bluuebunny/crossref_metadata_2025_split huggingface dataset:
Significant Prediction of In-hospital Major Adverse Events by D-Dimer Level in Patients With Acute Type A Aortic Dissection
Authors: Feng Weiqi , Wang Qiuji , Li Chenxi , Wu Jinlin , Kuang Juntao , Yang Jue , Fan Ruixin 
Published: February 2022

BackgroundAcute type A aortic dissection (ATAAD) is a rare, life-threatening condition affecting the aorta. This study explores the relationship between the level of admission D-dimer, which was assessed during the first 2 h from admission, and in-hospital major adverse events (MAE) with ATAAD.MethodsA total of 470 patients with enhanced computed tomography (CT) confirmed diagnosis of ATAAD who underwent operation treatment in Guangdong Provincial People's hospital between September 2017 and June 2021 were enrolled in the present study. The X-tile program was used to determine the optimal D-dimer thresholds for risk. Restricted cubic spline (RSC) was performed to assess the association between D-dimer and endpoint. The perioperative data were compared between the two groups, univariate and multivariate analyses were used to investigate the risk factors of major adverse events (in-hospital mortality, gastrointestinal bleeding, paraplegia, acute kidney failure, reopen the chest, low cardiac output syndrome, cerebrovascular accident, respiratory insufficiency, MODS, gastrointestinal bleeding, and severe infection).ResultsAmong 470 patients, 151 (32.1%) had MAE. In-hospital mortality was 7.44%. The patients with D-dimer &gt;14,500 ng/ml were more likely to present with acute kidney failure, low cardiac output, cerebrovascular accident, multiple organ dysfunction syndromes (MODS), gastrointestinal bleeding, and severe infection. D-dimer level was an independent risk factor for acute kidney failure (OR 2.09, 95% CI: 1.25–3.51, p = 0.005), MODS (OR 6.40, 95% CI: 1.23–33.39, p = 0.028), gastrointestinal bleeding (OR 17.76, 95% CI: 1.99–158.78, p = 0.010) and mortality (OR 3.17, 95% CI: 1.32–7.63, p = 0.010). Multivariate regression analysis of adverse events also suggested that D-dimer &gt;14,500 ng/ml (OR 1.68, 95% CI: 1.09–2.61, p = 0.020) was the independent risk factor of major adverse events.ConclusionsIncreasing D-dimer levels were independently associated with the in-hospital MAE and thus can be used as a useful prognostic biomarker before the surgery.
Exploring the Communal Pathogenesis, Ferroptosis Mechanism, and Potential Therapeutic Targets of Dilated Cardiomyopathy and Hypertrophic Cardiomyopathy via a Microarray Data Analysis
Authors: Wang Zuoxiang , Xia Qingyue , Su Wenxing , Cao Mingqiang , Sun Yunjuan , Zhang Mingyang , Chen Weixiang , Jiang Tingbo 
Published: February 2022

