bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Preloaded System for Renal and Visceral Arteries in Fenestrated Endografting
Authors: Gallitto Enrico , Faggioli Gianluca , Spath Paolo , Feroldi Francesca M. , Pini Rodolfo , Logiacco Antonino , Sufali Gemmi , Caputo Stefania , Gargiulo Mauro 
Published: June 2023

Aim/Background: The New Preloaded System (NPS) for renal/visceral arteries (TVVs) is an emerging technology in fenestrated endografting (FEVAR) that allows TVVs cannulation and stenting through the same access of the endograft main body. However, only few preliminary experiences are currently available in the literature. The aim of this study is to report the outcomes of NPS-FEVAR in juxta/para-renal (J/P-AAAs) and thoracoabdominal (TAAAs) aneurysms repair. Methods: This is a prospective ( NCT05224219), single-center/observational study of patients submitted to NPS-FEVAR for J/PAAAs and TAAAs between 2019 and 2022 (July). Definitions and outcomes were evaluated according to the current SVS-reporting standard. Technical success (TS) and TS preloaded related, spinal cord ischemia (SCI), and 30-day mortality were assessed as early endpoints. Survival, freedom from reinterventions (FFRs), and freedom from TTVs-instability (FFTVVs-instability) were analyzed during follow-up. Results: Among 157 F/B-EVAR cases, 74 (47%) NPS-FEVAR were planned and enrolled in the study [48 (65%) J/P-AAAs; 26 (35%) TAAAs]. The main indication for NPS-FEVAR was the presence of a hostile iliac axis (54%–73%) or the necessity of expeditious pelvic/lower-limb reperfusion for SCI prevention in TAAAs (20%–27%). Overall, 292 TVVs were accommodated by 289 fenestrations and 3 branches; 188 of 289 (65%) fenestrations were preloaded. NPS-FEVAR configuration was from “below” and “from below to above” in 28 (38%) and 46 (62%) cases, respectively. TS and TS preloaded system-related was 96% (71/74) and 99% (73/74), respectively. Target visceral vessels patency at the completion angiography was 99% (290/292). Failures were 2 renal arteries loss and 1 massive bleeding from a percutaneous closure system breakage. The latter patient developed postoperative multiorgans failure and died on the fifth postoperative day, causing only 30-day/in-hospital mortality (1.3%). One (1.3%) patient with a JAAA and preoperative bilateral occlusion of the hypogastric arteries suffered SCI. The median follow-up was 14 (IQR: 8) months. The estimated 3-year survival was 91% with no aneurysm-related mortality during follow-up. The estimated 3-year FFR and FFTVVs-instability were 85 and 92%, respectively. Conclusion: New preloaded system FEVAR is a safe and effective option in the treatment of J/PAAAs and TAAAs in the presence of hostile iliac access or to guarantee an expeditious pelvic/lower limb reperfusion, leading to satisfactory results in terms of TS, early and mid-term clinical outcomes. Clinical Impact New preloaded system for fenestrated and branched endografting allows to increase the feasibility of the advanced endovascular aortic repair in challenging iliac access, thoracoabdominal aneurysm repair and reduce difficulties in target visceral vessels cannulation.
The Prevalence of Sedentary Habits Among International Students in Eastern Ukraine - A Cross-Sectional Study
Authors: Adebusoye Favour T. , Awuah Wireko A. , Tenkorang Pearl O. , Wellington Jack , Abdul-Rahman Toufik , Ghosh Shankhaneel , Abiy Lydia , Debrah Anastasia F. , Dryha Natalia 
Published: June 2023

Objectives: To determine the occurrence of the behavioral risk factors associated with non-communicable diseases among international undergraduate students. Methods: A cross-sectional study of 155 international undergraduate students originating from 13 different countries, was asked to complete a 26-question survey organized into 5 sections: demographics, physical activity, substance use, dietary habits, and health assessment. The online survey was distributed via social media platforms such as Viber, Telegram, WhatsApp, email, and Instagram. Results: The majority of surveyed students (86%) had good or excellent capacity for everyday activities, and 62.6% utilized their electronic gadgets for at least 8 h daily. 67.1% were regular consumers of junk food, and 53.5% did not get medical checkups. Students addicted to tobacco and/or cigarettes constituted 52.6% of the sample, 38.1% were regular alcohol consumers, and 97.4% reported being aware of the impact of substance use on their health. Conclusion: A significant number of students engage in unhealthy behaviors. Despite this, most students reported having good health, with only a small percentage engaging in regular physical activity. The prevalence of these unhealthy behaviors highlights the need for educational institutions to provide support and resources to promote healthy lifestyles, including health assessments, health coaching, and social activities.
Arterial stiffness and its influence on cerebral morphology and cognitive function
Authors: Haidegger Melanie , Lindenbeck Simon , Hofer Edith , Rodler Christina , Zweiker Robert , Perl Sabine , Pirpamer Lukas , Kneihsl Markus , Fandler-Höfler Simon , Gattringer Thomas , Enzinger Christian , Schmidt Reinhold 
Published: June 2023

