bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between FIB-4, all-cause mortality, cardiovascular mortality, and cardiovascular disease risk among diabetic individuals: NHANES 1999–2008
Authors: Guan Lihua , Li Lei , Zou Yutong , Zhong Jian , Qiu Ling 
Published: September 2023

BackgroundDiabetes is prevalent worldwide and is associated with cardiovascular disease (CVD). Furthermore, due to the insulin resistance, diabetic populations are vulnerable to liver fibrosis, which increases the risk of CVD. Fibrosis-4 index (FIB-4)—a non-invasive biomarker for liver fibrosis—is crucial in predicting CVD among patients with liver diseases. However, the association between FIB-4, death, and CVD in the US diabetic population has not yet been investigated.MethodWe conducted a cross-sectional study using the data from the National Health and Nutrition Examination Survey (NHANES) 1999–2008. The mortality status was obtained from the National Death Index through December 31, 2015. Participants were divided into survivor and mortality group to compare the basic characteristics. The association between FIB-4, death, and CVD was analyzed using the restricted cubic spline method and Cox proportional hazards models. In stratified analysis, Participants were stratified based on age, sex, BMI, hypertension, or eGFR respectively.ResultsThe participants (N = 3,471) were divided into survivor (N = 1,785) and mortality groups (N = 1,632), with the mortality group exhibiting significantly higher FIB-4 values. Moreover, the risk of all-cause mortality (HR 1.24; 95% CI, 1.17–1.32) and CVD mortality (HR 1.17; 95% CI, 1.04–1.31) increased with each FIB-4 SD increase after adjusting for all covariates. However, except for myocardial infarction, FIB-4 had no significant effect on the incidence of the other three CVD subtypes (congestive heart failure, coronary heart disease, and angina pectoris). In stratified analysis, we found that the effect of FIB-4 on CVD mortality was influenced by age, and FIB-4 is a risk factor for people older than 60 years (HR 1.14; 95% CI, 1.01–1.29).ConclusionUsing data from NHANES 1999–2008, FIB-4 was found to be associated with all-cause and CVD mortality in the diabetic population, and this association was significantly affected by age. However, FIB-4 only affected the incidence of myocardial infarction. Future work should investigate the association between FIB-4 and CVD in the diabetic population.
Effects of rhythm control on left atrial structure remodeling in atrial fibrillation and heart failure with preserved ejection fraction
Authors: Bai Lin , Sun Yuxi , Si Jiping , Ding Zijie , Zhang Xinxin , Zhang Yanli , Xia Yunlong , Liu Ying 
Published: September 2023

BackgroundThe benefits of rhythm control for atrial fibrillation (AF) in heart failure with preserved ejection fraction (HFpEF) have not been conclusively determined. We assessed the effects of rhythm control on left atrial (LA) structure remodeling and prognosis in patients with AF and HFpEF.MethodsThis was a retrospective, real-world, observational study involving patients diagnosed with AF and HFpEF. The cohort was divided into rhythm-control and rate-control groups depending on their treatment strategies. The primary outcomes were all-cause mortality, rehospitalization for any cause, HF-related rehospitalization, and stroke. Differences in follow-up LA structure parameters were also analyzed.ResultsCompared to the rate-control group, patients in the rhythm-control group had a lower risk of HF-related rehospitalization even after adjusting for potential confounders (adjusted HR 0.605, 95% CI 0.413–0.887, p = 0.010). Moreover, rhythm-control therapy led to marked reductions in LA echocardiographic indicators and a higher proportion of LA reverse remodeling (LARR).ConclusionsRhythm-control therapy reverses LA structure remodeling and is associated with improved clinical outcomes; therefore, it is an optimal treatment approach for AF in HFpEF patients.
Uric acid levels correlate with disease activity in growth hormone-secreting pituitary adenoma patients
Authors: Mo Caiyan , Chen Han , Wang Fang , Guo Ying , Wang Yao , Tong Tao , Zhong Liyong 
Published: September 2023

