bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Change in Platelet Count and MPV Levels of Patients Who Received Hemodialysis for the First Time: Mogadishu Somalia Experience
Authors: Sari Oznur , Bashir Ahmed Muhammad 
Published: June 2022

Introduction. Mean platelet volume (MPV) is a marker used to assess the platelet’ size and is also an indicator of platelet reactivity and prothrombotic status. Objective. In this study, we aimed to determine the relationship between MPV and biochemical parameters in patients who had received hemodialysis (HD) for the first time and then in respect of those same patients after their fourth HD. Method. 151 HD patients were enrolled in this study. Patients were eligible for inclusion if they had received their first HD session during this study protocol. Prehemodialysis blood samples were taken. Most laboratory values, including mean platelet volume (MPV) level and platelets (PLT) count, were measured before the first HD and after the fourth HD session for each patient. Results. Among the patients in our study, the mean age profile of the male patients (n = 103; 68.2%) was found to be higher than that of the female patients (n = 48; 31.8%) (53.62 ± 18.19 vs. 46.17 ± 17.9 years) (

p

= 0.019).In the patients’ laboratory results after the fourth HD session, MPV, MPV/Plt, and Na values had increased to those after the first HD session (

p

< 0.001). When age and gender status were taken into account, the level of weak positive correlation with white blood cell count (WBC), neutrophil, and red cell distribution width (RDW) was found, while the weak negative correlation with platelet to lymphocyte ratio (PLR) was found (

p

< 0.001). Conclusions. In our study, we found that increase in MPV and MPV/PLT levels was significant in the fourth HD session of patients with CKD. It is also debatable that there are findings indicating an increase in platelet reactivity in the first weeks of the onset of HD. This could be an early indicator of the early prevention of cardiovascular diseases.
Desafíos de la educación en enfermería en pandemia: percepción y experiencia de los estudiantes de enfermería sobre la incorporación de la simulación virtual
Authors: Soto Paula , Muñoz Serrano Mónica , González Montero Daniela , Vergara Arias Karen 
Published: June 2022

Introducción: en el contexto de la pandemia mundial por COVID-19 se incorporan nuevas metodologías de enseñanza-aprendizaje para contribuir al logro de los objetivos de aprendizaje frente al cierre de las universidades y de los campos clínicos. Esta investigación evalúa la percepción y la experiencia de los estudiantes de tercer y cuarto año de pregrado de enfermería, frente al uso de escenarios de simulación virtual como complemento de la práctica clínica. Materiales y métodos: un total de 68 estudiantes (26%) respondieron la encuesta de percepción sobre su experiencia del uso de la simulación virtual a través del software vSim for Nursing™. Se realizó un análisis cuantitativo y cualitativo de los datos. Resultados: un 89,7% de los estudiantes consideraron que la simulación virtual es útil para el aprendizaje y que contribuye principalmente para la comprensión de los contenidos y desarrollo de las habilidades de valoración clínica.
Discusión: la experiencia en la simulación virtual es realista y útil tanto para aprender nuevos conocimientos, para reforzar los saberes previos y así también como una buena preparación para la práctica clínica. Se visualiza su incorporación desde el inicio al término de la carrera. Sin embargo, para áreas como salud mental otras metodologías podrían ser más adecuadas para mejorar las habilidades de comunicación.
Coordinated Transcriptional and Catabolic Programs Support Iron-Dependent Adaptation to RAS–MAPK Pathway Inhibition in Pancreatic Cancer
Authors: Ravichandran Mirunalini , Hu Jingjie , Cai Charles , Ward Nathan P. , Venida Anthony , Foakes Callum , Kuljanin Miljan , Yang Annan , Hennessey Connor J. , Yang Yang , Desousa Brandon R. , Rademaker Gilles , Staes Annelot A.L. , Cakir Zeynep , Jain Isha H. , Aguirre Andrew J. , Mancias Joseph D. , Shen Yin , DeNicola Gina M. , Perera Rushika M. 
Published: June 2022

