bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethanolic extract of Caesalpinia bonduc seeds triggers yeast metacaspase-dependent apoptotic pathway mediated by mitochondrial dysfunction through enhanced production of calcium and reactive oxygen species (ROS) in Candida albicans
Authors: Sasidharan Shan , Nishanth Kumar S. , Nair Hareendran J. 
Published: August 2022

Candida albicans is a widespread disease-causing yeast affecting humankind, which leads to urinary tract, cutaneous and various lethal systemic infections. As this infection rate steadily increases, it is becoming a significant public health problem. Recently, Caesalpinia bonduc has received much attention from researchers due to its diverse pharmacological properties, including antimicrobial effects. Accordingly, we first planned to explore the in-vitro anticandidal potential of three extracts obtained from C. bonduc seeds against four Candida species. Initially, the anticandidal activity of the seed extracts was checked by the microdilution technique. Out of three seed extracts tested, ethanolic extract of C. bonduc seed (EECS) recorded the best activity against C. albicans. Hence, we next aimed to find out the anticandidal mechanism of EECS in C. albicans. The liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) analysis showed that the major compounds present in the EECS were tocopherols, fucosterol, linoleic acid, β-amyrin, β-sitosterol, campesterol, cassane furanoditerpene, Norcassane furanoditerpene and other diterpenes. To evaluate the cell death mechanism in C. albicans, a series of parameters related to apoptosis, viz., reactive oxygen species (ROS) production, membrane permeability, mitochondrial membrane potential, release of cytochrome c, DNA fragmentation, nuclear condensation, increased Ca2+ level in cytosolic and mitochondrial and activation of metacaspase, were analyzed. The results showed that EECS treatment resulted in the elevation of ROS, which leads to plasma membrane permeability in C. albicans. Annexin V staining further confirms the early stage of apoptosis through phosphatidylserine (PS) externalization. We further inspected the late apoptotic stage using DAPI and TUNEL staining assays. From the results, it can be concluded that EECS triggered mitochondrial dysfunction by releasing high levels of ROS, cytochrome c and Ca2+resulting in the activation of metacaspase mediated apoptosis, which is the central mechanism behind the cell death of C. albicans. Finally, a Galleria mellonella-C. albicans infection system was employed to assess the in-vivo potential of EECS. The outcomes displayed that the EECS considerably enhanced the recovery rate of G. mellonella larvae from infection after the treatment. Additionally, EECS also recorded low hemolytic activity. This study thus spotlights the anticandidal potential and mechanism of action of EECS against C. albicans and thus delivers a promising treatment approach to manage C. albicans infection in the future.
Case report: Transcatheter pulmonary valve-in-valve implantation in a deteriorated self-expandable valve caused by infective endocarditis
Authors: Li Yan-Jie , Pan Xin , Wang Cheng , He Ben 
Published: August 2022

BackgroundInfective endocarditis is a complication with high mortality in patients with congenital heart disease, particularly for those with bioprosthetic valve.Case summaryWe report a case of a 54-year-old female with a history of tetralogy of Fallot who had been surgically repaired using a transannular patch due to severe pulmonary insufficiency with right heart enlargement and presented with worsening dyspnea. She had received transcatheter pulmonary valve implantation (TPVI) 5 years ago. Unfortunately, bioprosthesis-associated infective endocarditis occurred due to dental caries. Given persistent antibiotic medication, she became clinically stable with prosthesis functional recovery. However, dysfunctional bioprosthesis was still detected 3 years later, which was successfully treated by valve-in-valve TPVI with the help of modified buddy wire technique. At a 12-month follow-up after valve-in-valve TPVI, she was completely recovered with improved symptoms of heart failure.ConclusionThis is the first report of valve-in-valve TPVI of a self-expandable valve in a degenerated self-expandable valve. The case highlights increased surveillance for infective endocarditis of transcatheter pulmonary valve should be emphasized. Subsequent valve-in-valve TPVI is an effective treatment for valve failure in defined conditions improving the hemodynamics.
Prevalence, risk factors, and prediction of inappropriate use of non-vitamin K antagonist oral anticoagulants in elderly Chinese patients with atrial fibrillation: A study protocol
Authors: Zhao Shu-Juan , Chen Bo-Ya , Hong Xue-Jiao , Liu Yin-Ping , Cai Hai-Xia , Du Song , Gu Zhi-Chun , Ma Pei-Zhi 
Published: August 2022

BackgroundAtrial fibrillation (AF) is an arrhythmia that is prevalent globally, and its incidence grows exponentially with aging. Non-vitamin K antagonist oral anticoagulants (NOACs) have been developed in recent years, and it challenges the supremacy of warfarin for thromboembolism prophylaxis in AF. Nevertheless, there are limited data specifically evaluating the real-life use of NOACs in elderly patients with AF in China.MethodsThis is a national, multicenter, non-interventional, cross-sectional study that enrolls patients with AF aged 75 years and above from 31 institutions across China. Data were collected using the Hospital Information System. The primary outcomes include (1) profiles of NOAC use in the elderly; (2) frequency of inappropriate NOAC use based on guidelines and approved labeling recommendations; (3) exploring potential risk factors related to NOACs inappropriate use; and (4) creating a prediction tool for inappropriate NOACs use.ConclusionThe results of this study reveal the prevalence, risk factors, and corresponding prediction tool of inappropriate NOACs use in older patients with AF in China, as well as provide valuable insights into the clinical application of NOACs in high-risk populations in the real-world setting.Clinical trial registrationwww.ClinicalTrials.gov, identifier: NCT 05361889.
Effects of early phase 1 cardiac rehabilitation on cardiac function evaluated by impedance cardiography in patients with coronary heart disease and acute heart failure
Authors: Wang Yishu , Xiao Yanchao , Tang Jianjun , Liu Yutao , Li Hui , Peng Zengjin , Xu Danyan , Shen Li 
Published: August 2022

PurposeThe purpose of the study was to access the impact of phase 1 cardiac rehabilitation (CR) on cardiac function and hemodynamic changes in patients with coronary heart disease (CHD) and acute heart failure (AHF).Materials and methodsA total of 98 patients with CHD and AHF were recruited and randomized into two groups. Control group received standard pharmacotherapy and CR group received standard pharmacotherapy combined phase 1 CR. NT-proBNP and hemodynamic parameters measured by impedance cardiography (ICG) were estimated at baseline and at the end of treatment period.ResultsPhase 1 CR combined routine medical treatment could lower NT-proBNP levels. The percentage of high-risk patients was significantly decreased in CR group, although the post-treatment NT-proBNP level between control group and CR group showed no significant differences. Similarly, most hemodynamic parameters improved in the CR group, but not in the control group, suggesting that phase 1 CR in combination with the standard pharmacotherapy improved hemodynamic characteristics by elevating cardiac output, ameliorating preload, improving systolic and diastolic function, and relieving afterload, although the post-treatment hemodynamic parameters showed no statistically significant differences between the control group and the CR group.ConclusionPhase 1 CR combined routine medication can improve cardiac function and hemodynamic characteristics in patients with CHD and AHF. Thus, recommendation of phase 1 CR to stable patients is necessary.
Machine learning algorithms for predicting mortality after coronary artery bypass grafting
Authors: Khalaji Amirmohammad , Behnoush Amir Hossein , Jameie Mana , Sharifi Ali , Sheikhy Ali , Fallahzadeh Aida , Sadeghian Saeed , