bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing pattern of the pediatric multisystem inflammatory syndrome (PMIS) in children during COVID-19 infection: Experience from the emergency department of a LMICs tertiary care hospital.
Authors: Bano Surraiya , Akhtar Saleem , Anis Iqra , Ihsan Muhammad Tayyab , Raheem Ahmed 
Published: March 2023

Abstract
Background
Pediatric multisystem inflammatory syndrome (PMIS) is a hyperinflammatory syndrome with multi organ involvement. In children, severe complications were reported with features similar to incomplete Kawasaki disease during later phases of COVID- 19 infection.
Objectives
This study aimed to determine the frequency, pattern of presentation, and significant laboratory parameters related to PMIS in children presenting to the emergency department during COVID − 19.
Method
This was a prospective observational study. Children (1 month − 16 years) with symptoms suggestive of PMIS were included. A predesigned questionnaire was used to collect data on demographics, presenting complaints, performing investigations, offering treatment, and the outcome during the emergency stay. Besides using descriptive statistics, the Mann-Whitney U test compared the in-hospital mortality with triage vitals to see any significant differences between Alive and Expired. The Chi-square test or Fisher exact test was used for categorical data to see the association.
Result
56 patients, majority male (85.7%), were diagnosed with the pediatric multisystem inflammatory syndrome with a mean age of 7.67 ± 4.8 (ranging from 1 to 16 years). COVID PCR was positive in only 18% (10) patients, whereas COVID antibodies were positive in 78.6% (44). The main presenting complaints were related to respiratory 70% followed by neurological 57% and Gastrointestinal 54% with the common clinical sign of delayed capillary refill time (93%) and low volume pulses (89%). Out of 12 patients with negative COVID antibodies, 10(83.3%) patients tested PCR positive, whereas only 2 (16.7%) patients had both antibody body and PCR negative. Based on the multivariate binary regression model indicated that the risk for mortality was higher in patients with ED Stay of more than 4 Hours (OR = 5.4), a total hospital stays of more than five days (OR = 0.17, 95% CI: 0.02 to 0.64).
Conclusion
Most children with PMIS were found to have positive antibodies against COVID-19. An increased ED stay was associated with poor outcomes.
Does the accelerometer-based navigation system reduce blood loss and transfusion in one-stage sequential bilateral total knee arthroplasty? A randomized double-blind controlled trial
Authors: Jarusriwanna Atthakorn , Pornrattanamaneewong Chaturong , Narkbunnam Rapeepat , Ruangsomboon Pakpoom , Thitithapana Paweena , Chareancholvanich Keerati 
Published: March 2023

Abstract
Background: Total knee arthroplasty (TKA) is associated with significant blood loss and postoperative transfusion. The accelerometer-based navigation (ABN) system guides the bone cutting plane without breaching the intramedullary canal, which may reduce bleeding. This study aimed to investigate blood loss and transfusion compared between the ABN system and the conventional procedure in patients undergoing one-stage sequential bilateral total knee arthroplasty (SBTKA).
Methods: A total of 66 patients scheduled for SBTKA were randomly allocated to either the ABN or conventional group. Postoperative hematocrit (Hct) level, drainage blood loss, transfusion rate, and amount of packed red cell transfusion were collected. Total red blood cell (RBC) loss was then calculated for the primary outcome.
Results: The mean calculated total RBC loss in the ABN and conventional group was 669.7 and 630.0 mL, respectively (p=0.572). There was no significant difference between groups for other evaluated outcome parameter, including postoperative Hct level, drainage blood loss, or packed red cell transfusion volume. All patients in the conventional group required postoperative blood transfusion while 96.8% of patients in ABN group were transfused.
Conclusions: The total RBC loss and volume of packed red cells transfusion were not significant difference between interventions, which suggest no benefit of the ABN system in reducing blood loss and transfusion in patients undergoing SBTKA.
Trial registration: The protocol of this study was registered in the Thai Clinical Trials Registry database no. TCTR20201126002 on 26/11/2020.
Exogenous spraying of IAA improved the efficiency of microspore embryogenesis in wucai (Brassica campestris L.) by affecting the balance of endogenous hormones, energy metabolism and cell wall metabolism
Authors: Wang Chenggang , Zhang Peiyu , Li Hong , He Yun , Huang Furong , Wang Xu , Zhu Shidong , Yuan Linyun , Hou Jinfeng , Chen Guohu , Wang Wenjie , Wu Jianqiang , Tang Xiaoyan 
Published: March 2023