Abstract

The mechanisms underlying metabolic adaptation of pancreatic ductal adenocarcinoma (PDA) cells to pharmacologic inhibition of RAS–MAPK signaling are largely unknown. Using transcriptome and chromatin immunoprecipitation profiling of PDA cells treated with the MEK inhibitor (MEKi) trametinib, we identify transcriptional antagonism between c-MYC and the master transcription factors for lysosome gene expression, the MiT/TFE proteins. Under baseline conditions, c-MYC and MiT/TFE factors compete for binding to lysosome gene promoters to fine-tune gene expression. Treatment of PDA cells or patient organoids with MEKi leads to c-MYC downregulation and increased MiT/TFE-dependent lysosome biogenesis. Quantitative proteomics of immunopurified lysosomes uncovered reliance on ferritinophagy, the selective degradation of the iron storage complex ferritin, in MEKi-treated cells. Ferritinophagy promotes mitochondrial iron–sulfur cluster protein synthesis and enhanced mitochondrial respiration. Accordingly, suppressing iron utilization sensitizes PDA cells to MEKi, highlighting a critical and targetable reliance on lysosome-dependent iron supply during adaptation to KRAS–MAPK inhibition.

Significance:
Reduced c-MYC levels following MAPK pathway suppression facilitate the upregulation of autophagy and lysosome biogenesis. Increased autophagy–lysosome activity is required for increased ferritinophagy-mediated iron supply, which supports mitochondrial respiration under therapy stress. Disruption of ferritinophagy synergizes with KRAS–MAPK inhibition and blocks PDA growth, thus highlighting a key targetable metabolic dependency.
See related commentary by Jain and Amaravadi, p. 2023.
See related article by Santana-Codina et al., p. 2180.
This article is highlighted in the In This Issue feature, p. 2007
Evolving Mural Defects, Dilatation, and Biomechanical Dysfunction in Angiotensin II–Induced Thoracic Aortopathies
Authors: Weiss Dar , Long Aaron S. , Tellides George , Avril Stéphane , Humphrey Jay D. , Bersi Matthew R. 
Published: June 2022

Background:
Thoracic aortopathy associates with extracellular matrix remodeling and altered biomechanical properties. We sought to quantify the natural history of thoracic aortopathy in a common mouse model and to correlate measures of wall remodeling such as aortic dilatation or localized mural defects with evolving microstructural composition and biomechanical properties of the wall.

Methods:
We combined a high-resolution multimodality imaging approach (panoramic digital image correlation and optical coherence tomography) with histopathologic examinations and biaxial mechanical testing to correlate spatially, for the first time, macroscopic mural defects and medial degeneration within the ascending aorta with local changes in aortic wall composition and mechanical properties.

Results:
Findings revealed strong correlations between local decreases in elastic energy storage and increases in circumferential material stiffness with increasing proximal aortic diameter and especially mural defect size. Mural defects tended to exhibit a pronounced biomechanical dysfunction that is driven by an altered organization of collagen and elastic fibers.

Conclusions:
While aneurysmal dilatation is often observed within particular segments of the aorta, dissection and rupture initiate as highly localized mechanical failures. We show that wall composition and material properties are compromised in regions of local mural defects, which further increases the dilatation and overall structural vulnerability of the wall. Identification of therapies focused on promoting robust collagen accumulation may protect the wall from these vulnerabilities and limit the incidence of dissection and rupture.
Serum L-Carnitine Levels Are Associated With First Stroke in Chinese Adults With Hypertension
Authors: Zhou Ziyi , Zhang Nan , Song Yun , Liu Lishun , Li Jianping , Zhang Yan , Huo Yong , Liu Xiangyi , Duan Yong , Wang Binyan , Zhang Hao , Guo Huiyuan , Qin Xianhui , Wang Xiaobin , Xu Xiping 
Published: June 2022

Background:
This study aimed to evaluate the association of serum L-carnitine with first stroke and explore potential effect modifiers.

Methods:
This is a nested, case-control study drawn from the China Stroke Primary Prevention Trial among rural Chinese adults with hypertension, including 557 first stroke cases and 557 age-matched, sex-matched, treatment group–matched, and residence-matched controls. Serum L-carnitine was measured by liquid chromatography with tandem quadrupole mass spectrometry. Multiple conditional logistic regression models were used to evaluate the association between L-carnitine and first stroke.

