bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomechanical evaluation of two modified intramedullary fixation system for treating unstable femoral neck fractures: A finite element analysis
Authors: Huang Qiang , Zhang CongMing , Bai HuanAn , Wang Qian , Li Zhong , Lu Yao , Ma Teng 
Published: February 2023

Purpose: The existing implants for fixation of femoral neck fractures have poor biomechanical stability, so the failure rate is high. We designed two modified intramedullary implants for treating unstable femoral neck fractures (UFNFs). We tried to improve the biomechanical stability of fixation by shortening the moment and reducing stress concentration. Each modified intramedullary implant was compared with cannulated screws (CSs) through finite element analysis (FEA).Methods: Five different models were included: three cannulated screws (CSs, Model 1) in an inverted triangle configuration, the dynamic hip screw with an anti-rotation screw (DHS + AS, Model 2), the femoral neck system (FNS, Model 3), the modified intramedullary femoral neck system (IFNS, Model 4), and the modified intramedullary interlocking system (IIS, Model 5). Three-dimensional (3D) models of femur and implants were constructed by using 3D modelling software. Three load cases were simulated to assess the maximal displacement of models and fracture surface. The maximal stress at the bone and implants was also evaluated.Results: FEA data showed that Model 5 had the best performance in terms of maximum displacement while Model 1 had the worst performance for this index under axial load of 2100 N. With respect to Maximum stress, Model 4 had the best performance while Model 2 had the worst performance under axial load. The general trends under bending and torsion load were consistent with that under axial load. Our data demonstrated that the two modified intramedullary implants exhibited the best biomechanical stability, followed by FNS and DHS + AS, and then three cannulated screws in axial, bending, and torsion load cases.Conclusion: The two modified intramedullary designs showed the best biomechanical performance among the five implants included in this study. Therefore, this might provide some new options for trauma surgeons to deal with unstable femoral neck fractures.
Metabolic engineering of Zymomonas mobilis for co-production of D-lactic acid and ethanol using waste feedstocks of molasses and corncob residue hydrolysate
Authors: Hu Mimi , Bao Weiwei , Peng Qiqun , Hu Wei , Yang Xinyu , Xiang Yan , Yan Xiongying , Li Mian , Xu Ping , He Qiaoning , Yang Shihui 
Published: February 2023

Lactate is the precursor for polylactide. In this study, a lactate producer of Z. mobilis was constructed by replacing ZMO0038 with LmldhA gene driven by a strong promoter PadhB, replacing ZMO1650 with native pdc gene driven by Ptet, and replacing native pdc with another copy of LmldhA driven by PadhB to divert carbon from ethanol to D-lactate. The resultant strain ZML-pdc-ldh produced 13.8 ± 0.2 g/L lactate and 16.9 ± 0.3 g/L ethanol using 48 g/L glucose. Lactate production of ZML-pdc-ldh was further investigated after fermentation optimization in pH-controlled fermenters. ZML-pdc-ldh produced 24.2 ± 0.6 g/L lactate and 12.9 ± 0.8 g/L ethanol as well as 36.2 ± 1.0 g/L lactate and 40.3 ± 0.3 g/L ethanol, resulting in total carbon conversion rate of 98.3% ± 2.5% and 96.2% ± 0.1% with final product productivity of 1.9 ± 0.0 g/L/h and 2.2 ± 0.0 g/L/h in RMG5 and RMG12, respectively. Moreover, ZML-pdc-ldh produced 32.9 ± 0.1 g/L D-lactate and 27.7 ± 0.2 g/L ethanol as well as 42.8 ± 0.0 g/L D-lactate and 53.1 ± 0.7 g/L ethanol with 97.1% ± 0.0% and 99.1% ± 0.8% carbon conversion rate using 20% molasses or corncob residue hydrolysate, respectively. Our study thus demonstrated that it is effective for lactate production by fermentation condition optimization and metabolic engineering to strengthen heterologous ldh expression while reducing the native ethanol production pathway. The capability of recombinant lactate-producer of Z. mobilis for efficient waste feedstock conversion makes it a promising biorefinery platform for carbon-neutral biochemical production.
Pregnancy loss and risk of incident CVD within 5 years: Findings from the Women's Health Initiative
Authors: Wright Catherine E. , Enquobahrie Daniel A. , Prager Sarah , Painter Ian , Kooperberg Charles , Wild Robert A. , Park Ki , Sealy-Jefferson Shawnita , Kernic Mary A. 
Published: February 2023