Background: Recently, arterial stiffness has been associated with cerebral small vessel disease (SVD), brain atrophy and vascular dementia. Arterial stiffness is assessed via pulse wave velocity (PWV) measurement and is strongly dependent on arterial blood pressure. While circadian blood pressure fluctuations are important determinants of end-organ damage, the role of 24-h PWV variability is yet unclear. Objectives: We here investigated the association between PWV and its circadian changes on brain morphology and cognitive function in community-dwelling individuals. Design: Single-centre, prospective, community-based follow-up study. Methods: The study cohort comprised elderly community-based participants of the Austrian Stroke Prevention Family Study which was started in 2006. Patients with any history of cerebrovascular disease or dementia were excluded. The study consists of 84 participants who underwent ambulatory 24-h PWV measurement. White matter hyperintensity volume and brain volume were evaluated by 3-Tesla magnetic resonance imaging (MRI). A subgroup of patients was evaluated for cognitive function using an extensive neuropsychological test battery. Results: PWV was significantly related to reduced total brain volume ( p = 0.013), which was independent of blood pressure and blood pressure variability. We found no association between PWV with markers of cerebral SVD or impaired cognitive functioning. Only night-time PWV values were associated with global brain atrophy ( p = 0.005). Conclusions: This study shows a relationship of arterial stiffness and reduced total brain volume. Elevations in PWV during night-time are of greater importance than day-time measures.
Determinants of low health-related quality of life in patients with myelodysplastic syndromes: EUMDS Registry study
Authors: Stojkov Igor , Conrads-Frank Annette , Rochau Ursula , Arvandi Marjan , Koinig Karin A. , Schomaker Michael , Mittelman Moshe , Fenaux Pierre , Bowen David , Sanz Guillermo F. , Malcovati Luca , Langemeijer Saskia , Germing Ulrich , Madry Krzysztof , Guerci-Bresler Agnès , Culligan Dominic J. , Kotsianidis Ioannis , Sanhes Laurence , Mills Juliet , Puntscher Sibylle , Schmid Daniela , van Marrewijk Corine , Smith Alexandra , Efficace Fabio , de Witte Theo , Stauder Reinhard , Siebert Uwe 
Published: June 2023

Abstract
Patients with myelodysplastic syndromes (MDS) frequently experience a significant symptom burden, which reduces health-related quality of life (HRQoL). We aimed to identify determinants of low HRQoL in patients recently diagnosed with MDS, for guiding early intervention strategies. We evaluated longitudinal data in 2205 patients with MDS during their first year after diagnosis. Median values of EQ-5D 3-level (EQ-5D-3L) index (0.78) and visual analog scale (VAS) score (0.70) were used as thresholds for low HRQoL. In addition, the 5 dimensions of EQ-5D-3L were analyzed for impairments (any level vs “no problem” category). After multiple imputation of missing values, we used generalized estimating equations (GEE) to estimate odds ratios (OR) for univariable determinant screening (P &lt; .15), and to subsequently derive multivariable models for low HRQoL with 95% confidence intervals (CI). Multivariable GEE analysis showed the following independent determinants (OR, 95% CI) for low EQ-5D index: increased age (60-75 years: 1.33, 1.01-1.75; &gt;75: 1.84, 1.39-2.45), female sex (1.70, 1.43-2.03), high serum ferritin level (≥1000 vs ≤300 μg/L: 1.41, 1.06-1.87), comorbidity burden (per unit: 1.11, 1.02-1.20), and reduced Karnofsky performance status (KPS, per 10 units: 0.62, 0.58-0.67). For low VAS score, additional determinants were transfusion dependence (1.53, 1.03-2.29), low hemoglobin &lt;10 g/dL (1.34, 1.12-1.61), and high body mass index (≥30 vs 23-29.9 kg/m2: 1.26, 1.02-1.57). Sex, KPS, comorbidity burden, hemoglobin count, and transfusion burden were determinants for all EQ-5D dimensions. Low HRQoL is determined by multiple factors, which should be considered in the management and shared decision making of patients with MDS. This trial was registered at www.clinicaltrials.gov as #NCT00600860.
Comparative Study of the Rock-breaking Mechanism of a Disc Cutter and Wedge Tooth Cutter by Discrete Element Modelling
Authors: Jiang Hua , Zhao Huiyan , Zhang Xiaoyan , Jiang Yusheng , Zheng Yaofu 
Published: June 2023

