bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human umbilical cord mesenchymal stem cell exosome-derived miR-874-3p targeting RIPK1/PGAM5 attenuates kidney tubular epithelial cell damage
Authors: Yu Yihang , Chen Meiling , Guo Qitong , Shen Lianju , Liu Xing , Pan Jianbo , Zhang Yuanyuan , Xu Tao , Zhang Deying , Wei Guanghui 
Published: February 2023

Abstract
Background
Kidney insults due to various pathogenic factors, such as trauma, infection, and inflammation, can cause tubular epithelial cell injury and death, leading to acute kidney injury and the transformation of acute kidney injury to chronic kidney disease. There is no definitive treatment available. In previous studies, human umbilical cord mesenchymal stem cells have been shown to promote kidney injury. In this preclinical study, we investigate the role and mechanism of human umbilical cord mesenchymal stem cell exosomes (HucMSC-Exos) on the repair of renal tubular epithelial cells after injury.

Methods
C57BL/6 mice underwent unilateral ureteral obstruction, and epithelial cell injury was induced in HK-2 cells by cisplatin. HucMSC-Exos were assessed in vivo and in vitro. The extent of renal cell injury, activation of necroptosis pathway, and mitochondrial quality-control-related factors were determined in different groups. We also analyzed the possible regulatory effector molecules in HucMSC-Exos by transcriptomics.

Results
HucMSC-Exo inhibited necroptosis after renal tubular epithelial cell injury and promoted the dephosphorylation of the S637 site of the Drp1 gene by reducing the expression of PGAM5. This subsequently inhibited mitochondrial fission and maintained mitochondrial functional homeostasis, mitigating renal injury and promoting repair. In addition, HucMSC-Exo displayed a regulatory role by targeting RIPK1 through miR-874-3p.

Conclusion
The collective findings of the present study demonstrate that HucMSC-Exos can regulate necroptosis through miR-874-3p to attenuate renal tubular epithelial cell injury and enhance repair, providing new therapeutic modalities and ideas for the treatment of AKI and the process of AKI to CKD transformation to mitigate renal damage.
Dynamic patterns of gene expression and regulatory variation in the maize seed coat
Authors: Li Juan , Wang Liangfa , Wan Jiong , Dang Kuntai , Lin Yuan , Meng Shujun , Qiu Xiaoqian , Wang Qiyue , Zhao Jiawen , Mu Liqin , Luo Hongbing , Ding Dong , Chen Zehui , Tang Jihua 
Published: February 2023

Abstract
Background
Seed size is an important factor contributing to maize yield, but its molecular mechanism remains unclear. The seed coat, which serves as one of the three components of the maize grain, determines seed size to a certain extent. The seed coat also shares the maternal genotype and is an ideal material for studying heterosis.

Results
In this study, the self-pollinated seeds of the maize hybrid Yudan888 and its parental lines were continuously collected from 0 day after pollination (DAP) to 15 DAP for phenotyping, cytological observation and RNA-seq. The phenotypic data showed that 3 DAP and 8 DAP are the best time points to study maize seed coat heterosis. Cytological observations indicated that maize seed coat heterosis might be the result of the coordination between cell number and cell size. Furthermore, the RNA-seq results showed that the nonadditive genes changed significantly between 3 and 8 DAP. However, the number of genes expressed additively was not significantly different. Our findings suggest that seed coat heterosis in hybrid is the result of nonadditive expression caused by dynamic changes in genes at different time points during seed expansion and seed coat development. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment indicated that genes related to DNA replication, cell cycle regulation, circadian rhythms and metabolite accumulation contributed significantly to hybrid seed coat heterosis.

Conclusion
Maize seed coat phenotyping allowed us to infer that 3 DAP and 8 DAP are important time points in the study of seed coat heterosis. Our findings provide evidence for genes involved in DNA replication, cell cycle regulation, circadian rhythms and metabolite accumulation in hybrid with high or low parental expression as major contributors to hybrid seed coat heterosis.
Effects of continuous and slow tracheal tube cuff deflation on cough reflex during extubation in noncardiac surgery patients: a randomised clinical trial
Authors: Wang Xuan , Zhu Guangli , Tan Jing , Cao Xinyu , Duan Manlin 
Published: February 2023

Abstract
Background
The incidence of cough reflex during extubation is 76%. Cough reflex causes severe hemodynamic fluctuations and airway complications. This prospective trial investigated the potential effects of tracheal tube cuff deflation on cough reflex during extubation.