ObjectiveFew studies reported the effects of growth hormone-secreting pituitary adenoma (GHPA) on uric acid (UA) metabolism and the relationship between growth hormone (GH)/insulin-like growth factor-1 (IGF-1) levels and UA are controversial. This study aimed to evaluate the relationship between IGF-1 and UA in patients with GHPA and to further clarify whether UA levels are associated with GHPA disease activity by follow-up.MethodsA longitudinal study of 424 GHPA patients presenting to Beijing Tiantan Hospital, Capital Medical University between January 2015 and January 2023 was conducted. Spearman’s correlation tests were performed to examine the relationship between IGF-1 and UA at baseline. Univariate and multivariate linear regression analysis was conducted to investigate the independent association between UA and IGF-1. Changes in postoperative IGF-1 and UA levels were followed prospectively, and the differences in UA levels between the biochemical remission and nonremission groups were compared.ResultsAt baseline, male patients, the lower the age, the higher the IGF-1 and body mass index (BMI), and the higher the UA levels. IGF-1 was significantly associated with UA after controlling for sex, age, and BMI (r = 0.122, P = 0.012). In adjusted multiple linear regression analysis, IGF-1 was independently associated with UA, and UA levels increased significantly with increasing IGF-1. During postoperative follow-up, UA decreased gradually as IGF-1 levels decreased. At 12 months postoperatively, UA levels were significantly lower in the biochemical remission group than in the nonremission group (P = 0.038).ConclusionsIn patients with GHPA, UA levels are associated with disease activity. Changes in UA levels should be taken into account in the comprehensive treatment of GHPA, patients presenting with HUA should be given lifestyle guidance and appropriate urate-lowering treatment according to their condition to better improve their prognosis.
Description of thyroid disorders the year before conception: a population-based study
Authors: Tena Vivó Glòria , Parellada Esquius Neus , Cunillera Puértolas Oriol , Albareda Riera Mercè , Isidro Albaladejo Mónica , Vila Ballester Lluís 
Published: September 2023

ObjectiveThis study aimed to monitoring the prevalence of previously identified thyroid disorders and hypothyroidism monitoring before pregnancy.Material and methodsA retrospective cross-sectional study of women whose pregnancies occurred between 2014 and 2016 was conducted, including 120,763 pregnancies in Catalonia (Spain). The presence of thyroid disorders in women was based on disease diagnostic codes and/or prescription of levothyroxine or antithyroid drugs. To evaluate the thyroid disorder diagnosis and monitoring, thyrotropin (TSH), free T4 (FT4), antiperoxidase antibody (TPOAb), and anti-TSH receptor antibody (TRAb) records were gathered and categorised according to the reference values of each laboratory.ResultsThe prevalence of recorded thyroid disorders before the last menstrual period was 5.09% for hypothyroidism and 0.64% for hyperthyroidism,showing a significant increase with age. A thyroid monitoring test was not performed in the year before the last menstrual period in approximately 40% of women with a known thyroid disorder. Amongst the women with hypothyroidism who underwent a TSH test, 31.75% showed an above-normal result. Amongst women previously unknown to have thyroid disorders, 3.12% had elevated TSH levels and 0.73% had low TSH levels.ConclusionA high percentage of Catalan women with a known thyroid disorder were not properly monitored during the year before pregnancy. Amongst those monitored, more than one-third had TSH values outside the reference range. Therefore, it is important to evaluate women with thyroid disorders during pre-pregnancy visits.
Modeling and assessing load redistribution attacks considering cyber vulnerabilities in power systems
Authors: Shi Xingyu , Guo Huan , Wang Weiyu , Yin Banghuang , Cao Yijia 
Published: September 2023

Introduction: Load Redistribution (LR) attacks, as a common form of false data injection attack, have emerged as a significant cybersecurity threat to power system operations by manipulating load buses’ measurements at substations. Existing LR attack methods typically assume that any substation can be equally attacked, contributing to the analysis of LR attacks in power systems. However, the diversity of cyber vulnerabilities in substation communication links implies varying costs associated with falsifying load buses’ measurements. Thus, quantitatively evaluating these costs and analyzing the impact of LR attacks on power systems within cost constraints holds practical significance.Methods: In this paper, we employ a Bayesian attack graph model to characterize the intrusion process through cyber vulnerabilities. The costs of falsifying load buses’ measurements at substations are quantitatively evaluated using the mean time-to-compromise model. Subsequently, from the attacker’s perspective, we propose a bi-level optimization model for LR attacks, considering the mean time to compromise in conjunction with limited attack resources and power flow constraints.Results: Simulations conducted on the IEEE 14-bus system illustrate the influence of cyber vulnerabilities on LR attacks within power systems. Furthermore, we verify that the attack scenario of the existing LR attack model aligns with a case of the proposed bi-level LR attack model when there is sufficient attack time to compromise all communication links.Discussion: The findings of this research demonstrate that the impact of cyber vulnerabilities on LR attacks can be quantified by assessing the attack costs. Effective management of LR attacks can be achieved under cost constraints through optimization methods. These insights contribute to enhancing network security strategies for power systems, mitigating potential threats posed by LR attacks in power system operations.
Regulatory T-cell deficiency leads to features of autoimmune liver disease overlap syndrome in scurfy mice
Authors: Yilmaz Kaan , Haeberle Stefanie , Kim Yong Ook , Fritzler Marvin J. , Weng Shih-Yen , Goeppert Benjamin , Raker Verena K. , Steinbrink Kerstin , Schuppan Detlef , Enk Alexander , Hadaschik Eva N. 
Published: September 2023