BackgroundCardiomyopathies are a heterogeneous group of heart diseases that can gradually cause severe heart failure. In particular, dilated cardiomyopathy (DCM) and hypertrophic cardiomyopathy (HCM) are the two main types of cardiomyopathies, yet the independent and communal biological mechanisms of both remain far from elucidated. Meanwhile, ferroptosis is a non-apoptotic form of cell death that has been proven to be associated with cardiomyopathies, but the concrete nature of the interaction remains unclear. Hence, this study explored the pathogenesis and ferroptosis mechanism of HCM and DCM via a bioinformatics analysis.MethodsSix datasets were downloaded from the Gene Expression Omnibus (GEO) database based on the study inclusion/exclusion criteria. After screening the differentially expressed genes (DEGs) and hub genes of HCM and DCM, subsequent analyses, including functional annotation, co-expression, validation, and transcription factors (TF)–mRNA–microRNA (miRNA) regulatory network construction, were performed. In addition, ferroptosis-related DEGs were also identified and verified in HCM and DCM.ResultsWe found 171 independent DEGs of HCM mainly enriched in the regulation of ERK1 and ERK2 cascade, while 171 independent DEGs of DCM were significantly involved in cell adhesion. Meanwhile, 32 communal DEGs (26 upregulated genes and 6 downregulated genes) and 3 hub genes [periostin (POSTN), insulin-like growth factor-binding protein-5 (IGFBP5), and fibromodulin (FMOD)] were determined to be shared between HCM and DCM and the functional annotation of these genes highlighted the important position of growth hormone in HCM and DCM. Moreover, we identified activating transcription factor 3 (ATF3), lysophosphatidylcholine acyltransferase 3 (LPCAT3), and solute carrier family 1 member 5 (SLC1A5) as ferroptosis-related genes in HCM and STAT3 as a ferroptosis-related gene in DCM.ConclusionThe identified independent and communal DEGs contribute to uncover a potentially distinct and common mechanism of HCM and DCM and ferroptosis-related genes could provide us with a novel direction for exploration. In addition, 3 hub genes could be potential biomarkers or therapeutic targets in patients with cardiomyopathy.
Therapeutic Effect of His-Purkinje System Pacing Proportion on Persistent Atrial Fibrillation Patients With Heart Failure
Authors: Tong Fei , Sun Zhijun 
Published: February 2022

BackgroundHis-Purkinje system pacing (HPSP) combined with atrioventricular node ablation is an effective therapy for atrial fibrillation (AF) patients with heart failure (HF). However, atrioventricular node ablation has some limitations and disadvantages. HPSP combined with β -blockers reduces intrinsic heart rate and increases pacing proportion, which may be an alternative to HPSP combined with atrioventricular node ablation. This study was to assess the therapeutic effect of different HPSP proportion on AF patients with HF.MethodsThe study enrolled 30 consecutive persistent AF patients with HF who underwent HPSP. Heart rate was controlled by medical therapy. NYHA class, NT-proBNP, echocardiographic parameters were assessed at follow-up. MACE was defined as the composite endpoint of readmission for HF and cardiac mortality.ResultsThe AUC of pacing proportion for predicting MACE was 0.830 (SE = 0.140, 95%CI:0.649–0.941, p = 0.018), the optimal cut-off point of pacing proportion to predict MACE by ROC analysis was 71% (sensitivity:83.3%, specificity: 91.7%). In high pacing proportion group (&gt;71%), there were significant improvements of NYHA class, NT-proBNP, LVEF and LVEDD from the baseline in wide QRS complex (QRSd&gt;120 ms) patients and HFrEF patients at half year follow-up, and there were significant improvements in NYHA class, NT-proBNP from baseline in narrow QRS complex (QRSd ≤ 120 ms) patients and HFpEF patients at half year follow-up, moderate but no significant improvements of LVEF and LVEDD were observed in these patients. In low pacing proportion group (≤ 71%), there were no significant improvements of NT-proBNP, LVEDD or LVEF regardless of baseline QRS duration or LVEF (p &gt; 0.05).ConclusionHigh pacing proportion (&gt;71%) of HPSP can improve clinical outcomes and echocardiographic parameters in persistent AF patients with wide QRS complex or HFrEF, and clinical outcomes in persistent AF patients with narrow QRS complex or HFpEF. High pacing proportion of HPSP has a beneficial effect on the prognosis of persistent AF patients with HF.
Quantitative Evaluation of Post-stenotic Blood Flow Disturbance in Canine Femoral Artery Stenosis Model: An Early Experience With Vector Flow Imaging
Authors: Zhao Rui , Zheng Haining , Wang Wei , Du Yigang , Tong Yisha , Wen Chaoyang 
Published: February 2022