Methods
One hundred and twenty-six patients scheduled for operations within 3 h under general anaesthesia with orotracheal intubation were randomly assigned to one of three groups: control (C), experimental (E) or syringe (S) groups. Patients in group C underwent tracheal tube cuff deflation using a 10-ml syringe in 1 s, patients in group E underwent tracheal tube cuff deflation continuously and slowly in 5 s using a cuff pressure gauge until the pressure was zero and patients in group S underwent tracheal tube cuff deflation using a 10-ml syringe at a speed of 1 ml s−1. The incidence and severity of cough reflexs during extubation and the incidence of postoperative airway complications within 48 h were assessed.

Results
Compared with group C (60.0%), the incidence of cough reflex in group E was 9.8% (p < 0.001) and in group S was 12.5% (p < 0.001). The severity of cough reflex was graded as 2 (1–2) in group C, 1 (1–1) in group E and 1 (1–1) in group S (p < 0.001 for group comparisons). The incidence of hoarseness in group C was 0.0%, in group E was 19.5% and in group S was 5.0% (p < 0.05 for all groups, p = 0.009 between group C and E).

Conclusions
Compared with deflating a trachal tube cuff with a 10-ml syringe in 1 s, the use of a 10-ml syringe at a speed of 1 ml s−1 or a cuff pressure guage within 5 s can both reduce the incidence of cough reflex, but deflating with a cuff pressure guage can increase the incidence of postoperative hoarseness.

Trial registration
Chinese Clinical Trial Registry, identifier: ChiCTR2100054089, Date: 08/12/2021.
A nomogram model for assessing predictors and prognosis of postoperative delirium in patients receiving acute type A aortic dissection surgery
Authors: Lin Jian-Ling , Zheng Guo-Zhong , Chen Liang-Wan , Luo Zeng-Rong 
Published: February 2023

Abstract
Background
Postoperative delirium (POD) complicates the postoperative course. There is limited information on POD-related risk factors (RFs) and prognosis in patients with acute type A aortic dissection (ATAAD) after modified triple-branched stent graft implantation (MTBSG) surgery.

Methods
We retrospectively examined consecutive ATAAD patients who received MTBSG surgery in our hospital between January 2013 and December 2019. We employed univariate and multivariate analyses to identify stand-alone RFs for POD. A nomogram was next generated to estimate POD occurrence. The primary outcome was the development of POD, and the secondary outcomes were intensive care unit (ICU) and hospital stays, hospitalization costs, and in-hospital and follow-up mortality.

Results
We selected 692 patients, of whom 220 experienced POD (31.8%). Based on our analysis, the following factors enhanced the likelihood of POD development: alcohol consumption (p < 0.001), acute physiology and chronic health evaluation II score (p = 0.023), serum total bilirubin (p = 0.007), stage 3 acute kidney injury (p < 0.001), serum interleukin-6 (p = 0.031), post-operative analgesics usage (p = 0.015), and ventilation duration (p = 0.008). POD patients had significantly longer ventilator times (p = 0.003), ICU stays (p < 0.001), and hospital stays (p = 0.038), together with increased hospitalization costs (p < 0.001) and in-hospital mortality (p = 0.019). However, POD was not a RF for mortality during follow-up (log-rank p = 0.611).

