bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiorenal Syndrome in COVID-19 Patients: A Systematic Review
Authors: Lin Ling , Chen Yangqin , Han Dongwan , Yang Andrew , Wang Amanda Y. , Qi Wenjie 
Published: June 2022

AimsTo perform a systematic review assessing the clinical manifestations and outcomes of cardiorenal syndrome or the presence of both cardiac and renal complications in the 2019 coronavirus disease (COVID-19) patients.MethodsAll relevant studies about cardiorenal syndrome or both cardiac and renal complications in COVID-19 patients were retrieved on PUBMED, MEDLINE, and EMBASE from December 1, 2019 to February 20, 2022.ResultsOur search identified 15 studies including 637 patients with a diagnosis of cardiorenal syndrome or evidence of both cardiac and renal complications followingSARS-CoV-2 infection. They were male predominant (66.2%, 422/637), with a mean age of 58 years old. Cardiac complications included myocardial injury (13 studies), heart failure (7 studies), arrhythmias (5 studies), or myocarditis and cardiomyopathy (2 studies). Renal complications manifested as acute kidney injury with or without oliguria. Patients with cardiorenal injury were often associated with significantly elevated levels of inflammatory markers (CRP, PCT, IL-6). Patients with a diagnosis of cardiorenal syndrome or evidence of both cardiac and renal complications had more severe disease and poorer prognosis (9 studies).ConclusionThe presence of either cardiorenal syndrome or concurrent cardiac and renal complications had a significant impact on the severity of the disease and the mortality rate among patients with COVID-19 infection. Therefore, careful assessment and management of potential cardiac and renal complications in patients with COVID-19 infection are important to improve their outcomes.
Incidence, Risk Factors, and Outcomes of Severe Hypoxemia After Cardiac Surgery
Authors: Wang Dashuai , Ding Xiangchao , Su Yunshu , Yang Peiwen , Du Xinling , Sun Manda , Huang Xiaofan , Yue Zhang , Sun Fuqiang , Xie Fei , Liu Chao 
Published: June 2022

BackgroundHypoxemia is common in patients undergoing cardiac surgery, however, few studies about severe hypoxemia (SH) after cardiac surgery exist. The objectives of this study were to clarify the incidence, risk factors, and outcomes of SH after cardiac surgery.MethodsPatients undergoing cardiac surgery from 2016 to 2019 in a single center were enrolled and were divided into two groups based on whether postoperative SH developed. Independent risk factors for SH were identified by univariate and multivariate analysis. Model selection statistics were applied to help determine the most parsimonious final model.ResultsSevere hypoxemia developed in 222 of the 5,323 included patients (4.2%), was associated with poorer clinical outcomes. Six independent risk factors for SH after cardiac surgery were identified by multivariate analysis, such as surgical types, white blood cell (WBC) count, body mass index (BMI), serum albumin, cardiopulmonary bypass (CPB) time, and intraoperative transfusion of red blood cells (RBCs). After comprehensively considering the discrimination, calibration, and simplicity, the most appropriate and parsimonious model was finally established using four predictors, such as WBC count, BMI, CPB time, and intraoperative transfusion of RBCs. A nomogram and a web-based risk calculator based on the final model were constructed to facilitate clinical practice. Patients were stratified into three risk groups based on the nomogram and clinical practice.ConclusionSevere hypoxemia was common after cardiac surgery and was associated with poorer clinical outcomes. A parsimonious final model with good discrimination, calibration, and clinical utility was constructed, which may be helpful for personalized risk assessment and targeted intervention.
Wind Gusts Associated with Tornado-Scale Vortices in the Tropical Cyclone Boundary Layer: A Numerical Simulation
Authors: Liu Qingyuan , Wu Liguang , Qin Nannan , Song Jinjie , Wei Na 
Published: June 2022

