bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicobacter pylori Infection Maybe a Risk Factor for Cardiac Syndrome X
Authors: Zhang Dong-Hong , Yuan Chen , Wang Bei-Bei , Dong Xin-Jiang , Lv Shu-Ping , Li Fei-Hong , Hou Zhen-Xiu , Liu Xiao-Li , Chen Kang 
Published: July 2022

PurposeCardiac syndrome X (CSX) is a condition with normal coronary angiography but angina pectoris. Chronic inflammation caused by Helicobacter pylori (H. pylori) infection may play a pathogenic role in CSX. Therefore, we conducted a meta-analysis to explore the relationship between H. pylori infection and risk of CSX.MethodsA systematic search in the Web of Science, Medline, Embase and Chinese databases (CNKI and Wanfang) was conducted up to October 2021. Articles on the association between H. pylori infection and the risk of CSX were included and were analyzed by R software (version 4.1.0).ResultsTen case-control studies involving 703 CSX patients and 731 healthy controls were included. H. pylori infection was associated with an increased risk of CSX (OR: 8.29, 95% CI: 4.64–14.82). We also found a significant association in those 25–40 years of age (OR: 1.34, 95% CI: 1.04–1.72), those 40–50 years of age (OR: 11.27, 95% CI: 4.29–29.61), those over 50 years of age (OR: 7.18, 95% CI: 3.59–14.36), those in developing countries [Iran (OR: 12.99, 95% CI: 8.61–19.60) and China (OR: 5.14, 95% CI: 3.09–8.56)]. However, this association was not apparent in a developed country [Italy (OR: 0.93, 95% CI: 0.37–2.33)].ConclusionsOur study suggested a possible association between H. pylori infection and the risk of CSX. Its pathogenicity is stronger in middle-aged individuals and some developing countries. However, more studies are needed to further investigate whether early eradication of H. pylori can reduce the incidence rate of CSX, especially in middle-aged individuals and some developing countries.
Assessment of Human Factors After Advanced Life Support Courses Comparing Simulated Team and Real Team Assessment: A Randomized Controlled Cohort Trial
Authors: Nabecker Sabine , Huwendiek Sören , Seidl Christian , Hana Anisa , Theiler Lorenz , Greif Robert 
Published: July 2022

AimHuman factors are essential for high-quality resuscitation team collaboration and are, therefore, taught in international advanced life support courses, but their assessment differs widely. In Europe, the summative life support course assessment tests mainly adhere to guidelines but few human factors. This randomized controlled simulation trial investigated instructors’ and course participants’ perceptions of human factors assessment after two different summative assessments.MethodsAll 5th/6th-year medical students who attended 19 advanced life support courses according to the 2015 European Resuscitation Council guidelines during one study year were invited to participate. Each course was randomized to either: (1) Simulated team assessment (one instructor simulates a team, and the assessed person leads this “team” through a cardiac-arrest scenario test); (2) Real team assessment (4 students form a team, one of them is assessed as the team leader; team members are not assessed and act only on team leader’s commands). After the summative assessments, instructors, and students rated the tests’ ability to assess human factors using a visual analog scale (VAS, 0 = no agreement, 10 = total agreement).ResultsA total of 227 students participated in the 1-day Immediate Life Support courses, 196 students in the 2-day Advanced Life Support courses, additionally 54 instructors were included. Instructors judged all human factors significantly better in real team assessments; students rated leadership and situational awareness comparable between both assessments. Assessment pass rates were comparable between groups.ConclusionSummative assessment in real teams was perceived significantly better to assess human factors. These results might influence current summative assessment practices in advanced life support courses.
A pioneer surgical technique for isolated periodontal defects by “closed” retraction of the papilla: A feasibility study
Authors: Apatzidou Danae Anastasia 
Published: July 2022