Abstract
Background: Spraying indoleacetic acid (IAA) on the buds of Wucai (Brassica campestris L.) can increase the incidence of isolated microspore embryogenesis, but the mechanism of increasing microspore development remains unclear.
Results: The statistics of isolated microspore embryogenesis showed that spraying100 mg. L-1 IAA (purity 99%) to the bud was the optimal concentration for inducing isolated microspore embryogenesis in B. campestris L. Microscopic observation showed that IAA treatment accelerated the development process of microspores. In addition, the contents of amino acids, soluble total sugar, protein, and starch were significantly increased, and the dynamic balance between hormones was changed due to the change of endogenous hormone content. To explore the molecular mechanism of IAA affecting microspore embryogenesis, the mononuclear flower buds which were treated with IAA for 24h were selected and the mononuclear flower buds which were treated with the same dose of water at the same period were used as the control for transcriptome analysis. It was found that more DEGs was enriched in plant hormone synthesis and signal transduction pathways, pentose and glucuronic acid exchange pathway, and oxidative phosphorylation pathway, and most of them showed upregulation. These changes of DEGs broke the balance between endogenous plant hormones, initiated the generation of microspore embryos, accelerated the metabolism of the cell wall and the development of microspores.
Conclusions: This study helped to clarify the mechanism of microspore embryogenesis by IAA spring and provided a basis for further research on the molecular mechanisms of microspore development and the selection of key genes.
Light-oriented 3D printing of 4'-pentyl-4-cyanobiphenyl (5CB) liquid crystal/photocurable resins and its in-situ enhancement of mechanical performance
Authors: Sun Xiaolu , Chen Shaoyun , Qu Bo , Wang Rui , Zheng Yanyu , Liu Xiaoying , Li Wenjie , Gao Jianhong , Chen Qinhui , Zhuo Dongxian 
Published: March 2023

Abstract
A new printing resin with excellent performance (PR-5CB) was prepared by mixing 4'-pentyl-4-cyanobiphenyl (5CB) with acrylic photosensitive resin. The combination of the stereo lithography appearance (SLA) technique and the PR-5CB photosensitive resin allows precise adjustment of the existing morphology of liquid crystals in the resin to further control the mechanical properties of the printed product. Upon the addition of 5CB, the light-driven orientation of 5CB drives other acrylate prepolymers to orient along the orientation direction of 5CB, so that the entire fixed 3D printing polymer becomes anisotropic as observed by polarized optical microscopy. By controlling the 3D printing lamination method, printing resolution, and 5CB content, the mechanical properties of the 3D printed products can be effectively improved. The rheological properties, mechanical properties, and heat resistance of the PR-5CB resins were systematically investigated. The tensile strength, elongation at break, flexural strength, impact strength, and storage strength of the PC-5CB-3//(25 µm) printed products were 121.2 MPa, 25.5%, 222.0 MPa, 11.09 kJ/m2, and 1702.3 MPa respectively; these values are 281%, 241%, 270%, 275%, and 186% of those of the commercial inks. The initial decomposition temperature of the printed sample of PR-5CB-3// (25 µm) was 298.5 °C and the maximum decomposition temperature was 423.5 °C, which were also higher than those of the commercial resins. The results of this study are significant for the development of light-cured 3D printing. The developed approach offers unlimited potential for achieving autonomous design of structures that cannot be achieved by current additive manufacturing processes.
The Effect of Different Cleaning Materials on the Bond Strength of Resin Composite to Primary Teeth Dentin Contaminated with Root Canal Sealer
Authors: Çakır Asu 
Published: March 2023