BackgroundPrevious studies have demonstrated an increased risk of cardiovascular disease (CVD) in women with a history of pregnancy loss. Less is known about whether pregnancy loss is associated with age at the onset of CVD, but this is a question of interest, as a demonstrated association of pregnancy loss with early-onset CVD may provide clues to the biological basis of the association, as well as having implications for clinical care. We conducted an age-stratified analysis of pregnancy loss history and incident CVD in a large cohort of postmenopausal women aged 50–79 years old.MethodsAssociations between a history of pregnancy loss and incident CVD were examined among participants in the Women's Health Initiative Observational Study. Exposures were any history of pregnancy loss (miscarriage and/or stillbirth), recurrent (2+) loss, and a history of stillbirth. Logistic regression analyses were used to examine associations between pregnancy loss and incident CVD within 5 years of study entry in three age strata (50–59, 69–69, and 70–79). Outcomes of interest were total CVD, coronary heart disease (CHD), congestive heart failure, and stroke. To assess the risk of early onset CVD, Cox proportional hazard regression was used to examine incident CVD before the age of 60 in a subset of subjects aged 50–59 at study entry.ResultsAfter adjustment for cardiovascular risk factors, a history of stillbirth was associated with an elevated risk of all cardiovascular outcomes in the study cohort within 5 years of study entry. Interactions between age and pregnancy loss exposures were not significant for any cardiovascular outcome; however, age-stratified analyses demonstrated an association between a history of stillbirth and risk of incident CVD within 5 years in all age groups, with the highest point estimate seen in women aged 50–59 (OR 1.99; 95% CI, 1.16–3.43). Additionally, stillbirth was associated with incident CHD among women aged 50–59 (OR 3.12; 95% CI, 1.33–7.29) and 60–69 (OR 2.06; 95% CI, 1.24–3.43) and with incident heart failure and stroke among women aged 70–79. Among women aged 50–59 with a history of stillbirth, a non-significantly elevated hazard ratio was observed for heart failure before the age of 60 (HR 2.93, 95% CI, 0.96–6.64).ConclusionsHistory of stillbirth was strongly associated with a risk of cardiovascular outcomes within 5 years of baseline in a cohort of postmenopausal women aged 50–79. History of pregnancy loss, and of stillbirth in particular, might be a clinically useful marker of cardiovascular disease risk in women.
Age-dependent phenotypic modulation of smooth muscle cells in the normal ascending aorta
Authors: Balint Brittany , Bernstorff Inés García Lascurain , Schwab Tanja , Schäfers Hans-Joachim 
Published: February 2023

ObjectivesAscending aortic aneurysms are associated with pre-existing conditions, including connective tissue disorders (i.e., Marfan syndrome) and bicuspid aortic valves. The underlying mechanisms remain uncertain. Even less is known regarding ascending aortic aneurysms in individuals with normal (i.e., tricuspid) aortic valves (TAV), and without known aneurysm-associated disorders. Regardless of etiology, the risk of aortic complications increases with biological age. Phenotypic modulation of smooth muscle cells (SMCs) is a feature of ascending aortic aneurysms, whereby contractile SMCs are replaced with synthetic SMCs that are capable of degrading the aortic wall. We asked whether age itself causes dysfunctional SMC phenotype modulation, independent of aortic dilatation or pre-existing aneurysm-associated diseases.MethodsNon-dilated ascending aortic samples were obtained intra-operatively from 40 patients undergoing aortic valve surgery (range: 20–82 years old, mean: 59.1 ± 15.2). Patients with known genetic diseases or aortic valve malformations were excluded. Tissue was divided, and a portion was formalin-fixed and immunolabeled for alpha-smooth muscle actin (ASMA), a contractile SMC protein, and markers of synthetic (vimentin) or senescent (p16/p21) SMCs. Another fragment was used for SMC isolation (n = 10). Cultured SMCs were fixed at cell passage 2 and stained for phenotype markers, or were cultured indefinitely to determine replicative capacity.ResultsIn whole tissue, ASMA decreased (R2 = 0.47, P &lt; 0.0001), while vimentin increased (R2 = 0.33, P = 0.02) with age. In cultured SMCs, ASMA decreased (R2 = 0.35, P = 0.03) and vimentin increased (R2 = 0.25, P = 0.04) with age. p16 (R2 = 0.34, P = 0.02) and p21 (R2 = 0.29, P = 0.007) also increased with age in SMCs. Furthermore, the replicative capacity of SMCs from older patients was decreased compared to that of younger patients (P = 0.03).ConclusionBy investigating non-dilated aortic samples from individuals with normal TAVs, we found that age itself has a negative impact on SMCs in the ascending aortic wall, whereby SMCs switched from the contractile phenotype to maladaptive synthetic or senescent states with increased age. Therefore, based on our findings, modification of SMC phenotype should be studied as a therapeutic consideration against aneurysms in the future, regardless of etiology.
Depressurization-induced gas production from hydrate reservoirs in the Shenhu sea area using horizontal well: Numerical simulation on horizontal well section deployment for gas production enhancement
Authors: Wan Tinghui , Li Zhanzhao , Yu Yanjiang , Liang Qianyong , Lu Hongfeng , Wang Jingli 
Published: February 2023