AbstractThe operation of a shield tunnel boring machine (TBM) in a high-strength hard rock stratum results in significant cutter damage, adversely affecting the thrust and torque of the cutter head. Therefore, it is very important to carry out the research on the stress characteristics and optimize the cutter parameters of cutters break high-strength hard rock. In this paper, the rock-breaking performance of cutters in an andesite stratum in the tunnel of Qingdao Metro Line No. 8 was investigated using the discrete element method and theoretical analysis. The rock-breaking processes of a disc cutter and wedge tooth cutter were simulated by software particle flow code PFC3D, and the rock-breaking degree, stress of the cutter, and rock-breaking specific energy were analyzed. The rock damage caused by the cutter in a specific section was divided into three stages: the advanced influence, crushing, and stabilizing stages. The rock-breaking degree and the tangential and normal forces of the wedge tooth cutter are larger than that of the disc cutter under the same conditions. The disc cutter (wedge tooth cutter) has the highest rock-breaking efficiency at a cutter spacing of 100 mm (110 mm) and a penetration depth of 8 mm (10 mm), and the rock-breaking specific energy is 11.48 MJ/m3 (12.05 MJ/m3). Therefore, two types of cutters with different penetration depths or cutter spacing should be considered. The number of teeth of wedge tooth cutters can be increased in hard strata to improve the rock-breaking efficiency of the shield. The research results provide a reference for shield cutterhead selection and cutter layout in similar projects.
Bacterial hazard identification and exposure assessment of raw milk consumption in Jimma zone, South West Ethiopia
Authors: Gume Beje , Berhanu Leykun , Kassa Tesfaye , Bediru Habib , Fikre Assegid Getaneh , Dadi Lelisa Sena , Mereta Seid Tiku 
Published: June 2023

Abstract
Background
Raw milk may contain pathogenic microorganism that can sometimes fatally affect the health of consumers. However, risks related to raw milk consumption in Southwest Ethiopia are not well studied. The aim of this study was to evaluate the presence of five target pathogenic bacteria including Escherichia coli O157:H7, Salmonella enterica Typhimurium, Staphylococcus aureus, Listeria monocytogenes, and Campylobacter jejuni in raw milk and to assess exposure associated with the consumption of raw milk.

Method
A cross-sectional study was carried out between November 2019 and June 2020 to in Jimma zone, Southwest Ethiopia. Laboratory analysis was conducted on milk samples collected from Seven Woreda towns, including, Agaro, Yebu, Sekoru, Serbo, Shebe, Seka, Sheki and Jimma town administration. Semi-structured interview questions were administered to collect data on the amount and frequency of consumption. Descriptive statistics were used to summarize laboratory results and questionnaire survey data.

Result
Among 150 total raw milk samples, about 61.3% were found contaminated by one or more types of pathogens along the dairy value chain. The highest and the least bacterial counts recorded were 4.88 log10cfu/ml and 3.45 log10cfu/ml from E. coli and L. monocytogenes respectively. The mean concentrations of pathogens demonstrated significant statistical difference (p < 0.05) using 95% confidence interval where the prevalence percentage of isolates increased as the milk was transported from farms to the retail outlets. Except for C. jejuni; all other pathogens were detected in the range of unsatisfactory level of milk microbiological quality along the chain. The estimated mean annual risk of acquiring intoxication of E. coli across retailer outlets is 100% whereas salmonellosis, S. aureus intoxication, and listeriosis are 84%, 65% and 63% respectively.