Abstract
Background
In the literature review, no study was found on the bond strength of the adhesive on the dentin surface contaminated with root canal sealers in root canal treatment applications of primary teeth without underlying permanent teeth germ. This study aims to shed light on clinical applications by finding the most suitable material for cleaning primary tooth dentin contaminated with permanent tooth canal sealers.
Methods
The occlusal enamel layer was removed and the dentin of the primary tooth that was contaminated with root canal sealers (AH Plus, MTA Fillapex) was cleaned with different irrigation solutions (saline, NaOCI, ethanol). Specimens were restored with a self-etch adhesive (Prime & Bond Universal Dentsply) and composite (Nova Compo C Composite Imicryl Corporation). Sticks with a thickness of approximately 1 mm were obtained from each sample, and the bond strength of the samples was measured in a microtensile test device. The interfacial morphology of the bonded space was evaluated using scanning electron microscopy.
Results
The highest bond strength was determined in the control and AH Plus saline groups. The group cleaned with ethanol showed the lowest bond strength among all groups (p < 0.01).
Conclusion
Wet cotton pellets soaked in saline provided the best bond strength for cleaning dentin tissue. It has been determined that the most effective material for removing both epoxy resin-based and calcium silicate-based root canal sealants from the access cavity is saline.
Clinical Significance:
The results presented in this study are very important in increasing the clinical success of primary teeth without underlying permanent teeth germ in pedodontics clinics during root canal treatment.
Rescue of Xen45 Gel Stent Implant Occlusion In Refractory Glaucoma: A Case Report
Authors: zhang Yao , Xiang Haotian , Zhang Yangyang , Tang Li 
Published: March 2023

Abstract
Background
Xen Gel Stent implant is a new minimally invasive surgical treatment for glaucoma that has been proven effectiveness and safety profile. However, it may also lead to some complications. Xen Gel Stent occlusion is a relatively rare complication reported less frequently and has limited treatment experience. In our case report, we proposed a novel surgical treatment using a 10 − 0 nylon suture to recanalize the occluded Xen45 Gel Stent successfully.
Case presentation:
A 16-year-old female patient had bilateral juvenile glaucoma for the past 5 years. Her right eye had undergone three glaucoma surgeries but failed. At a presentation to our hospital, the intraocular pressure (IOP) in the right eye was 30 mmHg despite the application of four topical eye drops. Xen45 Gel Stent implant was chosen for treatment, but six days after implantation, the IOP rose to 40 mmHg due to an occlusion of the tip of Xen45 Gel Stent in the anterior chamber. Nd: YAG laser shockwave therapy was attempted but failed. The patient eventually had to return to the operating room for a revision procedure. A 10 − 0 nylon suture was threaded through the Xen45 Gel Stent to recanalize it. The IOP was successfully controlled in the 11-month follow-up.
Conclusion
If postoperative occlusion arises after Xen45 Gel Stent implantation, surgery using 10 − 0 nylon suture to recanalize Xen45 Gel Stent should be considered as a relatively safe, effective, and minimally invasive alternative that does not require removal or trimming of Xen45 Gel Stent.
Establishment of a multi-parameter prediction model for the functional cure of HBeAg-negative chronic hepatitis B patients treated with pegylated interferonα and decision process based on response-guided therapy strategy
Authors: Tang Qianqian , Ye Jun , Zhang Yafei , Zhang Peixin , Xia Guomei , Zhu Jie , Wei Shaofeng , Li Xu , Zhang Zhenhua 
Published: March 2023

Abstract
Background & Aims: This study aimed to establish multivariate prediction models according to a response-guided therapy (RGT) based strategy at baseline and week 12 and 24 of follow-up to predict the functional cure for HBeAg-negative patients with chronic hepatitis B (CHB) treated with pegylated interferonα (PEG-IFNα).
Methods: A total of 242 HBeAg-negative patients with CHB were treated with PEG-IFNα for 52 weeks and followed up for 24 weeks. Responses at the end of follow-up (EOF) were defined as hepatitis B surface antigen (HBsAg) loss, and patients were defined as either responders or non-responders.
Results: The three most meaningful predictors were an age ≤40 years,alanine aminotransferase (ALT) levels ≤40 U/L, and HBsAg levels ≤100 IU/mL at baseline; ALT levels ≥80 U/L, anti-HBc levels ≤8.42 S/CO, and HBsAg levels ≤50 IU/mLat week 12; and ALT levels ≥40 U/L, anti-HBc levels ≤8.46 S/CO, and HBsAg levels ≤0.2 IU/mL at week 24. The response rates of patients with a score of 0–1 and 4–5 at baseline, week 12, and 24 were 13.5%, 7.8%, and 11.7%; and 63.6%, 68.1%, and 98.1%, respectively. At week 12, the cumulative scores were 0–2, 3–4, 5–7, and 8–10 (response rates 5.0%, 18.9%, 41.3%, and 71.4%, respectively). At week 24, the cumulative scores were 0–3, 4–6, 7–10, and 11–15 (response rates: 1.3%, 12.3%, 37.0%, and 92.5%, respectively).
Conclusion: We established a multi-parameter prediction model for the functional cure of HBeAg-negative patients with CHB treated with PEG-IFNα.
A functional near-infrared spectroscopy study on hemodynamic changes of patients with prolonged disorders of consciousness responding to different auditory stimuli
Authors: Lu Haitao , Jiang Jin , Si Juanning , Wang Yizheng , Huang Fubiao 
Published: March 2023