It has been demonstrated that the tornado-scale vortex (TSV) is one of the fine-scale structures associated with extreme updrafts in the tropical cyclone boundary layer (TCBL), but the relationship between surface wind gusts and TSVs is still unclear. In this study, the one-second model output simulated in the Weather Research and Forecast (WRF) model with the large eddy simulation (WRF-LES) is used to investigate the relationships between TSVs and surface wind gusts. Results show that surface wind gust factors in the regions where TSVs are prevalent are significantly larger than those in other regions. 88% of the maximum gust factors associated with TSVs (vertical velocity larger than 20 m s−1) are larger than 1.25 (gust factors larger than 1.25 account for only 1% of the 1-min gust factors in the TC inner core), and the mean maximum 1-min gust factor associated with a TSV is larger than 1.3, while the mean 1-min gust factor in the TC inner core is only 1.1. The surface gust factors associated with TSVs in tropical cyclone eyewall can reach about 1.8, which can cause severe surface wind hazards. This study suggests that potential risk will increase in the regions where TSVs are prevalent because of the large wind gusts and gust factors. Finer real-time observations are needed to monitor the evolution of TSVs for improving the operational TC-related surface gust warnings.
A New MAMLD1 Variant in an Infant With Microphallus and Hypospadias With Hormonal Pattern Suggesting Partial Hypogonadotropic Hypogonadism—Case Report
Authors: Yeste Diego , Aguilar-Riera Cristina , Canestrino Gennaro , Fernández-Alvarez Paula , Clemente María , Camats-Tarruella Núria 
Published: June 2022

MAMLD1 (X chromosome) is one of the recognized genes related to different sex development. It is expressed in testis and ovaries and seems to be involved in fetal sex development and in adult reproductive function, including testosterone biosynthesis. However, its exact role remains unclear. Over 40 genetic variants have been described, mainly in male individuals and mostly associated with hypospadias. Although MAMLD1 has been shown to regulate the expression of the steroidogenic pathway, patients with MAMLD1 variants mostly show normal gonadal function and normal testosterone levels. Here we describe a patient (46,XY) with hypospadias and microphallus, with low testosterone and dihydrotestosterone (DHT) levels, and with inappropriately low values of luteinizing hormone (LH) during minipuberty. This hormonal pattern was suggestive of partial hypogonadotropic hypogonadism. A stimulation test with hCG (4 months) showed no significant increase in both testosterone and dihydrotestosterone concentrations. At 5 months of age, he was treated with intramuscular testosterone, and the penis length increased to 3.5 cm. The treatment was stopped at 6 months of age. Our gonadal function massive-sequencing panel detected a previously unreported nonsense variant in the MAMLD1 gene (c.1738C&gt;T:p.Gln580Ter), which was classified as pathogenic. This MAMLD1 variant, predicting a truncated protein, could explain his genital phenotype. His hormonal profile (low testosterone, dihydrotestosterone, and LH concentrations) together with no significant increase of testosterone and DHT plasma concentrations (hCG test) highlight the potential role of this gene in the biosynthesis of testosterone during the fetal stage and minipuberty of the infant. Besides this, the LH values may suggest an involvement of MAMLD1 in the LH axis or a possible oligogenesis. It is the first time that a decrease in DHT has been described in a patient with an abnormal MAMLD1.
The Relationship Between Pre-Operative Glycosylated Haemoglobin and Opioid Consumption After Caesarean Section in Women With Gestational Diabetes Mellitus
Authors: Yang Chen , Li Yue , Hu Jianying , Wu Jiangnan , Huang Shaoqiang 
Published: June 2022