ObjectiveTo investigate the value of Vector Flow Imaging (V Flow) in the assessment of post-stenotic turbulence in the canine arterial stenosis model.Materials and MethodsCanine femoral artery stenosis models were established using ameroid constrictors in 12 beagle dogs. 50% and then 70% femoral artery stenoses were confirmed by selective femoral artery angiography. V Flow was used to measure femoral artery flow turbulence index (Tur) preoperatively as a baseline. After establishing of a 50% and then 70% stenoses, the Tur indices were recorded in the femoral artery at 1, 3, 5, 7, 9, 11, 13, 15, 17, and 19 mm distal to the stenosis.ResultsBaseline Tur indices of normal canine femoral arteries were &lt;1% in 11 of 12 cases (91.7%). Distal to a 50% stenosis, the Tur index (&gt;1%) was recorded in 83.3–100% cases between 1 and 9 mm, 41.7–58.3% between 11 and 17 mm, and 16.7% at 19 mm. For a 70% stenosis, the Tur index (&gt;1%) occurred in 81.8–100% cases between 1 and 17 mm distal to the stenosis, and 63.6% at 19 mm. The Tur index peaked around 7 mm or 2.3 times of the initial vessel diameter (3 mm) downstream for a 50% stenosis and 11 mm or 3.7 times of vessel diameter downstream for a 70% stenosis.ConclusionV Flow with Tur index measurement adds quantitative information of post-stenotic turbulence when assessing an arterial stenosis with ultrasound. Tur index of 1% seems a useful threshold for assessment of flow turbulence in this small sample study. Further studies with larger sample size are needed to evaluate the value of V Flow in clinical applications.
Case Report: A Rare Case of Acute Anterior Myocardial Infarction Simultaneously Associated With Aortic Mural Thrombosis Due to Essential Thrombocytosis
Authors: Ye Sheng , Xia Wu-jie , Chen Peng 
Published: February 2022

BackgroundEssential thrombocytosis (ET) simultaneously complicated with acute myocardial infarction and aortic thrombosis is extremely rare and associated with poor outcomes.CaseA 54-year-old female was admitted to our emergency department with abdominal pain for 3 h. ST-segment elevation in leads V1–V3 on electrocardiography led to the diagnosis of acute anterior myocardial infarction. Coronary angiography demonstrated total occlusion of the proximal left anterior descending artery, and the patient was treated with angioplasty and placement of a drug-eluting stent. CT angiography revealed a massive mural thrombus located in the descending aorta. Bone marrow biopsy confirmed the diagnosis of ET. The patient was successfully treated with antithrombotic therapy and hydroxyurea.ConclusionAt present, the clinical diagnosis and treatment of ET complicated with acute myocardial infarction and aortic thrombosis are mostly based on literature reports. Early target vessel revascularization, antiplatelet and anticoagulant combined with cytoreductive therapy may improve the prognosis. Clinicians should consider the risk of bleeding and thrombosis and create individualized treatment strategies for these patients.
Dynamic Interaction Between Deforestation and Rice Cultivation During the Holocene in the Lower Yangtze River, China
Authors: He Keyang , Lu Houyuan , Sun Guoping , Wang Yonglei , Zheng Yunfei , Zheng Hongbo , Lei Shao , Li Yongning , Zhang Jianping 
Published: February 2022