In 2020, China successfully conducted the second round of natural gas hydrate pilot production with horizontal wells at W11-W17 deposits in the Shenhu sea area of South China Sea, but the average daily gas production is far from reaching the commercial exploitation. Low productivity has become one of the key factors hindering the commercial exploitation of gas hydrate reservoir. This work taking SHSC-4 well as an example, uses numerical simulation method to analyze the impact of the placement of horizontal well section, length and the production system on productivity of horizontal well in depressurization exploitation. From the analysis of simulation results, it can be seen that the best performance of production capacity can be achieved when horizontal section placed in layer II, which is compared with that placed in layer I and III. More importantly, hydrate in layer I and free gas in layer III can be effectively utilized to improve productivity when layer II is exploited. When the horizontal section is arranged in layer II and produced by depressurization with small pressure difference (1 MPa), the longer the horizontal section length is, the better the productivity will be. However, the average cumulative gas production increment per meter is gradually decreasing. According to the simulation results, 300 m is a reasonable horizontal section length for the exploitation of layer II, and the cumulative gas production reaches 2.55 million cubic meters after 60 days of continuous exploitation. In addition, due to the limitations of convective heat transfer in the low-permeability reservoir in the Shenhu sea area, sensible heat can significantly improve the secondary hydrate generated in the wellbore and the reservoir around the wellbore due to throttling expansion effect, which has a good effect on productivity improvement. Compared with the situation without heating, when the horizontal section is arranged in layer II and the length is 300 m, the production mode of depressurization and combined heating is adopted, and the cumulative gas production of 60 days with different pressure difference (1–5 MPa) is 0.14, 5.55, 14.75, 23.72, and 29.5 times higher than that without heating.
The effect of intermittent fasting on the clinical and hematological parameters of patients with sickle cell disease: A preliminary study
Authors: Ahmed Khalid , Abdu Yasamin , Khasawneh Sief , Shukri Ahmed , Adam Ehab , Mustafa Salma , Affas Mohammad , Mohamed Ibrahim Mohamed Izham , Al Zayed Abdullah , Yassin Mohamed A. 
Published: February 2023

IntroductionSickle cell disease is a genetic disorder that frequently presents with vaso-occlusive crisis (VOC). Most patients with sickle cell disease in Qatar are Muslims; hence, they practice intermittent fasting during the holy month of Ramadan. However, there is a paucity of literature describing the effect of intermittent fasting on the occurrence of severe VOC. As a result, there is a lack of guidelines or standardized protocols that can help physicians advise patients with sickle cell disease who wish to practice intermittent fasting. Therefore, this study's aim was to investigate the effect of intermittent fasting on the clinical and hematological parameters of individuals with sickle cell disease.MethodsWe conducted a retrospective study for 52 Muslim patients with sickle cell disease in Qatar aged ≥18 years who were confirmed to be fasting during the holy month of Ramadan during any of the years 2019–2021. The difference in the occurrence of severe VOC, hemolytic crisis, and other clinical, hematological, and metabolic parameters were studied one month before, during, and one month after the intermittent fasting of Ramadan using the patient's medical records. Mean (sd), median (IQR), and frequency (%) described the data. One-way with repeated measures ANOVA with a Greenhouse-Geisser correction and Friedman tests (*) were used at alpha level 0.05.ResultsThe study participants' (mean±sd) age was (31.1±9.2) years, 51.9% were males, and 48.1% were females. Roughly seventy percent of the participants were of Arab ethnicity, while the rest were either African or Asian. Most of the patients were homozygotes (SS) (90.4%). The median number of severe VOC (P = 0.7) and hemolytic crisis (P = 0.5) was not found to be significantly different before, during, or after Ramadan. Significant differences, however, were found in platelet count (P = 0.003), reticulocyte count (P &lt; 0.001), and creatinine level (P = 0.038) with intermittent fasting.DiscussionIn this preliminary study, intermittent fasting does not seem to influence the rate of occurrence of severe vaso-occlusive crisis or hemolytic crisis in patients with sickle cell disease; however, it was found to be associated with differences in platelet count, reticulocytes count, and creatinine level. The statistical and clinical significance of these findings needs to be confirmed in studies with a larger sample size.
Sleep traits, fat accumulation, and glycemic traits in relation to gastroesophageal reflux disease: A Mendelian randomization study
Authors: Zhao Xiaoyan , Ding Rui , Su Chengguo , Yue Rensong 
Published: February 2023