IntroductionWomen with Gestational diabetes mellitus (GDM) had a higher need and consumption of analgesics than women without GDM. The preoperative level of HbA1c was associated with the postoperative consumption for analgesics in diabetic patients. This prospective observational study go further to investigate the relationship between the pre-operative HbA1c and the post-operative consumption for analgesics in women with GDM.MethodsWomen with GDM and a singleton pregnancy undergoing elective cesarean section under combined spinal-epidural anaesthesia were divided into two groups based on pre-operative HbA1c: group HbA1c &lt; 6% and group HbA1c ≥ 6%. Analgesics consumption, number of patient-controlled analgesia (PCA) compression, and pain scores in 6 hours and 24 hours post-operation were compared between the two groups. Then Pearson’s correlation coefficient and a stepwise multivariate linear regression were performed to investigate possible independentpredictors of post-operative 24-hour sufentanil consumption.ResultsAnalgesics consumption was significantly lower (18.8 ± 0.4 vs 23.2 ± 4.3; 82.7 ± 2.4 vs 115.8 ± 17.4, P &lt; 0.001), and number of PCA compressions was significantly less frequent (1 [1-2] vs 3 [1-5]; 5 [3-7] vs 7 [3-15], P &lt; 0.001), and in group HbA1c &lt; 6% than in group HbA1c ≥ 6% in 6 hours and 24 hours post-operation.The univariate analysis showed that sufentanil consumption at 24 hours post-operation was significantly related to pre-operative HbA1c (r = 0.338, P &lt; 0.001) and parity (r = 0.184, P = 0.03) and was related to blood glucose management methods (r = 0.172, P = 0.043). Multivariate linear regression analysis showed that HbA1c was the independent factor related to post-operative 24-hour sufentanil consumption (adjusted r2 = 0.246, P &lt; 0.001)ConclusionsThis study demonstrated that in pregnant women with GDM, the pre-operative HbA1c is independently related to the need for and consumption of analgesics in 24 hours after CS.
Nomogram for Quantitatively Estimating the Risk of Fibrosis Progression in Type 2 Diabetic Patients With Nonalcoholic Fatty Liver Disease: A Pilot Study
Authors: Xia Jinying , Jin Guang , Hua Qifeng , Cui Shihan , Li Jianhui 
Published: June 2022

BackgroundCorrect identification of the fibrosis progression risk is a critical step in the management of patients with type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease (NAFLD), because liver fibrosis, especially advanced liver fibrosis, is difficult to reverse. However, the progression of liver fibrosis is typically unnoticeable, leading to many patients failing to adhere to long-term therapeutic interventions. Reliable clinical tools for the quantification of the fibrosis progression risk may have effects on following long-term therapeutic recommendations to avoid further liver injury.ObjectiveThis study aims to develop a nomogram for quantitatively estimating the risk of fibrosis progression in T2DM patients with NAFLD during lifestyle intervention.MethodsA total of 432 medical records of T2DM patients with NAFLD were retrospectively analyzed in this study. We divided patients into the progression and no-progression groups according to whether the value of liver stiffness measurement (LSM) increased by &gt; 2 kPa at the last visit. The independent factors associated with the fibrosis progression, which were screened by univariate and multivariate Logistic regression, constituted the nomogram to determine the likelihood of fibrosis progression in T2DM patients with NAFLD.ResultsSixty-five of the 432 individuals (15%) were found to have fibrosis progression. Changes in body mass index [odds ratio (OR) = 1.586], glycosylated hemoglobin A1c (OR = 6.636), alanine aminotransferase (OR = 1.052), and platelet counts (OR = 0.908) were independently associated with fibrosis progression (all P &lt; 0.05) and functioned as components of the newly developed nomogram. It showed satisfied discrimination and calibration after 1,000 bootstrapping. The DCA indicated that the nomogram yielded clinical net benefit when the threshold probability was &lt; 0.8.ConclusionWe developed a nomogram incorporating dynamic alterations in clinical features to estimate the risk of fibrosis progression in T2DM patients with NAFLD, which aids the patients’ compliance with long-term life interventions while allowing for prompt intervention adjustments.
A Comparison Between Omicron and Earlier COVID-19 Variants' Disease Severity in the Milan Area, Italy
Authors: Consolazio David , Murtas Rossella , Tunesi Sara , Lamberti Anna , Senatore Sabrina , Faccini Marino , Russo Antonio Giampiero 
Published: June 2022

BackgroundIn the context of the fourth wave of the COVID-19 pandemic in Italy, which occurred in correspondence with the outbreak of the Omicron variant, it became fundamental to assess differences in the risk of severe disease between the Omicron variant and the earlier SARS-CoV-2 variants that were still in circulation despite Omicron becoming prevalent.MethodsWe collected data on 2,267 genotyped PCR-positive swab tests and assessed whether the presence of symptoms, risk of hospitalization, and recovery times were significantly different between Omicron and the earlier variants. Multivariable models adjusted for sex, age class, citizenship, comorbidities, and symptomatology allowed assessing the difference in outcomes between Omicron and the earlier variants according to vaccination status and timing of administration.ResultsCompared to the earlier variants in the same period, Omicron was less symptomatic, resulted in fewer hospital admissions for those who were unvaccinated and for those who were already immunized after the booster dose, and was associated with quicker recovery, yet not in subjects with three vaccination doses.ConclusionDespite being milder, Omicron's higher transmissibility and vaccine resistance should not lead to underrating its damage potential, especially with regard to hospital and health service saturation.
In silico Analysis of Peptide-Based Biomarkers for the Diagnosis and Prevention of Latent Tuberculosis Infection
Authors: Cheng Peng , Wang Liang , Gong Wenping 
Published: June 2022