AimA pioneer periodontal surgical approach employing the closed surgical technique (CST) in combination with the tissue-engineered biocomplex aimed to gain access to the osseous defect and improve soft tissue architecture.MethodsThe CST was applied in four systemically healthy periodontitis patients/defects who were followed for 12 months. It avoids papilla dissection and retraction of flaps in an open manner; thus, suturing is not required. It is designed for the reconstruction of residual isolated periodontal defects and is best indicated in the aesthetic region. It can be applied as a sole treatment approach to facilitate deep instrumentation of the defect, or it could be combined with subgingival application of regenerative materials. Hereby, the biocomplex was applied containing autologous alveolar bone marrow mesenchymal stem cells, seeded into collagen scaffolds, enriched with autologous fibrin/platelet lysate.ResultsThe CST minimized postoperative discomfort and led to improved treatment outcomes with probing pocket depth reduction [average (SD)] of 24.4% (18.5), gain in clinical attachment levels of 25.8% (20.1), and evidence of remineralisation of the alveolar crest.ConclusionThe CST is a tissue-friendly operation and facilitates subgingival application of biological agents via tunneling the soft tissues. However, surgical experience is required for nontraumatic manipulation of the gingival tissues during “closed” retraction of the flaps.Clinical trial registrationRegistered with Clinicaltrials.gov; ClinicalTrials.gov ID: NCT02449005.
Effectiveness and Tolerability of Once-Weekly GLP-1 Receptor Agonists in Clinical Practice: A Focus on Switching Between Once-Weekly Molecules in Type 2 Diabetes
Authors: Di Dalmazi Giulia , Coluzzi Sara , Baldassarre Maria Pompea Antonia , Ghit Amr , Graziano Giusi , Rossi Maria Chiara , Ciappini Beatrice , Milo Marica , Carrieri Federica , Nicolucci Antonio , Consoli Agostino , Formoso Gloria 
Published: July 2022

AimsThis study aims to evaluate the effectiveness and tolerability of once-weekly glucagon-like peptide receptor agonists (OW GLP-1RAs) and to assess the clinical benefits of switching from one GLP-1RA to another (switchers) in a routine clinical setting.Materials and MethodsThis is a retrospective, real-world cohort study, based on electronic medical records utilized in one Italian diabetes clinic. Estimated mean changes in HbA1c and body weight after 6 and 12 months from the first prescription of a long-acting GLP1-RA were evaluated using longitudinal linear mixed models for repeated measures. The effectiveness of the three long-acting GLP1-RAs was compared separately in the GLP1-RA naive and switchers cohorts, after propensity score adjustment.ResultsInitiating a long-acting GLP1-RA was associated with statistically significant improvements in HbA1c (−1%) and body weight (−2.6 kg) after 6 months, and benefits were maintained after 12 months. In GLP1-RA naive cohort, semaglutide showed the largest effect on HbA1c (−1.55%; 95%CI, −1.77;−1.34) and body weight (−3.76 kg; 95%CI, −5.05;−2.47) at 6 months, maintained at 12 months (−1.55%; 95%CI, −1.82;−1.28 and −6.29 kg; 95%CI, −7.94;−4.63). In the switchers’ cohort, statistically significant reductions at 6 months in HbA1c and body weight were documented with semaglutide and dulaglutide only, with semaglutide associated with the most marked reduction (−0.84%; 95%CI, −1.03;−0.65 and −3.43 kg; 95%, −4.67;−2.19). Dropout rates were 9.2%, 28.5%, and 41.7% in semaglutide, dulaglutide, and exenatide groups, respectively.ConclusionsThe effectiveness and tolerability of the OW GLP-1RAs in the real world were documented. Semaglutide was associated with the highest response without impact on safety. Clinical improvements were obtained even in switchers, especially in those switching to semaglutide.
Children With Short Stature Display Reduced ACE2 Expression in Peripheral Blood Mononuclear Cells
Authors: Tonon Federica , Tornese Gianluca , Giudici Fabiola , Nicolardi Francesca , Toffoli Barbara , Barbi Egidio , Fabris Bruno , Bernardi Stella 
Published: July 2022