IntroductionScurfy mice have a complete deficiency of functional regulatory T cells (Treg) due to a frameshift mutation in the Foxp3 gene. The impaired immune homeostasis results in a lethal lymphoproliferative disorder affecting multiple organs, including the liver. The autoimmune pathology in scurfy mice is in part accompanied by autoantibodies such as antinuclear antibodies (ANA). ANA are serological hallmarks of several autoimmune disorders including autoimmune liver diseases (AILD). However, the underlying pathogenesis and the role of Treg in AILD remain to be elucidated. The present study therefore aimed to characterize the liver disease in scurfy mice.MethodsSera from scurfy mice were screened for ANA by indirect immunofluorescence assay (IFA) and tested for a wide range of AILD-associated autoantibodies by enzyme-linked immunosorbent assay, line immunoassay, and addressable laser bead immunoassay. CD4+ T cells of scurfy mice were transferred into T cell-deficient B6/nude mice. Monoclonal autoantibodies from scurfy mice and recipient B6/nude mice were tested for ANA by IFA. Liver tissue of scurfy mice was analyzed by conventional histology. Collagen deposition in scurfy liver was quantified via hepatic hydroxyproline content. Real-time quantitative PCR was used to determine fibrosis-related hepatic gene expression. Hepatic immune cells were differentiated by flow cytometry.ResultsAll scurfy mice produced ANA. AILD-associated autoantibodies, predominantly antimitochondrial antibodies, were detected at significantly higher levels in scurfy sera. CD4+ T cells from scurfy mice were sufficient to induce anti-dsDNA autoantibodies and ANA with an AILD-related nuclear envelope staining pattern. Liver histology revealed portal inflammation with bile duct damage and proliferation, as in primary biliary cholangitis (PBC), and interface hepatitis with portal-parenchymal necroinflammation, as found in autoimmune hepatitis (AIH). In scurfy liver, TNFα and fibrosis-related transcripts including Col1a1, Timp1, Acta2, Mmp2, and Mmp9 were upregulated. The level of proinflammatory monocytic macrophages (Ly-6Chi) was increased, while M2-type macrophages (CD206+) were downregulated compared to wildtype controls. Despite severe hepatic inflammation, fibrosis did not develop within 25 days, which is close to the lifespan of scurfy mice.DiscussionOur findings suggest that Treg-deficient scurfy mice spontaneously develop clinical, serological, and immunopathological characteristics of AILD with overlapping features of PBC and AIH.
From the modeling of diadromous species’ marine distributions to the characterization of their current and future marine habitats
Authors: Navarro Clara , Janc Anais , Lassalle Géraldine , Lambert Patrick , Dambrine Chloé 
Published: September 2023

IntroductionMany diadromous fish species are currently facing the threat of generalized population extirpations across their range, and conservation efforts implemented primarily within the continental domain may not be sufficient to ensure their viability. In consequence, better understanding the use of the marine environment by these species turned out to be critical.Material and methodWe developed marine species distribution models for two species, Allis shad (Alosa alosa) and the European flounder (Platichthys flesus), and proposed a way to interpret the habitat suitability from a more functional perspective. Our approach defined marine habitats as highly suitable environments that remained with a high potential through the species life stage duration at sea. First, a species-specific probabilistic threshold was applied to select for highly suitable environments each year of the simulations. Then, annual maps of high suitability were combined into recurrence maps showing areas were the environmental conditions remained the most suitable across the life at sea of the given species, these areas being called ‘marine habitats’. We applied this approach to study the current and future marine habitats of Allis shad and European flounder under climate change scenarios.ResultsThe main current marine habitats of these species were coastal, primarily in the Bay of Biscay for Allis shad and in the English Channel-North Sea for European flounder. These habitats are expected to experience minimal changes by mid-century, and the species may even benefit from new habitats at higher latitudes. However, the European flounder is likely to face greater challenges in the central part of its range by the end of the century, as potential spawning grounds may be threatened.DiscussionThis study provided a way to rethink ‘traditional’ suitability maps by integrating basic knowledge on the diadromous species life at sea. Our findings were part of a larger effort to link continental and marine habitats in improving management of diadromous species.
Clinical significance of the C-reactive protein-to-bilirubin ratio in patients with ulcerative colitis
Authors: Huang Xijing , Liu Ya , Zhou Zhou , Pan Yan , Zhang Yinghui , Gao Caiping , He Chong 
Published: September 2023