BackgroundLatent tuberculosis infection (LTBI) is the primary source of active tuberculosis (ATB), but there are no specific methods for diagnosing and preventing LTBI.MethodsDominant T and B cell epitopes predicted from five antigens related to LTBI and Mycobacterium tuberculosis region of difference (LTBI-RD) were used to construct a novel polypeptide molecule (PPM). Then, the physicochemical properties, secondary structure, tertiary structure of the PPM, and its binding ability to toll-like receptor 2 (TLR2) and TLR4 were analyzed by bioinformatics tools. Finally, immune stimulation and expression optimization of the PPM were carried out.ResultsFour helper T lymphocytes (HTL) epitopes, five cytotoxic T lymphocytes (CTL) epitopes, and three B cell epitopes were predicted and screened from five LTBI-RD related antigens. These epitopes were connected in series with linkers and adjuvants to construct a novel PPM termed C543P. The results indicated that antigenicity and immunogenicity scores of the C543P candidate were 0.936399 and 1.36469, respectively. The structural analysis results showed that the C543P candidate had good stability. Its secondary structure contained 43.6% α-helix, the Z-score after tertiary structure optimization was −7.9, and the Ramachandran diagram showed that 88.77% amino acid residues of the C543P candidate were in the allowable region. Furthermore, the C543P candidate showed an excellent affinity to TLR2 (−1091.7kcal/mol) and TLR4 (−1102.7kcal/mol). In addition, we also analyzed the immunological characteristics of the C543P candidate. Immune stimulation prediction showed that the C543P candidate could effectively activate T and B lymphocytes and produce high levels of Th1 cytokines such as IFN-γ and IL-2.ConclusionWe constructed a novel PPM with acceptable antigenicity, immunogenicity, stability, and ability to induce robust immune responses. This study provides a new diagnostic biomarker or peptides-based vaccine for LTBI diagnosis and prevention.
An Overview of the Protein Binding of Cephalosporins in Human Body Fluids: A Systematic Review
Authors: Jongmans C. , Muller A. E. , Van Den Broek P. , Cruz De Almeida B. De Melo , Van Den Berg C. , Van Oldenrijk J. , Bos P. K. , Koch B. C. P. 
Published: June 2022

Introduction: Protein binding can diminish the pharmacological effect of beta-lactam antibiotics. Only the free fraction has an antibacterial effect. The aim of this systematic literature review was to give an overview of the current knowledge of protein binding of cephalosporins in human body fluids as well as to describe patient characteristics influencing the level of protein binding.Method: A systematic literature search was performed in Embase, Medline ALL, Web of Science Core Collection and the Cochrane Central Register of Controlled Trials with the following search terms: “protein binding,” “beta-lactam antibiotic,” and “body fluid.” Only studies were included where protein binding was measured in humans in vivo.Results: The majority of studies reporting protein binding were performed in serum or plasma. Other fluids included pericardial fluid, blister fluid, bronchial secretion, pleural exudate, wound exudate, cerebrospinal fluid, dialysate, and peritoneal fluid. Protein binding differs between diverse cephalosporins and between different patient categories. For cefazolin, ceftriaxone, cefpiramide, and cefonicid a non-linear pattern in protein binding in serum or plasma was described. Several patient characteristics were associated with low serum albumin concentrations and were found to have lower protein binding compared to healthy volunteers. This was for critically ill patients, dialysis patients, and patients undergoing cardiopulmonary bypass during surgery. While mean/median percentages of protein binding are lower in these patient groups, individual values may vary considerably. Age is not likely to influence protein binding by itself, however limited data suggest that lower protein binding in newborns. Obesity was not correlated with altered protein binding.Discussion/Conclusion: Conclusions on protein binding in other body fluids than blood cannot be drawn due to the scarcity of data. In serum and plasma, there is a large variability in protein binding per cephalosporin and between different categories of patients. Several characteristics were identified which lead to a lower protein binding. The finding that some of the cephalosporins display a non-linear pattern of protein binding makes it even more difficult to predict the unbound concentrations in individual patients. Taken all these factors, it is recommended to measure unbound concentrations to optimize antibiotic exposure in individual patients.Systematic Review Registration: PROSPERO, identifier (CRD42021252776).
Efficacy of Online Intervention for ADHD: A Meta-Analysis and Systematic Review
Authors: Shou Songting , Xiu Shengyao , Li Yuanliang , Zhang Ning , Yu Jinglong , Ding Jie , Wang Junhong 
Published: June 2022