BackgroundThe cause of short stature remains often unknown. The renin-angiotensin system contributes to growth regulation. Several groups reported that angiotensin-converting enzyme 2 (ACE2)-knockout mice weighed less than controls. Our case-control study aimed to investigate if children with short stature had reduced ACE2 expression as compared to controls, and its significance.Materials and Methodschildren aged between 2 and 14 years were consecutively recruited in a University Hospital pediatric tertiary care center. Cases were children with short stature defined as height SD ≤ −2 diagnosed with growth hormone deficiency (GHD) or idiopathic short stature (ISS), before any treatment. Exclusion criteria were: acute diseases, kidney disease, endocrine or autoimmune disorders, precocious puberty, genetic syndromes, SGA history. ACE and ACE2 expression were measured in peripheral blood mononuclear cells, angiotensins were measured by ELISA.ResultsChildren with short stature displayed significantly lower ACE2 expression, being 0.40 fold induction (0.01-2.27) as compared to controls, and higher ACE/ACE2, with no differences between GHD and ISS. ACE2 expression was significantly and inversely associated with the risk of short stature, OR 0.26 (0.07-0.82), and it had a moderate accuracy to predict it, with an AUC of 0.73 (0.61-0.84). The cutoff of 0.45 fold induction of ACE2 expression was the value best predicting short stature, identifying correctly 70% of the children.ConclusionsOur study confirms the association between the reduction of ACE2 expression and growth retardation. Further studies are needed to determine its diagnostic implications.
Circulating Fibroblast Growth Factor 21 and Total Testosterone in Type 2 Diabetes Mellitus Men With Coronary Heart Disease
Authors: Mei Yufeng , Lyu Yongnan , Zhao Zhiming , Li Yan 
Published: July 2022

BackgroundFibroblast growth factor 21 increased in population with type 2 diabetes mellitus (T2DM), while serum total testosterone often decreased in men with T2DM. This study aimed to investigate the relationship between the prevalence of coronary artery disease (CAD) and circulating FGF21 concentrations and serum testosterone in T2DM men.Methods490 men with T2DM from January 2021 to December 2021 were recruited from the Renmin Hospital of Wuhan University, and they were divided into CAD group (n=248) and control group (n=242). FGF21 were determined based on ELISA principle and serum total testosterone was measured in a liquid chromatography mass spectrometer LC/MS-8050 (Shimadzu, Japan). Logistic and restricted cubic spline analyses were performed to examine the association between the prevalence of CAD and circulating FGF21 concentrations and serum testosterone in T2DM men. The receiver operating curve (ROC) analysis was used to explore the predictive performance.ResultsCirculating FGF21 levels were higher in T2DM men with CAD compared with those without CAD [214.63 (121.82, 348.64) pg/ml vs 166.55 (94.81,254.48) pg/ml, p&lt;0.001], while serum total testosterone was lower [3.08 ± 0.07 ng/ml vs 3.76 ± 0.09 ng/ml, p&lt;0.001]. The fully adjusted odds ratio (OR) and 95% confidence intervals (95%CI) was 2.956(1.409,6.201) for those in quartile 4 of FGF21 versus quartile 1 and the fully adjusted OR (95%CI) was 0.346(0.174,0.686) for those in quartile 4 of testosterone versus quartile 1. The receiver operating curve (ROC) analysis showed that the area under the curve (AUC) of combination of FGF21 and testosterone for predicting the occurrence of CAD in men with T2DM was 0.702 (95% CI: 0.667-0.741).ConclusionCirculating FGF21 levels were positively associated with CAD in men with T2DM, whereas serum total testosterone levels showed an inverse correlation with CAD in diabetic men.
Nomogram model based on preoperative serum thyroglobulin and clinical characteristics of papillary thyroid carcinoma to predict cervical lymph node metastasis
Authors: Chang Qungang , Zhang Jieming , Wang Yaqian , Li Hongqiang , Du Xin , Zuo Daohong , Yin Detao 
Published: July 2022

ObjectivePreoperative evaluation of cervical lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) has been one of the serious clinical challenges. The present study aims at understanding the relationship between preoperative serum thyroglobulin (PS-Tg) and LNM and intends to establish nomogram models to predict cervical LNM.MethodsThe data of 1,324 PTC patients were retrospectively collected and randomly divided into training cohort (n = 993) and validation cohort (n = 331). Univariate and multivariate logistic regression analyses were performed to determine the risk factors of central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM). The nomogram models were constructed and further evaluated by 1,000 resampling bootstrap analyses. The receiver operating characteristic curve (ROC curve), calibration curve, and decision curve analysis (DCA) of the nomogram models were carried out for the training, validation, and external validation cohorts.ResultsAnalyses revealed that age, male, maximum tumor size &gt;1 cm, PS-Tg ≥31.650 ng/ml, extrathyroidal extension (ETE), and multifocality were the significant risk factors for CLNM in PTC patients. Similarly, such factors as maximum tumor size &gt;1 cm, PS-Tg ≥30.175 ng/ml, CLNM positive, ETE, and multifocality were significantly related to LLNM. Two nomogram models predicting the risk of CLNM and LLNM were established with a favorable C-index of 0.801 and 0.911, respectively. Both nomogram models demonstrated good calibration and clinical benefits in the training and validation cohorts.ConclusionPS-Tg level is an independent risk factor for both CLNM and LLNM. The nomogram based on PS-Tg and other clinical characteristics are effective for predicting cervical LNM in PTC patients.
Development of DC Microgrid Integrated Electric Vehicle Charging Station With Fuzzy Logic Controller
Authors: Hadero Mathewos , Khan Baseem 
Published: July 2022

