated in the study are female. From the total patients, 52.03% took home remedies for recovery as 46.62% visited the hospitals. Preexisting medical conditions are not affected by 69.59% of patients. However, in the cross-sectional study, differences in knowledge are found between healthcare and non-healthcare patients. Healthcare patients have more significant (p-value < 0.05) knowledge (e.g. chikungunya is a viral infection) than non-healthcare patients. From the two-sample T-test, we found no significant difference in the average awareness in some truth, false and perception-based statements among healthcare and non-healthcare patients. In a follow-up study, patients have faced different types of post-chikungunya symptoms like joint pain, muscle pain, skin problems (mostly rashes), headache, etc. from which, joint pain and headache were most significant (p-value < 0.05). Findings of this suggest that they experienced worse QoL in terms of a physical and mental state than before having affected by chikungunya infection although there is less effect on QoL in terms of financial condition. Our study shows that the difference between healthcare and non-healthcare patients is significant. This will help us to establish awareness and knowledge campaigns among the general people. Additionally, our study will help people to take post chikungunya cautions.
ClearSpeechTogether versus standard NHS speech intervention: Study protocol for a single, mixed method, rater blinded pilot randomised controlled trial for people living with MSA-C
Authors: Lowit Anja , Beith Alistair , Young David , Hadjivassiliou Marios 
Published: June 2023

Abstract

Background: Speech and communication problems are a common symptom of cerebellar Multiple System Atrophy (MSA-C). While recent studies have suggested that these patients can benefit from speech therapy, no properly controlled, large scale investigation of effectiveness has been conducted to date. Furthermore, studies have not focused on how novel, often workload intensive approaches compare to existing standard care. The aim of the current project is to establish feasibility and acceptability of a intensive, mixed individual / group, peer supported speech therapy approach (ClearSpeechTogether) in a group of patients with MSA-C, and to pilot a two-arm RCT comparing it to standard individual therapy.
Methods: This protocol outlines a pilot study for a mixed-method registered controlled trial. 24 patients will be allocated in a 1:1 ratio to either existing speech \& language therapy provision or ClearSpeechTogether. Two pre-therapy speech assessments will be carried out followed by 6 weeks of therapy, a post-therapy assessment and a follow-up assessment after 8 weeks. These assessments will evaluate physiological functioning, impairment and participation. Three qualitative interviews will also be conducted at pre, post and follow-up to investigate patients' experiences of the interventions.
Discussion: Demonstrating acceptability, feasibility and communication benefits in the current pilot would set the basis for a larger registered controlled trial. If indications of additional benefits of ClearSpeechTogether over existing provisions are found a full superiority trial would be conducted.
Trial registration: ISRCTN, ISRCTN44652664. Registered 16 December 2022, https://www.isrctn.com/ISRCTN44652664