BackgroundWith the popularity of computers, the internet, and the global spread of COVID-19, more and more attention deficit hyperactivity disorder (ADHD) patients need timely interventions through the internet. At present, there are many online intervention schemes may help these patients. It is necessary to integrate data to analyze their effectiveness.ObjectivesOur purpose is to integrate the ADHD online interventions trials, study its treatment effect and analyze its feasibility, and provide reference information for doctors in other institutions to formulate better treatment plans.MethodsWe searched PubMed, EMBASE and Cochrane libraries. We didn't limit the start date and end date of search results. Our last search was on December 1, 2021. The keyword is ADHD online therapy. We used the Cochrane bias risk tool to assess the quality of included studies, used the standardized mean difference (SMD) as an effect scale indicator to measure data. Random effects model, subgroup analysis were used to analyze the data.ResultsSix randomized controlled trials (RCTs) were identified, including 261 patients with ADHD. These studies showed that online interventions was more effective than waiting list in improving attention deficit and social function of adults and children with ADHD. The attention deficit scores of subjects were calculated in six studies. The sample size of the test group was 123, the sample size of the control group was 133, and the combined SMD was −0.73 (95% confidence interval: −1.01, −0.44). The social function scores of subjects were calculated in six studies. The sample size of the experimental group was 123 and the control group was 133. The combined SMD was −0.59 (95% confidence interval: −0.85, −0.33).ConclusionsThe results show that online interventions of ADHD may be an effective intervention. In the future, we need more online intervention researches to improve the symptoms of different patients, especially for some patients who have difficulties in accepting face-to-face treatment.
Single-Item Happiness Measure Features Adequate Validity Among Adolescents
Authors: Lukoševičiūtė Justė , Gariepy Geneviève , Mabelis Judith , Gaspar Tania , Joffė-Luinienė Roza , Šmigelskas Kastytis 
Published: June 2022

BackgroundHappiness is becoming increasingly relevant in recent research, including adolescents. Many studies are using the single-item measure for adolescent happiness, however, its validity is not well known. We aimed to examine the validity of this measure among adolescents in three countries from distinct European regions – Eastern (Lithuania), Southern (Portugal), and Western (Scotland).Materials and MethodsThe analysis included data from Health Behaviour in School-aged Children (HBSC) study from three countries and three last surveys (2009/10, 2013/14, and 2017/18). The total sample comprised 47,439 schoolchildren. For validity, the indicators reflecting subjective health, life satisfaction, quality of life, well-being, social support, health complaints, bullying, and self-directed violence were assessed. The calculations were conducted in the total sample and by gender, age, survey year, and country.ResultsThe different indicators of concurrent and convergent validity revealed consistent correlations with happiness, with better well-being, health, and subjective perceptions being related to higher happiness. Meanwhile, health complaints, bullying behaviors, and self-directed violence were related to lower happiness. The subgroup differences were consistent across gender, age groups, countries, and survey rounds. The extent of differences was more expressed among girls.ConclusionThe single item for adolescent happiness measurement features a consistent pattern of validity concerning indicators of concurrent and convergent validity. Higher self-reported happiness is associated with better mental and physical health and well-being, and less expressed negative factors (complaints, bullying, and self-directed violence). In addition, among girls the correlations tend to be stronger than boys.