Conclusion
The study highlights the significant health risks associated with the consumption of raw milk due to its unacceptable microbiological quality. The traditional production and consumption patterns of raw milk are the primary reasons for the high annual probability of infection. Therefore, regular monitoring and implementation of hazard identification and critical control point principles are necessary from raw milk production to retail points to ensure the safety of consumers.
Insight into broad substrate specificity and synergistic contribution of a fungal α-glucosidase in Chinese Nong-flavor daqu
Authors: Yi Zhuolin , Chen Lanchai , Jin Yanling , Shen Yi , Liu Nian , Fang Yang , Xiao Yao , Wang Xi , Peng Kui , He Kaize , Zhao Hai 
Published: June 2023

Abstract
Background
Chinese Nong-favor daqu, the presentative liquor starter of Baijiu, has been enriched with huge amounts of enzymes in degrading various biological macromolecules by openly man-made process for thousand years. According to previous metatranscriptomics analysis, plenty of α-glucosidases were identified to be active in NF daqu and played the key role in degrading starch under solid-state fermentation. However, none of α-glucosidases was characterized from NF daqu, and their actual functions in NF daqu were still unknown.

Results
An α-glucosidase (NFAg31A, GH31-1 subfamily), the second highest expressed α-glucosidases in starch degradation of NF daqu, was directly obtained by heterologous expression in Escherichia coli BL21 (DE3). NFAg31A exhibited the highest sequence identities of 65.8% with α-glucosidase II from Chaetomium thermophilum, indicating its origin of fungal species, and it showed some similar features with homologous α-glucosidase IIs, i.e., optimal activity at pH ~ 7.0 and litter higher temperature of 45 ℃, well stability at 41.3 ℃ and a broad pH range of pH 6.0 to pH 10.0, and preference on hydrolyzing Glc-α1,3-Glc. Besides this preference, NFAg31A showed comparable activities on Glc-α1,2-Glc and Glc-α1,4-Glc, and low activity on Glc-α1,6-Glc, indicating its broad specificities on α-glycosidic substrates. Additionally, its activity was not stimulated by any of those detected metal ions and chemicals, and could be largely inhibited by glucose under solid-state fermentation. Most importantly, it exhibited competent and synergistic effects with two characterized α-amylases of NF daqu on hydrolyzing starch, i.e., all of them could efficiently degrade starch and malto-saccharides, two α-amylases showed advantage in degrading starch and long-chain malto-saccharides, and NFAg31A played the competent role with α-amylases in degrading short-chain malto-saccharides and the irreplaceable contribution in hydrolyzing maltose into glucose, thus alleviating the product inhibitions of α-amylases.

Conclusions
This study provides not only a suitable α-glucosidase in strengthening the quality of daqu, but also an efficient way to reveal roles of the complicated enzyme system in traditional solid-state fermentation. This study would further stimulate more enzyme mining from NF daqu, and promote their actual applications in solid-state fermentation of NF liquor brewing, as well as in other solid-state fermentation of starchy industry in the future.
A pre-experimental design evaluation of brief harm reduction interventions to improve coping self-efficacy of carers of people with substance use disorder
Authors: Swanepoel Ilze , Crafford Gretel , Geyer Stephan , Marcus Tessa S. 
Published: June 2023

Abstract
Background
Globally, the rise in the number of people living with a substance use disorder (SUD) carries a multitude of individual and social health implications for carers and their families, often impacting negatively on their quality of life. Considered from a harm reduction approach, SUD is understood as a chronic protracted, complex health and social condition. From the extant literature, there is no evidence of the harm reduction approach being applied to address the needs of carers/family members who carry the burden of SUD care. This study preliminarily evaluated the Care4Carers Programme. It is a purposively designed set of brief interventions to improve the coping self-efficacy of carers of people with SUD (PwSUD carers) by equipping them to think about ways to exert control over their motivation, behaviours and social environment.

Methods
A pre-experimental, one group pretest–posttest design was implemented with 15 purposively selected participants in the Gauteng Province of South Africa. The intervention was conducted by the lead researcher, a registered social worker. Eight brief intervention sessions were held, over 5–6 weeks at research sites where the participants were identified. The coping self-efficacy scale was completed before and directly after exposure to the programme. Results were analysed using paired t-tests.

Results
There were statistically significant (p < .05) improvements in carers’ coping self-efficacy, both overall and in respect of each of its constituent components: problem-focused coping, emotion-focused coping and social support strategies.