BackgroundUlcerative colitis (UC) is a chronic relapsing remitting disease of the colon. Appropriate monitoring of the disease status is necessary for patients to adopt optimal therapy and obtain a better prognosis. Finding an ideal non-invasive biomarker, which is suitable for long-term monitoring in clinical settings will bring a significant benefit to the individualized management of patients with UC. The aim of this study is to determine the clinical significance of a novel optimizing serological biomarker by integrating C-reactive protein (CRP) and bilirubin levels in monitoring disease activity.MethodsA total of 182 patients with UC were retrospectively enrolled. Clinical characteristics and laboratory parameters of the subjects were retrieved from the electronic medical record database of our hospital. The CRP-to-bilirubin ratio (CBR) was computed for clinical activity of UC defined by the partial Mayo score and endoscopic activity by the Mayo endoscopic score (MES).ResultsCBR was significantly elevated in patients with UC than that in healthy controls. Patients with clinically or endoscopically active UC showed evidently higher CBR levels compared to those with inactive disease, even in a subset of patients with normal CRP levels. Receiver operating characteristic (ROC) analysis showed that the area under the curve (AUC) of CBR was higher than that of CRP or bilirubin alone for determining clinical remission and endoscopic mucosal improvement. Furthermore, CBR levels were significantly decreased when patients achieved mucosal improvement compared with when they had active endoscopic inflammation.ConclusionCBR could be useful to reflect disease activity in patients with UC.
The evaluation of cardiac functions in deep Trendelenburg position during robotic-assisted laparoscopic prostatectomy
Authors: Kılınç Emir , Yildirim Serap Aktas , Ulugöl Halim , Büyüköner Elif Eroğlu , Güçyetmez Bülent , Toraman Fevzi 
Published: September 2023

ObjectiveThis study aimed to demonstrate the reliability of the cardiac cycle efficiency value through its correlation with longitudinal strain by observing the effect of the deep Trendelenburg position.DesignA prospective, observational study.SettingSingle center.ParticipantsBetween May and September 2022, the hemodynamic parameters of 30 patients who underwent robotic assisted laparoscopic prostatectomy under general anesthesia were prospectively evaluated.Measurements and main resultsAll invasive cardiac monitoring parameters and longitudinal strain achieved transesophageal echocardiography were recorded in pre-deep Trendelenburg position (T3) and 10th minute of deep Trendelenburg position (T4). Delta values were calculated for the cardiac cycle efficiency and longitudinal strain (values at T4 minus values at T3). The estimated power was calculated as 0.99 in accordance with the cardiac cycle efficiency values at T3 and T4 (effect size: 0.85 standard deviations of the mean difference: 0.22, alpha: 0.05). At T4, heart rate, pulse pressure variation, cardiac cycle efficiency, dP/dt and longitudinal strain were significantly lower than those at T3 (p = 0.009, p &lt; 0.001, p &lt; 0.001, and p &lt; 0.001, respectively). There was a positive correlation between the delta-cardiac cycle efficiency and delta-longitudinal strain (R2 = 0.36, p &lt; 0.001).ConclusionAlthough the absence of significant changes in mean arterial pressure and cardiac index after Trendelenburg position suggests that cardiac workload has not changed, changes in cardiac cycle efficiency and longitudinal strain indicate increased cardiac workload due to increased ventriculo-arterial coupling.
Recovery kinetics of short-term depression of GABAergic and glutamatergic synapses at layer 2/3 pyramidal cells in the mouse barrel cortex
Authors: Lombardi Aniello , Wang Qiang , Stüttgen Maik C. , Mittmann Thomas , Luhmann Heiko J. , Kilb Werner 
Published: September 2023