Conclusions
We demonstrated a strong link between POD and poor prognosis in ATAAD patients. We also constructed a prognosis estimator model which will benefit early management guidance to minimize the incidence of POD.
A comparison of four epidemic waves of COVID-19 in Malawi; an observational cohort study
Authors: Anscombe Catherine , Lissauer Samantha , Thole Herbert , Rylance Jamie , Dula Dingase , Menyere Mavis , Kutambe Belson , van der Veer Charlotte , Phiri Tamara , Banda Ndaziona P. , Mndolo Kwazizira S. , Mponda Kelvin , Phiri Chimota , Mallewa Jane , Nyirenda Mulinda , Katha Grace , Mwandumba Henry , Gordon Stephen B. , Jambo Kondwani C. , Cornick Jennifer , Feasey Nicholas , Barnes Kayla G. , Morton Ben , Ashton Philip M. ,   Blantyre COVID-19 Consortium, Kalua Wezzie , Mandala Peter , Katutula Barbara , Ng’oma Rosaleen , Lanken Steven , Phulusa Jacob , Mkandawire Mercy , Kaimba Sylvester , Nthala Sharon , Nsomba Edna , Keyala Lucy , Chinoko Beatrice , Gmeiner Markus , Kaudzu Vella , Freyne Bridget , Swarthout Todd D. , Tam Pui-Ying Iroh , Sichone Simon , Ahmadu Ajisa , Stima Grace , Masina Mazuba , Kanjewa Oscar , Nyasulu Vita , Chinyama End , Zuza Allan , Denis Brigitte , Storey Evance , Bondera Nedson , Matchado Danford , Chande Adams , Chingota Arthur , Ntwea Chimenya , Mkandawire Langford , Mhango Chimwemwe , Lakudzala Agness , Chaponda Mphatso , Mwenechanya Percy , Mvaya Leonard , Tembo Dumizulu , Henrion Marc Y. R. , Chirombo James , Kambiya Paul , Masesa Clemens , Gondwe Joel 
Published: February 2023

Abstract
Background
Compared to the abundance of clinical and genomic information available on patients hospitalised with COVID-19 disease from high-income countries, there is a paucity of data from low-income countries. Our aim was to explore the relationship between viral lineage and patient outcome.

Methods
We enrolled a prospective observational cohort of adult patients hospitalised with PCR-confirmed COVID-19 disease between July 2020 and March 2022 from Blantyre, Malawi, covering four waves of SARS-CoV-2 infections. Clinical and diagnostic data were collected using an adapted ISARIC clinical characterization protocol for COVID-19. SARS-CoV-2 isolates were sequenced using the MinION™ in Blantyre.

Results
We enrolled 314 patients, good quality sequencing data was available for 55 patients. The sequencing data showed that 8 of 11 participants recruited in wave one had B.1 infections, 6/6 in wave two had Beta, 25/26 in wave three had Delta and 11/12 in wave four had Omicron. Patients infected during the Delta and Omicron waves reported fewer underlying chronic conditions and a shorter time to presentation. Significantly fewer patients required oxygen (22.7% [17/75] vs. 58.6% [140/239], p < 0.001) and steroids (38.7% [29/75] vs. 70.3% [167/239], p < 0.001) in the Omicron wave compared with the other waves. Multivariable logistic-regression demonstrated a trend toward increased mortality in the Delta wave (OR 4.99 [95% CI 1.0–25.0 p = 0.05) compared to the first wave of infection.

Conclusions
Our data show that each wave of patients hospitalised with SARS-CoV-2 was infected with a distinct viral variant. The clinical data suggests that patients with severe COVID-19 disease were more likely to die during the Delta wave.
Psychometric evaluation of the Connor-Davidson Resilience Scale among Iranian population
Authors: Sharif Nia Hamid , She Long , Froelicher Erika Sivarajan , Marôco João , Moshtagh Mozhgan , Hejazi Sima 
Published: February 2023

Abstract
Background
The resilience construct is considered a personal trait composed of multiple aspects. Connor–Davidson Resilience Scale is a standard tool composed of five factors and 25 items. This study aimed to determine the psychometric properties of this scale.

Methods
In this cross-sectional study, after the scale translation, the factorial structural validity was assessed via the confirmatory factor analysis with 70 180 samples. Internal consistency, composite reliability, convergent validity were assessed by calculating Cronbach’s alpha, composite reliability, maximum reliability, and Average Variance Extracted. The discriminant validity was assessed using Heterotrait-monotrait ratio of correlations matrix and also, measure invariance was evaluated.

Results
The original five-factor model had good model fit indices but due to low factor loading of item 2 and 20, the model was modified. The Cronbach’s alpha and composite reliability for four factors were above 0.7 (except for factor 5). The convergent validity for all five factors were achieved. Between factors 1 with 2 and 4, 2 with 3 and 4 discriminant validity was not established (correlations > 0.9) and the results suggested that there might be a second-order latent construct behind these factors. Therefore, a second-order assessment was performed. The results of the second-order latent construct assessment showed a good goodness-of fit and strong measurement invariance for both men and women.