Conclusions
The Care4Carers Programme improved the coping self-efficacy of carers of people living with SUDs. The application of this programmatic harm reduction intervention to support PwSUD carers should be tested on a larger scale across South Africa.
Tidal lung hysteresis to interpret PEEP-induced changes in compliance in ARDS patients
Authors: Mojoli Francesco , Pozzi Marco , Arisi Eric , Mongodi Silvia , Orlando Anita , Maggio Giuseppe , Capra Marzani Federico , Brochard Laurent 
Published: June 2023

Abstract
Background
In ARDS, the PEEP level associated with the best respiratory system compliance is often selected; however, intra-tidal recruitment can increase compliance, falsely suggesting improvement in baseline mechanics. Tidal lung hysteresis increases with intra-tidal recruitment and can help interpreting changes in compliance. This study aims to assess tidal recruitment in ARDS patients and to test a combined approach, based on tidal hysteresis and compliance, to interpret decremental PEEP trials.

Methods
A decremental PEEP trial was performed in 38 COVID-19 moderate to severe ARDS patients. At each step, we performed a low-flow inflation-deflation manoeuvre between PEEP and a constant plateau pressure, to measure tidal hysteresis and compliance.

Results
According to changes of tidal hysteresis, three typical patterns were observed: 10 (26%) patients showed consistently high tidal-recruitment, 12 (32%) consistently low tidal-recruitment and 16 (42%) displayed a biphasic pattern moving from low to high tidal-recruitment below a certain PEEP. Compliance increased after 82% of PEEP step decreases and this was associated to a large increase of tidal hysteresis in 44% of cases. Agreement between best compliance and combined approaches was accordingly poor (K = 0.024). The combined approach suggested to increase PEEP in high tidal-recruiters, mainly to keep PEEP constant in biphasic pattern and to decrease PEEP in low tidal-recruiters. PEEP based on the combined approach was associated with lower tidal hysteresis (92.7 ± 20.9 vs. 204.7 ± 110.0 mL; p < 0.001) and lower dissipated energy per breath (0.1 ± 0.1 vs. 0.4 ± 0.2 J; p < 0.001) compared to the best compliance approach. Tidal hysteresis ≥ 100 mL was highly predictive of tidal recruitment at next PEEP step reduction (AUC 0.97; p < 0.001).

Conclusions
Assessment of tidal hysteresis improves the interpretation of decremental PEEP trials and may help limiting tidal recruitment and energy dissipated into the respiratory system during mechanical ventilation of ARDS patients.
Multivariate modular metabolic engineering for enhanced l-methionine biosynthesis in Escherichia coli
Authors: Li Zhongcai , Liu Qian , Sun Jiahui , Sun Jianjian , Li Mingjie , Zhang Yun , Deng Aihua , Liu Shuwen , Wen Tingyi 
Published: June 2023

Abstract
Background
l-Methionine is the only bulk amino acid that has not been industrially produced by the fermentation method. Due to highly complex and strictly regulated biosynthesis, the development of microbial strains for high-level l-methionine production has remained challenging in recent years.

Results
By strengthening the l-methionine terminal synthetic module via site-directed mutation of l-homoserine O-succinyltransferase (MetA) and overexpression of metAfbr, metC, and yjeH, l-methionine production was increased to 1.93 g/L in shake flask fermentation. Deletion of the pykA and pykF genes further improved l-methionine production to 2.51 g/L in shake flask fermentation. Computer simulation and auxotrophic experiments verified that during the synthesis of l-methionine, equimolar amounts of l-isoleucine were accumulated via the elimination reaction of cystathionine γ-synthetase MetB due to the insufficient supply of l-cysteine. To increase the supply of l-cysteine, the l-cysteine synthetic module was strengthened by overexpression of cysEfbr, serAfbr, and cysDN, which further increased the production of l-methionine by 52.9% and significantly reduced the accumulation of the byproduct l-isoleucine by 29.1%. After optimizing the addition of ammonium thiosulfate, the final metabolically engineered strain MET17 produced 21.28 g/L l-methionine in 64 h with glucose as the carbon source in a 5 L fermenter, representing the highest l-methionine titer reported to date.

Conclusions
In this study, a high-efficiency strain for l-methionine production was derived from wild-type Escherichia coli W3110 by rational metabolic engineering strategies, providing an efficient platform for the industrial production of l-methionine.