IntroductionShort-term synaptic plasticity (STP) is a widespread mechanism underlying activity-dependent modifications of cortical networks.MethodsTo investigate how STP influences excitatory and inhibitory synapses in layer 2/3 of mouse barrel cortex, we combined whole-cell patch-clamp recordings from visually identified pyramidal neurons (PyrN) and parvalbumin-positive interneurons (PV-IN) of cortical layer 2/3 in acute slices with electrical stimulation of afferent fibers in layer 4 and optogenetic activation of PV-IN.ResultsThese experiments revealed that electrical burst stimulation (10 pulses at 10 Hz) of layer 4 afferents to layer 2/3 neurons induced comparable short-term depression (STD) of glutamatergic postsynaptic currents (PSCs) in PyrN and in PV-IN, while disynaptic GABAergic PSCs in PyrN showed a stronger depression. Burst-induced depression of glutamatergic PSCs decayed within &lt;4 s, while the decay of GABAergic PSCs required &gt;11 s. Optogenetically-induced GABAergic PSCs in PyrN also demonstrated STD after burst stimulation, with a decay of &gt;11 s. Excitatory postsynaptic potentials (EPSPs) in PyrN were unaffected after electrical burst stimulation, while a selective optogenetic STD of GABAergic synapses caused a transient increase of electrically evoked EPSPs in PyrN.DiscussionIn summary, these results demonstrate substantial short-term plasticity at all synapses investigated and suggest that the prominent STD observed in GABAergic synapses can moderate the functional efficacy of glutamatergic STD after repetitive synaptic stimulations. This mechanism may contribute to a reliable information flow toward the integrative layer 2/3 for complex time-varying sensory stimuli.
Altered neural intrinsic oscillations in patients with multiple sclerosis: effects of cortical thickness
Authors: Liang Xiao , Wang Lei , Zhu Yanyan , Wang Yao , He Ting , Wu Lin , Huang Muhua , Zhou Fuqing 
Published: September 2023

ObjectiveTo investigate the effects of cortical thickness on the identification accuracy of fractional amplitude of low-frequency fluctuation (fALFF) in patients with multiple sclerosis (MS).MethodsResting-state functional magnetic resonance imaging data were collected from 31 remitting MS, 20 acute MS, and 42 healthy controls (HCs). After preprocessing, we first calculated two-dimensional fALFF (2d-fALFF) maps using the DPABISurf toolkit, and 2d-fALFF per unit thickness was obtained by dividing 2d-fALFF by cortical thickness. Then, between-group comparison, clinical correlation, and classification analyses were performed in 2d-fALFF and 2d-fALFF per unit thickness maps. Finally, we also examined whether the effect of cortical thickness on 2d-fALFF maps was affected by the subfrequency band.ResultsIn contrast with 2d-fALFF, more changed regions in 2d-fALFF per unit thickness maps were detected in MS patients, such as increased region of the right inferior frontal cortex and faded regions of the right paracentral lobule, middle cingulate cortex, and right medial temporal cortex. There was a significant positive correlation between the disease duration and the 2d-fALFF values in the left early visual cortex in remitting MS patients (r = 0.517, Bonferroni-corrected, p = 0.008 × 4 &lt; 0.05). In contrast with 2d-fALFF, we detected a positive correlation between the 2d-fALFF per unit thickness of the right ventral stream visual cortex and the modified Fatigue Impact Scale (MFIS) scores (r = 0.555, Bonferroni-corrected, p = 0.017 × 4 &gt; 0.05). For detecting MS patients, 2d-fALFF and 2d- fALFF per unit thickness both performed remarkably well in support vector machine (SVM) analysis, especially in the remitting phase (AUC = 86, 83%). Compared with 2d-fALFF, the SVM model of 2d-fALFF per unit thickness had significantly higher classification performance in distinguishing between remitting and acute MS. More changed regions and more clinically relevant 2d-fALFF per unit thickness maps in the subfrequency band were also detected in MS patients.ConclusionBy dividing the functional value by the cortical thickness, the identification accuracy of fALFF in MS patients was detected to be potentially influenced by cortical thickness. Additionally, 2d-fALFF per unit thickness is a potential diagnostic marker that can be utilized to distinguish between acute and remitting MS patients. Notably, we observed similar variations in the subfrequency band.