The utilization of the electric vehicles increasing day by day. Further, energy grid infrastructure is not modernized enough to supply the growing demand of electric vehicles. Therefore, it is difficult to fully depend on the energy obtained from grid. As a result, integration of renewable energy (solar), grid supply and energy storage is critical. Therefore, the need of renewable energy powered charging facility with adequate controlling is the present day requirement. This paper proposed the development of a direct current (DC) microgrid for electric vehicle charging stations. This work employs a fuzzy logic controller to optimally integrate a DC microgrid. The maximum operating voltage of this DC microgrid charging station is 500 V. Power flow management using a fuzzy logic controller keeps voltage within the expected range with standard voltage deviation. Further, it improves the response time (1.645 ms). Moreover, the operating costs per year of the proposed system are also being investigated.
Spatiotemporal Variations of Ecosystem Service Indicators and the Driving Factors Under Climate Change in the Qinghai–Tibet Highway Corridor
Authors: Yang Siqi , Zhu Gaoru , Zhang Lixiao , Xu Honglei , Cheng Jinxiang 
Published: July 2022

In recent decades, the influence of climate change and human activities on the ecosystem services (ES) in the Qinghai–Tibet Plateau (QTP) has been extensively investigated. However, few studies focus on linear traffic corridor area, which is heavily affected by human activities. Taking the Golmud–Lhasa national highway corridor as a case, this study investigated the land-use and land-cover change (LUCC) and spatiotemporal variations of ES indicators using ecosystem indices of fractional vegetation cover (FVC), leaf area index (LAI), evapotranspiration (ET), and net primary productivity (NPP) from 2000 to 2020. The results indicated that LUCC was faster in the last decade, mostly characterized by the conversion from grassland to unused land. In buffer within 3000 m, the proportions of productive areas represented the increased trends with distance. In terms of ES variations, the improved areas outweighed the degraded areas in terms of FVC, LAI, and NPP from 2000 to 2020, mostly positioned in the Qinghai Province. In addition, FVC, LAI, and NPP peaked at approximately 6000 m over time. With regard to influencing factors, precipitation (20.54%) and temperature (14.19%) both positively influenced the spatiotemporal variation of FVC. Nearly 60% of the area exhibited an increased NPP over time, especially in the Qinghai Province, which could be attributed to the temperature increase over the last two decades. In addition, the distance effects of climatic factors on ES indicators exhibited that the coincident effects almost showed an opposite trend, while the reverse effects showed a similar trend. The findings of this study could provide a reference for the ecological recovery of traffic corridors in alpine fragile areas.
Variations in the Yamuna River Water Quality During the COVID-19 Lockdowns
Authors: Singh Bhupendra Pratap , Rana Pallvi , Mittal Nishtha , Kumar Sumit , Athar Mohammad , Abduljaleel Zainularifeen , Rahman Shakilur 
Published: July 2022

The COVID-19 pandemic that emerged in Wuhan city of China in December 2019 has adversely impacted the health and the economy, society, and other significant spheres of the human environment. The pandemic has severely impacted economic activities, especially the industrial production, transportation, tourism, and hoteling industries. The present study analyses the impact of varying severity of lockdowns of economic activities during various phases of the pandemic on the water quality of the Yamuna river on parameters like pH values, biological oxygen demand, chemical oxygen demand, dissolved oxygen, total suspended solids, and electrical conductivity. The study has found a significant improvement in water quality parameters with closing economic activities during lockdowns. The average levels of concentration of these parameters of water quality were quite low during the lockdown period at 7.26 (pH value), 31.32, 136.07, 7.93, 30.33 mg/L, and 1500.24 μS/cm compared to pre lockdown periods levels at 7.53 (pH), 39.62, 116.52, 6.1, 57.2 mg/L and 1743.01 μS/cm for biological oxygen demand, chemical oxygen demand, dissolved oxygen, total suspended solids, and electrical conductivity, respectively. In addition, the study has found a strong significant positive correlation between COD with BOD and TSS during the lockdown period. The major findings from the present study could be instrumental in making environmentally sustainable policies for the country’s economic development. There is also a huge scope of scaling up of the study at the national level to analyze the health of the rivers in the backdrop of lockdowns.
SYK Is Associated With Malignant Phenotype and Immune Checkpoints in Diffuse Glioma
Authors: Zhou Quanwei , Wei Min , Shen Wenyue , Huang Sheng , Fan Jianfeng , Huang He 
Published: July 2022