Results:

The mean level of serum L-carnitine in the stroke population was 4.7 μg/mL, which was significantly lower than that of the control group (5.7 μg/mL). When L-carnitine was assessed as quintiles, compared with the reference group (quintile 1, <3.3 μg/mL), the odds of stroke were 0.62 (95% CI, 0.39–1.00) in quintile 2, 0.66 (95% CI, 0.40–1.10) in quintile 3, 0.47 (95% CI, 0.28–0.81) in quintile 4, and 0.50 (95% CI, 0.30–0.84) in quintile 5. The trend test was significant (
P
=0.01). When quintiles 2 to 5 were combined, the adjusted odds ratio of first stroke was 0.58 (95% CI, 0.38–0.87) compared with quintile 1. Similar associations were found for ischemic stroke and hemorrhagic stroke. In subgroup analysis, a significant L-carnitine–stroke association was only observed in the normal folate group (
P
interaction, 0.039) and in the
MTHFR
CC genotype group (
P
interaction, 0.047).

Conclusions:

In this study of rural Chinese adults with hypertension, serum L-carnitine had an inverse but nonlinear association with first stroke. Folate status and the
MTHFR
C677T variant were significant effect modifiers of the association.
Single-Cell Transcriptome Analysis of the Circle of Willis in a Mouse Cerebral Aneurysm Model
Authors: Martinez Alejandra N. , Tortelote Giovane G. , Pascale Crissey L. , McCormack Isabella G. , Nordham Kristen D. , Suder Natalie J. , Couldwell Mitchell W. , Dumont Aaron S. 
Published: June 2022

Background:
The circle of Willis (CoW) is the most common location for aneurysms to form in humans. Although the major cell types of the intracranial vasculature are well known, the heterogeneity and relative contributions of the different cells in healthy and aneurysmal vessels have not been well characterized. Here, we present the first comprehensive analysis of the lineage heterogeneity and altered transcriptomic profiles of vascular cells from healthy and aneurysmal mouse CoW using single-cell RNA sequencing.

Methods:
Cerebral aneurysms (CAs) were induced in adult male mice using an elastase model. Single-cell RNA sequencing was then performed on CoW samples obtained from animals that either had aneurysms form or rupture 14 days post-induction. Sham-operated animals served as controls.

Results:
Unbiased clustering analysis of the transcriptional profiles from >3900 CoW cells identified 19 clusters representing ten cell lineages: vascular smooth muscle cells, endothelial cells fibroblasts, pericytes and immune cells (macrophages, T and B lymphocytes, dendritic cells, mast cells, and neutrophils). The 5 vascular smooth muscle cell subpopulations had distinct transcriptional profiles and were classified as proliferative, stress-induced senescent, quiescent, inflammatory-like, or hyperproliferative. The transcriptional signature of the metabolic pathways of ATP generation was found to be downregulated in 2 major vascular smooth muscle cell clusters when CA was induced. Aneurysm induction led to significant expansion of the total macrophage population, and this expansion was further increased with rupture. Both inflammatory and resolution-phase macrophages were identified, and a massive spike of neutrophils was seen with CA rupture. Additionally, the neutrophil-to-lymphocyte ratio (NLR), which originated from CA induction mirrored what happens in humans.

Conclusions:
Our data identify CA disease-relevant transcriptional signatures of vascular cells in the CoW and is searchable via a web-based R/shiny interface.
Assessing (and Making Sense of) Severity
Authors: Cakal Ergun 
Published: June 2022

Abstract
The element of severity remains core to the definition and interpretation of torture under international law. It has long represented a source of confusion and obfuscation for the legally-oriented anti-torture professional, whether academic, advocate or adjudicator. Its character as decisive differentiator, setting torture apart from cruelty, inhumanity and degradation, remains problematically entrenched and contested. It is a legal construct not finding its origins in the scholarship on pain, and evades precise measurement – as pain is socio-culturally constructed, relative and subjective. Accepting the prevailing complexity and addressing the perennial ambiguity, this article aims to offer some clarifications towards conceptualising and contextualising, and thereby better specifying and applying, torture’s core.
Skill of Medium-Range Forecast Models Using the Same Initial Conditions
Authors: Magnusson L. , Ackerley D. , Bouteloup Y. , Chen J.-H. , Doyle J. , Earnshaw P. , Kwon Y. C. , Köhler M. , Lang S. T. K , Lim Y.-J. , Matsueda M. , Matsunobu T. , McTaggart-Cowan R. , Reinecke A. , Yamaguchi M. , Zhou L. 
Published: June 2022