Conclusion
The 23-item version of Connor-Davidson Resilience Scale is a reliable and valid scale to measure resilience as a complex construct in the Iran context.
Factors associated with childhood pneumonia and care seeking practices in Nepal: further analysis of 2019 Nepal Multiple Indicator Cluster Survey
Authors: Dharel Sunita , Shrestha Binjwala , Basel Prem 
Published: February 2023

Abstract
Background
Acute Respiratory Infection (ARI) is still a major public health problem in Nepal. The prevalence of ARI among under five children was 2.1% in 2019 and many children from marginalized families suffer disproportionately and many of them die without proper care and treatment. The objective of this study was to identify factors associated with childhood pneumonia and care-seeking practices in Nepal.

Methods
This was a secondary analysis of the Nepal Multiple Indicator Cluster Survey (MICS) 2019, which uses multi-stage Probability Proportional to Size sampling. Data from 6658 children were analyzed using SPSS 22. Chi-square test and logistic regression analysis were conducted with odds ratio and its corresponding 95% confidence interval after adjusting for confounders.

Results
Children aged 0 to 23 months had1.5 times higher odds of pneumonia compared to the age group 24 to 59 months (AOR = 1.5, CI 1.0–2.3) and children from rural area had 1.9 times the odds of having pneumonia than urban children (AOR = 1.9, CI 1.2–3.2). Underweight children had 2.3 times greater odds of having pneumonia than normal weight children (AOR = 2.3, CI 1.4–3.9). The odds of having pneumonia were 2.5 higher among children of current smoking mothers compared those with non-smoking mothers (AOR = 2.5, CI 1.1–5.7). Similarly, children from disadvantaged families had 0.6 times protective odds of pneumonia than children from non-disadvantaged families (AOR = 0.6, CI 0.4–1.0). Only one quarter of children received treatment from public facilities. Of those who received treatment, nearly half of the children received inappropriate treatment for pneumonia. One in ten children with pneumonia did not receive any kind of treatment at all.

Conclusions
Pneumonia is still a public health problem in low-income countries. Public health program and treatment services should be targeted to younger children, careful attention should be given to underweight children, and awareness and nutrition related activities should be focused on rural areas. Addressing inequity in access to and utilization of treatment of childhood illnesses should be prioritized. Keywords: Childhood pneumonia, epidemiology, health care seeking behavior, Nepal.
Associations between changes in physical activity and perceived social exclusion and loneliness within middle-aged adults – longitudinal evidence from the German ageing survey
Authors: Baumbach Linda , König Hans-Helmut , Hajek André 
Published: February 2023

Abstract
Background
Previous research showed negative associations between physical activity and loneliness in older adults. However, information on associations among middle-aged adults is scarce. In this prognostic factor study, we investigated if starting or stopping to follow the WHO physical activity recommendations was associated with changes in perceived social exclusion and loneliness in this age bracket.

Methods
We used longitudinal representative data of participants aged 40 to 64 years from the German Ageing Survey waves in 2014 and 2017 (analytical sample = 4,264 observations, 54% women). Perceived social exclusion was investigated with the scale from Bude and Lantermann. Loneliness was quantified with the 6-items loneliness scale from De Jong Gierveld. Information from the International Physical Activity Survey items on the time spend in moderate and vigorous physical activity per week was dichotomized. Participants were coded as either following or not following the WHO´s physical activity recommendations of spending at least 150 min of moderate, 75 min of vigorous or an appropriated combination of physical activity per week. We investigated the within (individual) association between starting and stopping to follow WHO´s physical activity recommendations and perceived social exclusion as well as loneliness in asymmetric fixed effects regressions. Analyses were adjusted for age, marital status, employment status, social-network size, general self-efficacy, depressive symptoms, self-rated health, BMI, comorbidities, and physical functioning (SF-36).

Results
Stopping to follow the physical activity recommendations from the WHO was associated with perceived social exclusion (ß= 0.09 p = 0.04) but not with loneliness (ß=-0.01, p = 0.71). Starting to follow the WHO physical activity recommendations was neither associated with social exclusion (ß=-0.02, p = 0.54) nor with loneliness (ß=-0.01, p = 0.74) in adjusted asymmetric fixed effects regressions.