Abstract
Treating prolonged disorders of consciousness (pDoC) is challenging. Thus, accurate assessment of residual consciousness in patients with pDoC is important for the management and recovery of patients. Functional near-infrared spectroscopy (fNIRS) can reflect brain activity through oxygenated cortical hemoglobin/deoxygenated hemoglobin (HbO/HbR) changes and has recently gained increasing attention for its potential applications in assessing residual consciousness. However, the number of fNIRS studies assessing residual awareness in patients with pDoC is still limited. The following study evaluates the brain function in 18 patients with pDoC (including 14 vegetative states [VS]) and 4 minimally conscious states [MCS]) and 15 healthy controls using two types of external stimuli, i.e., active stimulation (motor imagery) and passive stimulation (subject's own name [SON]) by fNIRS. The results showed that the mean concentrations of HbO/HbR in the prefrontal cortex of the healthy controls during the passive stimulation were significantly lower than those of the active stimulation, and the slope of the best-fit line was high. However, the hemodynamic responses of the patients with pDoC were opposite to the healthy controls. Additionally, the mean concentrations of HbO/HbR increased as the level of consciousness decreased during passive stimulation. Our findings suggest that the residual level of consciousness in pDoC patients can be assessed by measuring brain responses to different stimulations using fNIRS. The present study further demonstrates the feasibility andreliability of fNIRS in assessing residual consciousness in patients with pDoC, providing a basis for its expanded clinical application.
Very early onset of coronary artery aneurysm in a 3-month infant with Kawasaki disease: a case report and literature review
Authors: Jiao Wenyan , Wei Li , Jiao Fuyong , Pjetraj Dorina , Feng Jianying , Wang Jvyan , Catassi Carlo , Gatti Simona 
Published: March 2023

Abstract
Background
Kawasaki disease (KD) is a medium vessel vasculitis, of unknown etiology, typically presenting in children younger than 5 years of age. Prolonged fever (at least five days) is a major clinical criterion of KD, while cardiac involvement may occur in up to 25% of patients, generally in the second week of the disease.
Case presentation:
We describe the case of KD developing in a 3-month infant, with an early occurrence of coronary artery aneurism after only 3 days of fever, complicated by thrombosis, requiring aggressive treatments.
Conclusions
Time of development of cardiac complications can be different in young infants with KD and both diagnostic criteria and treatment indications should be individualized in this class of age.
PTH levels, sleep quality, and cognitive function in primary hyperparathyroidism
Authors: Wang Yuting , Xin Yunhui , Zhao Teng , Shen Hong , Liu Xing , Wang Jiacheng , Wang Qian , Feng Dalin , Shen Rongfang , Wei Bojun 
Published: March 2023