Abstract
In the Different Models, Same Initial Conditions (DIMOSIC) project, forecasts from different global medium-range forecast models have been created based on the same initial conditions. The dataset consists of 10-day deterministic forecasts from seven models and includes 122 forecast dates spanning one calendar year. All forecasts are initialized from the same ECMWF operational analyses to minimize the differences due to initialization. The models are run at or near their respective operational resolutions to explore similarities and differences between operational global forecast models. The main aims of this study are 1) to evaluate the forecast skill and how it depends on model formulation, 2) to assess systematic differences and errors at short lead times, 3) to compare multimodel ensemble spread to model uncertainty schemes, and 4) to identify models that generate similar solutions. Our results show that all models in this study are capable of producing high-quality forecasts given a high-quality analysis. But at the same time, we find a large variety in model biases, both in terms of temperature errors and precipitation. We are able to identify models whose forecasts are more similar to each other than they are to those of other systems, due to the use of similar model physics packages. However, in terms of multimodel ensemble spread, our results also demonstrate that forecast sensitivities to different model formulations still are substantial. We therefore believe that the diversity in model design that stems from parallel development efforts at global modeling centers around the world remains valuable for future progress in the numerical weather prediction community.
Modeled Interannual Variability of Arctic Sea Ice Cover is within Observational Uncertainty
Authors: Wyburn-Powell Christopher , Jahn Alexandra , R. England Mark 
Published: June 2022

Abstract
Internal variability is the dominant cause of projection uncertainty of Arctic sea ice in the short and medium term. However, it is difficult to determine the realism of simulated internal variability in climate models, as observations only provide one possible realization while climate models can provide numerous different realizations. To enable a robust assessment of simulated internal variability of Arctic sea ice, we use a resampling technique to build synthetic ensembles for both observations and climate models, focusing on interannual variability, which is the dominant time scale of Arctic sea ice internal variability. We assess the realism of the interannual variability of Arctic sea ice cover as simulated by six models from phase 5 of the Coupled Model Intercomparison Project (CMIP5) that provide large ensembles compared to four observational datasets. We augment the standard definition of model and observational consistency by representing the full distribution of resamplings, analogous to the distribution of variability that could have randomly occurred. We find that modeled interannual variability typically lies within observational uncertainty. The three models with the smallest mean state biases are the only ones consistent in the pan-Arctic for all months, but no model is consistent for all regions and seasons. Hence, choosing the right model for a given task as well as using internal variability as an additional metric to assess sea ice simulations is important. The fact that CMIP5 large ensembles broadly simulate interannual variability consistent within observational uncertainty gives confidence in the internal projection uncertainty for Arctic sea ice based on these models.

Significance Statement
The purpose of this study is to evaluate the historical simulated internal variability of Arctic sea ice in climate models. Determining model realism is important to have confidence in the projected sea ice evolution from these models, but so far only mean state and trends are commonly assessed metrics. Here we assess internal variability with a focus on the interannual variability, which is the dominant time scale for internal variability. We find that, in general, models agree well with observations, but as no model is within observational uncertainty for all months and locations, choosing the right model for a given task is crucial. Further refinement of internal variability realism assessments will require reduced observational uncertainty.
Reducing Emergency Department Length of Stay in Critically Injured Pediatric Trauma Patients: A Quality Improvement Initiative
Authors: Castle Jennifer T. , Levy Brittany E. , Wilt Wesley S. , Draus John M. 
Published: June 2022