Conclusion
In middle-aged adults, longitudinal associations were found for physical activity and perceived social exclusion. Perceived social exclusion may be prevented by maintaining at least 150 min of moderate physical activities per week, which is the WHO physical activity recommendation. Future research should investigate moderators and mediators in the association between physical activity and social exclusion as well as loneliness.
Bronchoalveolar lavage fluid polymerase chain reaction for invasive pulmonary aspergillosis among high-risk patients: a diagnostic meta-analysis
Authors: Han Yinling , Wu Xiang , Jiang Guangwei , Guo Anyi , Jin Zhangchu , Ying Yinghua , Lai Jianxing , Li Wen , Yan Fugui 
Published: February 2023

Abstract
Background
Polymerase chain reaction (PCR) assays are perceived to facilitate the diagnosis of fungal infections. However, due to lack of standardization, the value of bronchoalveolar lavage (BAL) fluid PCR in diagnosis of invasive pulmonary aspergillosis (IPA) remains unclear.

Methods
We conducted a systematic meta-analysis to evaluate the accuracy of BAL fluid PCR in IPA diagnosis among high-risk patients. All studies involving patients at risk for IPA were included. The sensitivity, specificity, positive and negative likelihood ratios of BAL fluid PCR were summarized for diagnosis of proven/probable IPA, or proven IPA only. Potential heterogeneity was assessed by subgroup analyses and meta-regression.

Results
Forty-one studies involving 5668 patients were analyzed. The summary sensitivity, specificity, positive and negative likelihood ratios of BAL fluid PCR for proven/probable IPA were 0.75 (95% CI = 0.67–0.81), 0.94 (95% CI = 0.90–0.96), 11.8 (95% CI = 7.7–18.1) and 0.27 (95% CI = 0.20–0.36), respectively. Whereas for proven IPA only, sensitivity and specificity were 0.91 (95% CI = 0.68–0.98) and 0.80 (95% CI = 0.74–0.85) in fourteen studies involving 2061 patients. Significant heterogeneity was present due to the underlying disease, antifungal treatment and differences in DNA extraction techniques and choice of PCR assay. Compared to patients with hematological malignancies (HM) and hematopoietic stem cell/solid organ transplantation (HSCT/SOT), sensitivity was higher in the population with disease such as chronic obstructive pulmonary disease, solid tumor, autoimmune disease with prolonged use of corticosteroids, etc. (0.88 vs. 0.68, P < 0.001), which was related to the concurrent use of antifungal prophylaxis among patients with HM and HSCT/SOT.

Conclusion
BAL fluid PCR is a useful diagnostic tool for IPA in immunocompromised patients and is also effective for diagnosing IPA in patients without HM and HSCT/SOT. Furthermore, standard protocols for DNA extraction and PCR assays should be focused on to improve the diagnostic accuracy.
Trial registration PROSPERO, registration number CRD42021239028.
Clinical characteristics and predictive model of pulmonary tuberculosis patients with pulmonary fungal coinfection
Authors: Yan Hongxuan , Guo Li , Pang Yu , Liu Fangchao , Liu Tianhui , Gao Mengqiu 
Published: February 2023

Abstract
Background
In clinical settings, pulmonary tuberculosis (PTB) patients were often found to have pulmonary fungal coinfection. This study aimed to assess the clinical characteristics of patients suffering from coinfection with TB and pulmonary fungal and construct a predictive model for evaluating the probability of pulmonary fungal coinfection in patients with pulmonary tuberculosis.

Methods
The present case–control study retrospectively collected information from 286 patients affected by PTB who received treatment from December 6,2016- December 6,2021 at Beijing Chest Hospital, Capital Medical University. As control subjects, patients with sex and address corresponding to those of the case subjects were included in the study in a ratio of 1:1. These 286 patients were randomly divided into the training and internal validation sets in a ratio of 3:1. Chi-square test and logistic regression analysis were performed for the training set, and a predictive model was developed using the selected predictors. Bootstrapping was performed for internal validation.

Results
Seven variables [illness course, pulmonary cavitation, broad-spectrum antibiotics use for at least 1 week, chemotherapy or immunosuppressants, surgery, bacterial pneumonia, and hypoproteinemia] were validated and used to develop a predictive model which showed good discrimination capability for both training set [area under the curve (AUC) = 0.860, 95% confidence interval (CI) = 0.811–0.909] and internal validation set (AUC = 0.884, 95% CI = 0.799–0.970). The calibration curves also showed that the probabilities predicted using the predictive model had satisfactory consistency with the actual probability for both training and internal validation sets.

Conclusions
We developed a predictive model that can predict the probability of pulmonary fungal coinfection in pulmonary tuberculosis patients. It showed potential clinical utility.