BackgroundSleep traits, fat accumulation, and glycemic traits are associated with gastroesophageal reflux disease (GERD) in observational studies. However, whether their associations are causal remains unknown. We performed a Mendelian randomization (MR) study to determine these causal relationships.MethodsIndependent genetic variants associated with insomnia, sleep duration, short sleep duration, body fat percentage, visceral adipose tissue (VAT) mass, type 2 diabetes, fasting glucose, and fasting insulin at the genome-wide significance level were selected as instrumental variables. Summary-level data for GERD were derived from a genome-wide association meta-analysis including 78,707 cases and 288,734 controls of European descent. Inverse variance weighted (IVW) was used for the main analysis, with weighted median and MR-Egger as complements to IVW. Sensitivity analyses were performed using Cochran’s Q test, MR-Egger intercept test, and leave-one-out analysis to estimate the stability of the results.ResultsThe MR study showed the causal relationships of genetically predicted insomnia (odds ratio [OR] = 1.306, 95% confidence interval [CI] 1.261 to 1.352; p = 2.24 × 10−51), short sleep duration (OR = 1.304, 95% CI: 1.147 to 1.483, p = 4.83 × 10−5), body fat percentage (OR = 1.793, 95% CI 1.496 to 2.149; p = 2.68 × 10−10), and visceral adipose tissue (OR = 2.090, 95% CI 1.963 to 2.225; p = 4.42 × 10−117) with the risk of GERD. There was little evidence for causal associations between genetically predicted glycemic traits and GERD. In multivariable analyses, genetically predicted VAT accumulation, insomnia, and decreased sleep duration were associated with an increased risk of GERD.ConclusionThis study suggests the possible roles of insomnia, short sleep, body fat percentage, and visceral adiposity in the development of GERD.
Relationship between preoperative malnutrition, frailty, sarcopenia, body composition, and anthropometry in elderly patients undergoing major pancreatic and biliary surgery
Authors: Wang Lijuan , Li Pengxue , Hu Yifu , Cheng Bo , Ding Lili , Li Lei , Song Jinghai , Wei Junmin , Xu Jingyong 
Published: February 2023

ObjectiveTo analyze the correlation between preoperative nutritional status, frailty, sarcopenia, body composition, and anthropometry in geriatric inpatients undergoing major pancreatic and biliary surgery.MethodsThis is a cross-sectional study of the database from December 2020 to September 2022 in the department of hepatopancreatobiliary surgery, Beijing Hospital. Basal data, anthropometry, and body composition were recorded. NRS 2002, GLIM, FFP 2001, and AWGS 2019 criteria were performed. The incidence, overlap, and correlation of malnutrition, frailty, sarcopenia, and other nutrition-related variables were investigated. Group comparisons were implemented by stratification of age and malignancy. The present study adhered to the STROBE guidelines for cross-sectional study.ResultsA total of 140 consecutive cases were included. The prevalence of nutritional risk, malnutrition, frailty, and sarcopenia was 70.0, 67.1, 20.7, and 36.4%, respectively. The overlaps of malnutrition with sarcopenia, malnutrition with frailty, and sarcopenia with frailty were 36.4, 19.3, and 15.0%. There is a positive correlation between every two of the four diagnostic tools, and all six p-values were below 0.002. Albumin, prealbumin, CC, GS, 6MTW, ASMI, and FFMI showed a significantly negative correlation with the diagnoses of the four tools. Participants with frailty or sarcopenia were significantly more likely to suffer from malnutrition than their control groups with a 5.037 and 3.267 times higher risk, respectively (for frailty, 95% CI: 1.715–14.794, p = 0.003 and for sarcopenia, 95% CI: 2.151–4.963, p&lt;0.001). Summarizing from stratification analysis, most body composition and function variables were worsen in the ≥70 years group than in the younger group, and malignant patients tended to experience more intake reduction and weight loss than the benign group, which affected the nutrition diagnosis.ConclusionElderly inpatients undergoing major pancreatic and biliary surgery possessed high prevalence and overlap rates of malnutrition, frailty, and sarcopenia. Body composition and function deteriorated obviously with aging.
The relationship between probiotics and retinopathy of prematurity in preterm infants: A population-based retrospective study in China.
Authors: Bai Wen Hua , Gu Dan Feng , Dai Yun , Chen Yu Hong , Yang Zu Ming , Lu Li Jun 
Published: February 2023