Human activity has transformed the Earth’s landscapes pervasively for thousands of years, and the most important anthropogenic alteration was the clearing of forests and the establishment of agriculture. As a center of rice domestication and early population growth, the lower Yangtze River has been extensively transformed in the Holocene. However, the timing, extent, and process of deforestation and its relationship with the intensification of rice cultivation remain controversial. Here, four representative archaeological sites ranging from 8,100 to 4,300 cal a BP, that is, Jingtoushan, Hemudu, Yushan, and Xiawangdu sites, were selected for detailed palynological analysis, and evidence of anthropogenic deforestation and subsistence strategy were also synthesized to investigate dynamic human–forest interaction. Although natural vegetation had already been altered at the Jingtoushan site around 8,000 cal a BP, it was more likely to be the management of acorns by limiting burning to open habitats and increasing yield. As the subsistence shifted from acorn exploitation toward rice cultivation after 6,000 cal a BP, real deforestation for agriculture may occur at the Yushan and Xiawangdu sites due to conflict on labor input and land use. However, these deforestations were just confined to the archaeological sites at local scale, and no consistent vegetation change occurred at regional scales induced by human activities until the last 3,000 years.
Healthcare Professionals’ Views of Factors Influencing Diabetes Self-Management and the Utility of a mHealth Application and Its Features to Support Self-Care
Authors: Yoon Sungwon , Ng Jun Hao , Kwan Yu Heng , Low Lian Leng 
Published: February 2022

IntroductionThe perspectives of healthcare professionals (HCPs) are pivotal to co-development of self-management strategies for patients with diabetes. However, literature has been largely limited to perspectives of patients within the context of a Western healthcare setting. This study aims to explore factors influencing diabetes self-management in adult patients with diabetes from the perspectives of HCPs and their views of the value of mHealth application for diabetes self-management.Materials and MethodsWe conducted focus group discussions (FGD) with purposively selected HCPs in Singapore. All FGDs were audio-recorded and transcribed verbatim. Thematic analysis was conducted using NVivo 12.ResultsA total of 56 HCPs participated in the study. Barriers to self-management included limited patient commitment to lifestyle changes, suboptimal adherence to medication and treatment, patient resistance to insulin initiation and insufficient rapport between patients and HCPs. Patients’ perceived susceptibility to complications, social support from family and community, multidisciplinary team care and patient’s understanding of the benefits of self-care were viewed as facilitating self-management. HCPs saw mHealth apps as a vital opportunity to engage patients in the self-management of conditions and empower them to foster behavior changes. Yet, there were concerns regarding patient’s limited digital literacy, lack of integration into routine electronic system and reluctance.DiscussionWe identified a set of factors influencing self-management in adult patients with diabetes and useful app features that can empower patients to manage their conditions. Findings will inform the development of a mHealth application, and its features designed to improve self-care.
Hashimoto’s Thyroiditis: A “Double-Edged Sword” in Thyroid Carcinoma
Authors: Xu Jiangyue , Ding Ke , Mu Lan , Huang Jiangsheng , Ye Fei , Peng Yu , Guo Can , Ren Chutong 
Published: February 2022

BackgroundThe prevalence of thyroid carcinoma (TC) and Hashimoto’s thyroiditis (HT) has been increasing dramatically over the past decades. We investigated the relationship between HT and TC.MethodsWe followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines for carrying out and reporting this meta-analysis. The literature from January 1, 2010 to December 31, 2020, regardless of region and publication type, was searched comprehensively in PubMed, Embase, Web of Science, and Cochrane Library databases. After careful selection and data extraction, the pooled odds ratio of various clinical characteristics in 39 studies were calculated. Publication bias was analyzed using funnel plots.ResultsMeta-analysis of 39 original research articles showed HT to be a risk factor of TC (pooled odds ratio = 1.71; 95% confidence interval, 1.57–1.80; p &lt; 0.00001) and papillary thyroid carcinoma (1.67, 1.51–1.85, &lt;0.00001). Patients with papillary thyroid carcinoma (PTC) combined with HT were more likely to have multifocal carcinomas. The prevalence of an extrathyroidal extension, metastasis, BRAFV600E mutation, and recurrence was significantly lower in patients with PTC combined with HT.ConclusionsHT is a “double-edged sword” in TC patients. HT increases the risk of TC and PTC but is a protective factor against PTC progression.
Efficacy and Safety of Empagliflozin on Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis
Authors: Zhang Yuyuan , Liu Xiaobo , Zhang Huazhu , Wang Xuechang 
Published: February 2022