Abstract
Background
Cognitive function in patients with primary hyperparathyroidism (PHPT) may be affected and be identified to have been linked to the level of parathyroid hormone (PTH). Previous studies have suggested that patients with PHPT present poor sleep quality, which might interact with cognitive decline. The purpose of this study was to determine whether sleep quality mediates the association between PTH level and cognitive function and investigate whether surgery improves sleep quality and cognition in PHPT patients.
Methods
Between June 2019 and August 2022, we recruited 146 patients diagnosed with PHPT (n = 146). We collected clinical data from medical records and evaluated sleep quality and cognition preoperatively and 2 months postoperatively by using the Pittsburgh Sleep Quality Index and Min-Mental State Examination. We examined the mediation effects of sleep disturbance and latency on correlations between PTH level and cognitive impairment by using the Bootstrap method.
Results
The sleep quality and cognitive function were correlated with PTH level before surgery. Sleep latency or sleep disturbance exhibited a partial mediating effect on the association between PTH level and MMSE scores in PHPT patients. (p < 0.05) In PHPT patients, there was a significant decline in PTH levels and an improvement in cognitive function post-surgery compared to pre-surgery, but no significant differences in sleep quality.
Conclusion
Sleep disturbance and sleep latency may mediate the association between PTH level and cognitive impairment in PHPT before surgery. The surgery could reduce PTH levels and improve cognition, but might not improve sleep quality in PHPT patients.
Facilities, Challenges, Attitudes, and Preferences of Nursing Students Related to E-Learning in the Covid-19 Pandemic in Iranian Context: A Cross-Sectional Study
Authors: sadaf Amir mohammad Atashin , Amini Kourosh , Ramezanibadr Farhad , Long Tracey , Imanipour Mohammad 
Published: March 2023

Abstract

Background During the Covid-19 pandemic, nursing schools were forced to deliver nursing courses in ways other than the traditional face to face classroom setting. Many lessons were learned by nurse educators regarding electronic and online learning strategies. It is necessary to be aware of the factors affecting e-learning and identify the strengths and weaknesses to improve the student learning process in nursing school. Aim of study: The present study aimed to determine Facilities, challenges, attitudes, and preferences of nursing students regarding e-learning during the Covid-19 pandemic. Methods In this cross-sectional study, 228 undergraduate nursing students participated. The random sampling method used a standard questionnaire that students completed voluntarily. SPSS version 22 was used for data analysis. Results During the covid-19 pandemic, the majority of nursing students of Zanjan University of Medical Sciences participated in electronic classes at home using mobile phones. Students reported that physical problems increased by participating in e-classes. The level of complaints about these problems was related to the female gender of the students. The most significant challenges for students in online classes were difficulty typing and frequent internet outages. Classroom management for instructors was difficult due to students spontaneously leaving the virtual online classroom rather than attending the entire learning session. Overall, the attitudes of students towards various aspects of e-learning were positive. There was a noted correlation between student attitude by gender and educational background. Students preferred that professors used more PowerPoint, showed instructional videos, and had interactive group discussion sessions rather than lecture only. Students objected to attending more than two online classes in one day if the duration lasted more than 60 minutes and have a rest time of fewer than 30 minutes between classes. Conclusion Despite overall student satisfaction with e-learning, this method of education is still far from student preferences and requires planning for an effective learning experience that meets their priorities and preferences. Using a hybrid of face-to-face and e-learning approaches together can be a more effective teaching method than either strategy alone.
Empagliflozin effects on iron metabolism as a possible mechanism for improved clinical outcomes in non-diabetic patients with systolic heart failure
Authors: Angermann Christiane , Santos-Gallego Carlos , Requena-Ibanez Juan , Sehner Susanne , Zeller Tanja , Gerhardt Louisa , Maack Christoph , Sanz Javier , Frantz Stefan , Fuster Valentin , Ertl Georg , Badimon Juan J 
Published: March 2023

Abstract
Sodium-glucose cotransporter-2 (SGLT2) inhibitors improve clinical outcomes in patients with heart failure (HF), but mechanisms of action are incompletely understood. In the EMPATROPISM trial, empagliflozin reversed cardiac remodeling and increased physical capacity in stable non-diabetic patients with systolic HF. EMPATROPISM-FE explored post hoc in this cohort, who had a high prevalence of iron deficiency, whether treatment effects were related to changes in iron metabolism. Here we show that myocardial iron content estimated by cardiac magnetic resonance T2* quantification increased after initiation of empagliflozin, but not placebo (between-group difference p = 0.01). T2* changes were significantly correlated with changes in left ventricular volumes, mass and ejection fraction, peak oxygen consumption and 6-minute walking distance; concomitant changes in red blood cell indices were consistent with augmented hematopoiesis. Our findings suggest that effects of empagliflozin on iron metabolism may be a potential mechanism mediating its beneficial clinical effects in patients with HF.
Clinical Trial Registration: www.clinicaltrials.gov; NCT03485222