Background Efficient transfer of adult trauma patients to the intensive care unit (ICU) is associated with decreased emergency department (ED) length of stay (ED LOS) and improved patient outcomes. While well studied in adults, quality improvement (QI) initiatives focused on the rapid transfer of pediatric trauma patients are lacking. We report the effect of institutional system changes directed at expediting the transfer of pediatric trauma patients to the pediatric ICU (PICU). Methods This initiative commenced in 2013. Preliminary data regarding ED LOS for pediatric trauma patients were collected from January through December 2012 as the pre-implementation cohort. Using the plan-do-study-act (PDSA) framework of QI, the first PDSA cycle was implemented in January 2013. In subsequent PDSA cycles, we implemented the mandatory attendance of the PICU charge nurse and the PICU attending physician to all highest-level pediatric trauma activations. Throughout, ED LOS was collected and mapped on a run chart. ED LOS and variance were compared between all cycles of implementation. Results One hundred and fifty-one pediatric patients arrived or were upgraded to the highest-level pediatric trauma activation and admitted to the PICU from 2012 through 2019. We observed a decrease in median ED LOS of 105 minutes between the pre- and post-implementation groups. With each PDSA cycle, we observed a decrease in median ED LOS and variation. Conclusion The inclusion of the PICU charge nurse and attending physician at highest-level pediatric trauma activations facilitated more rapid access to the PICU with decreased ED LOS.
Predictors of respiratory failure after thoracic surgery: a retrospective cohort study with comparison between lobar and sub-lobar resection
Authors: Pezzuto Aldo , Trabalza Marinucci Beatrice , Ricci Alberto , Ciccozzi Massimo , Tonini Giuseppe , D’Ascanio Michela , Guerrieri Giulio , Chianese Maria , Castelli Silvia , Rendina Erino Angelo 
Published: June 2022

Objective Only approximately 15% of patients with lung cancer are suitable for surgery and clinical postoperative outcomes vary. The aim of this study was to investigate variables associated with post-surgery respiratory failure in this patient cohort. Methods Patients who underwent surgery for lung cancer were retrospectively studied for respiratory function. All patients had undergone lung resection by a mini-thoracotomy approach. The study population was divided into two subgroups for comparison: lobectomy group, who underwent lobar resection; and sub-lobar resection group. Results A total of 85 patients were included, with a prevalence of lung cancer stage IA and adenocarcinoma histotype. Lobectomy (versus sub-lobar resection), the presence of chronic obstructive pulmonary disease (COPD), and a COPD assessment test (CAT) score >10, were all associated with an increased risk of respiratory failure. The partial pressure of arterial oxygen decreased more in the lobectomy group than in the sub-lobar resection group following surgery, with a significant postoperative between-group difference in values. Postoperative CAT scores were also better in the sub-lobar resection group. Conclusions Post-surgical variations in functional parameters were greater in the group treated by lobectomy. COPD, high CAT score and surgery type were associated with postoperative development of respiratory failure.
Radiomic Features Based on MRI Predict Progression-Free Survival in Pediatric Diffuse Midline Glioma/Diffuse Intrinsic Pontine Glioma
Authors: Wagner Matthias W. , Namdar Khashayar , Napoleone Marc , Hainc Nicolin , Amirabadi Afsaneh , Fonseca Adriana , Laughlin Suzanne , Shroff Manohar M. , Bouffet Eric , Hawkins Cynthia , Khalvati Farzad , Bartels Ute , Ertl-Wagner Birgit B. 
Published: June 2022

Purpose: Biopsy-based assessment of H3 K27 M status helps in predicting survival, but biopsy is usually limited to unusual presentations and clinical trials. We aimed to evaluate whether radiomics can serve as prognostic marker to stratify diffuse intrinsic pontine glioma (DIPG) subsets. Methods: In this retrospective study, diagnostic brain MRIs of children with DIPG were analyzed. Radiomic features were extracted from tumor segmentations and data were split into training/testing sets (80:20). A conditional survival forest model was applied to predict progression-free survival (PFS) using training data. The trained model was validated on the test data, and concordances were calculated for PFS. Experiments were repeated 100 times using randomized versions of the respective percentage of the training/test data. Results: A total of 89 patients were identified (48 females, 53.9%). Median age at time of diagnosis was 6.64 years (range: 1–16.9 years) and median PFS was 8 months (range: 1–84 months). Molecular data were available for 26 patients (29.2%) (1 wild type, 3 K27M-H3.1, 22 K27M-H3.3). Radiomic features of FLAIR and nonenhanced T1-weighted sequences were predictive of PFS. The best FLAIR radiomics model yielded a concordance of .87 [95% CI: .86–.88] at 4 months PFS. The best T1-weighted radiomics model yielded a concordance of .82 [95% CI: .8–.84] at 4 months PFS. The best combined FLAIR + T1-weighted radiomics model yielded a concordance of .74 [95% CI: .71–.77] at 3 months PFS. The predominant predictive radiomic feature matrix was gray-level size-zone. Conclusion: MRI-based radiomics may predict progression-free survival in pediatric diffuse midline glioma/diffuse intrinsic pontine glioma.