ObjectiveClinical trials have recently shown a connection between nonalcoholic fatty liver disease (NAFLD) and empagliflozin. This paper aimed at comprehensively assessing the effectiveness and security of empagliflozin in NAFLD patients.MethodsPubMed, Embase, Web of Science, Cochrane Library, CNKI, CBM, Wan-Fang digital database, VIP, and WHO ICTRP were searched for randomized controlled trials (RCTs) on the role of empagliflozin in NAFLD from inception to November 2, 2021. For continuous dating, we used values of mean differences (MD) to present.ResultsA total of four articles involving 244 NAFLD patients were included. Compared with the control group, empagliflozin could significantly reduce the body mass index (BMI) (MD: −0.98 [95% CI: −1.87, −0.10], p = 0.03), liver stiffness measurement (LSM) (MD: 0.49 [95% CI: −0.93, −0.06], p = 0.03), aspartate aminotransferase (AST) (MD: −3.10 [95% CI: −6.18, −0.02], p = 0.05), homeostasis model assessment of insulin resistance (HOMA-IR) (MD: −0.45 [95% CI: −0.90, 0.00], p = 0.05) of the treatment group.ConclusionsEmpagliflozin can improve body composition, insulin resistance, and liver fibrosis and decrease the hepatic enzymes in patients with NAFLD. Empagliflozin emerges as a new option for treating patients with NAFLD. However, further research shall determine the efficacy and safety of empagliflozin in NAFLD.
Predicting Elevated TSH Levels in the Physical Examination Population With a Machine Learning Model
Authors: Cheng Xinqi , Li Shicheng , Deng Lizong , Luo Wei , Wang Dancheng , Cheng Jin , Ma Chaochao , Chen Luming , Jiang Taijiao , Qiu Ling , Zhang Guojun 
Published: February 2022

ObjectiveThe purpose of this study was to predict elevated TSH levels by developing an effective machine learning model based on large-scale physical examination results.MethodsSubjects who underwent general physical examinations from January 2015 to December 2019 were enrolled in this study. A total of 21 clinical parameters were analyzed, including six demographic parameters (sex, age, etc.) and 15 laboratory parameters (thyroid peroxidase antibody (TPO-Ab), thyroglobulin antibody (TG-Ab), etc.). The risk factors for elevated TSH levels in the univariate and multivariate Logistic analyses were used to construct machine learning models. Four machine learning models were trained to predict the outcome of elevated TSH levels one year/two years after patient enrollment, including decision tree (DT), linear regression (LR), eXtreme Gradient boosting (XGBoost), and support vector machine (SVM). Feature importance was calculated in the machine learning models to show which parameter plays a vital role in predicting elevated TSH levels.ResultsA total of 12,735 individuals were enrolled in this study. Univariate and multivariate Logistic regression analyses showed that elevated TSH levels were significantly correlated with gender, FT3/FT4, total cholesterol (TC), TPO-Ab, Tg-Ab, creatinine (Cr), and triglycerides (TG). Among the four machine learning models, XGBoost performed best in the one-year task of predicting elevated TSH levels (AUC (0.87(+/- 0.03))). The most critical feature in this model was FT3/FT4, followed by TPO-Ab and other clinical parameters. In the two-year task of predicting TSH levels, none of the four models performed well.ConclusionsIn this study, we trained an effective XGBoost model for predicting elevated TSH levels one year after patient enrollment. The measurement of FT3 and FT4 could provide an early warning of elevated TSH levels to prevent relative thyroid diseases.
Diabetes Epidemiology Among Adults in Port-au-Prince, Haiti: A Cross-Sectional Study
Authors: Sufra Rodney , Lookens Pierre Jean , Dade Eliezer , Rouzier Vanessa , Apollon Alexandra , St Preux Stephano , Préval Fabiola , Inddy Joseph , Metz Miranda , Tymejczyk Olga , Nash Denis , Malebranche Rodolphe , Deschamps Marie , Pape Jean W. , Goncalves Marcus D. , McNairy Margaret L. , Yan Lily D. 
Published: February 2022