Background: Diffuse glioma, the most common intracranial malignant tumor, is characterized by immunosuppression. The prognostic significance and potential therapeutic value of SYK remain obscure. Here, we explored the performance of SYK in predicting patient outcomes and as a therapeutic target.Methods: The mRNA expression and clinical data for pancancer and normal tissues and more than 2,000 glioma samples were collected from public databases. The expression level of SYK was evaluated by qPCR and IHC. The prognostic value of SYK was assessed using the Kaplan–Meier curves and univariate and multivariate Cox regression analyses. A sequence of immune and stromal infiltration analyses was calculated based on the ESTIMATE algorithm, ssGSEA algorithm, TIMER, and single-cell analysis. The SYK-related subtypes were identified via a Consensus Cluster Plus analysis.Results: SYK was significantly differentially expressed in multiple tumors and normal tissues. Importantly, high-expression SYK was enriched in malignant phenotypes of diffuse gliomas, which was further validated by qPCR and IHC. Survival analysis uncovered that SYK was an independently unfavorable prognostic marker in diffuse glioma. Functional enrichment analysis and immune and stromal infiltration analyses showed that SYK was involved in shaping the immunosuppressive microenvironment of diffuse glioma. Additionally, SYK expression was closely associated with some immune checkpoint molecules and M2 macrophage infiltration, which was validated by IHC and single-cell analysis. Diffuse glioma with Sub1 exhibited a worse prognosis, immunosuppressive microenvironment, and higher expression of immune checkpoint genes.Conclusion: SYK is involved in shaping the immunosuppressive microenvironment and served as a promising prognosis biomarker and immunotherapeutic target for diffuse glioma.
Global, Regional, and National Burden and Trends of Down Syndrome From 1990 to 2019
Authors: Chen Liyuan , Wang Lifei , Wang Yi , Hu Haishan , Zhan Yuan , Zeng Zhilin , Liu Lidan 
Published: July 2022

Introduction: Down syndrome (DS) is the leading cause of genetically defined intellectual disability and congenital birth defects worldwide. A large population of people diagnosed with DS globally is posing an enormous socioeconomic burden. However, the global burden and trends of DS have not been reported.Methods: Based on the data from the Global Burden of Disease database in 2019, we analyzed the incidence, prevalence, disability-adjusted life years (DALYs), and death of DS from 1990 to 2019 according to sex, age, regions, and social-demographic index (SDI). Then, age-standardized rates (ASRs) and estimated annual percentage change (EAPC) of these aforementioned indexes were calculated to evaluate the temporal trend of DS. Finally, the association of SDI with DS epidemiological parameters was assessed.Results: In the past 30 years, the incident cases, age-standardized incident rate (ASIR), and age-standardized prevalent rate (ASPR) of DS first decreased slightly and subsequently increased globally. The number of prevalent cases increased steadily, while the number and age-standardized rate (ASRs) of DALYs and deaths decreased gradually from 1990 to 2019. In the meantime, disease burdens were different across various SDI regions. The prevalent cases and ASPR for both sexes were increasing in all SDI regions except for the high-middle SDI region. At the national level, Brunei Darussalam, Ireland, and Haiti were the top three countries with the highest ASIR in 2019. Georgia was in the top three with the highest increase in ASRs of four parameters, while Serbia was consistently ranked in the top three with fastest declining. Furthermore, we found that ASIR and ASPR were positively correlated with SDI, yet the age-standardized DALYs and age-standardized death rate (ASDR) were negatively correlated with SDI.Conclusion: In the past 30 years, the burden and trends of DS were heterogeneous across different regions and countries with different sociodemographic characteristics. Great improvements had been achieved in reducing DALYs and deaths globally. However, the increased number and ASRs of incident and prevalent cases in some regions, especially in low SDI regions, were contributing to numerous challenges to public health. The findings may provide valuable information to the development or implementation of more effective measures.