BackgroundRetinopathy of prematurity (ROP) is a retinal vascular disease with a high incidence in premature infants and is a leading cause of childhood blindness worldwide. The purpose of our study was to analyze the association between the use of probiotics and retinopathy of prematurity.MethodsThis study retrospectively collected clinical data of premature infants with gestational age &lt;32 weeks and birth weight &lt;1500 g admitted to the neonatal intensive care unit from January 1, 2019 to December 31, 2021 in Suzhou Municipal Hospital, China. Demographic and clinical data of the inclusion population were collected. The outcome was the occurrence of ROP. The chi-square test was used to compare categorical variables, while the t-test and the nonparametric Mann-Whitney U rank-sum test were used for continuous variables. Univariate and multivariate logistic regression were used to analyze the relationship between probiotics and ROP.ResultsA total of 443 preterm infants met the inclusion criteria, of which 264 didn't receive probiotics and 179 were supplemented with probiotics. There were 121 newborns with ROP in the included population. The results of univariate analysis showed that the preterm infants with and without probiotics were significantly different in the gestational age, the birth weight, the one-minute Apgar score, the oxygen inhalation time, the acceptance rate of invasive mechanical ventilation, the prevalence of bronchopulmonary dysplasia, ROP and severe intraventricular hemorrhage and periventricular leukomalacia (P &lt; 0.05). Unadjusted univariate logistic regression model result showed that probiotics (OR 0.383, 95% CI 0.240∼0.611) were the factors affecting ROP in preterm infants (P &lt; 0.01). Multivariate logistic regression result (OR 0.575, 95% CI 0.333∼0.994) was consistent with univariate analysis (P &lt; 0.05).ConclusionThis study showed that probiotic was associated with a reduced risk of ROP in preterm infants with gestational age of &lt;32 weeks and birth weight of &lt;1500 g, but more large-scale prospective studies are still needed.
Failure of early non-invasive ventilation in preterm infants with respiratory distress syndrome in current care practice in Spanish level-III neonatal intensive care units – a prospective observational study
Authors: Boix Hector , Fernández Cristina , Serrano Martín María del Mar , Arruza Luis , Concheiro Ana , Gimeno Ana , Sánchez Ana , Rite Segundo , Jiménez Francisco , Méndez Paula , Agüera Juan José ,   on behalf of the VENTIS study research group
Published: February 2023

IntroductionDespite advances in respiratory distress syndrome (RDS) management over the past decade, non-invasive ventilation (NIV) failure is frequent and associated with adverse outcomes. There are insufficient data on the failure of different NIV strategies currently used in clinical practice in preterm infants.MethodsThis was a prospective, multicenter, observational study of very preterm infants [gestational age (GA) &lt;32 weeks] admitted to the neonatal intensive care unit for RDS that required NIV from the first 30 min after birth. The primary outcome was the incidence of NIV failure, defined as the need for mechanical ventilation for &lt;72 h of life. Secondary outcomes were risk factors associated with NIV failure and complication rates.ResultsThe study included 173 preterm infants with a median GA of 28 (IQR 27–30) weeks and a median birth weight of 1,100 (IQR 800–1,333) g. The incidence of NIV failure was 15.6%. In the multivariate analysis, lower GA (OR, 0.728; 95% CI, 0.576–0.920) independently increased the risk of NIV failure. Compared to NIV success, NIV failure was associated with higher rates of unfavorable outcomes, including pneumothorax, intraventricular hemorrhage, periventricular leukomalacia, pulmonary hemorrhage, and a combined outcome of moderate-to-severe bronchopulmonary dysplasia or death.ConclusionNIV failure occurred in 15.6% of the preterm neonates and was associated with adverse outcomes. The use of LISA and newer NIV modalities most likely accounts for the reduced failure rate. Gestational age remains the best predictor of NIV failure and is more reliable than the fraction of inspired oxygen during the first hour of life.