IntroductionDiabetes mellitus is a chronic noncommunicable disease associated with death and major disability, with increasing prevalence in low- and middle-income countries. There is limited population-based data about diabetes in Haiti. The objective of this study was to assess the prevalence of diabetes and associated factors among adults in Port-au-Prince, Haiti using a population-based cohort.MethodsThis study analyzes cross-sectional enrollment data from the population-based Haiti Cardiovascular Disease Cohort Study, conducted using multistage sampling with global positioning system waypoints in census blocks in the metropolitan area of Port-au-Prince, Haiti. A total of 3,005 adults ≥18 years old were enrolled from March 2019 to August 2021. We collected socio-demographic data, health-related behaviors, and clinical data using standardized questionnaires. Diabetes was defined as any of the following criteria: enrollment fasting glucose value ≥ 126 mg/dL or non-fasting glucose ≥ 200 mg/dL, patient self-report of taking diabetes medications, or study physician diagnosis of diabetes based on clinical evaluation.ResultsAmong 2985 (99.3%) with complete diabetes data, median age was 40 years, 58.1% were female, and 17.2% were obese. The prevalence of diabetes was 5.4% crude, and 5.2% age standardized. In unadjusted analysis, older age, higher body mass index (BMI), low physical activity, low education were associated with a higher odds of diabetes. After multivariable logistic regression, older age [60+ vs 18-29, Odds Ratio (OR)17.7, 95% CI 6.6 to 47.9] and higher BMI (obese vs normal/underweight, OR 2.7, 95% CI 1.7 to 4.4) remained statistically significantly associated with higher odds of diabetes.ConclusionThe prevalence of diabetes was relatively low among adults in Port-au-Prince, but much higher among certain groups (participants who were older and obese). The Haitian health system should be strengthened to prevent, diagnose, and treat diabetes among high-risk groups.
Accurate Location of Catheter Tip With the Free-to-Total Metanephrine Ratio During Adrenal Vein Sampling
Authors: Christou Foteini , Pivin Edward , Denys Alban , Abid Karim A. , Zingg Tobias , Matter Maurice , Pechère-Bertschi Antoinette , Maillard Marc , Grouzmann Eric , Wuerzner Gregoire 
Published: February 2022

BackgroundThe selectivity index (SI) of cortisol is used to document correct catheter placement during adrenal vein sampling (AVS) in patients with primary aldosteronism (PA). We aimed to determine the cutoff values of the SIs based on cortisol, free metanephrine, and the free-to-total metanephrine ratio (FTMR) using an adapted AVS protocol in combination with CT.MethodsAdults with PA and referred for AVS were recruited in two hypertension centers. The cortisol and free metanephrine-derived SIs were calculated as the concentration of the analyte in adrenal veins divided by the concentration of the analyte in the distal vena cava. The FTMR-derived SI was calculated as the concentration of free metanephrine in the adrenal vein divided by that of total metanephrine in the ipsilateral adrenal vein. The AVS was classified as an unequivocal radiological success (uAVS) if the tip of the catheter was seen in the adrenal vein. The SI cutoffs of each index marker were established using receiver operating characteristic curve analysis.ResultsOut of 125 enrolled patients, 65 patients had an uAVS. The SI cutoffs were 2.6 for cortisol, 10.0 for free metanephrine, 0.31 for the FTMR on the left side, and 2.5, 9.9, and 0.25 on the right side. Compared to free metanephrine and the FTMR, cortisol misclassified AVS as unsuccessful in 36.6% and 39.0% of the cases, respectively.ConclusionThis study is the first to calculate the SIs of cortisol, free metanephrine, and the FTMR indices for the AVS procedure. It confirms that free metanephrine-based SIs are better than those based on cortisol.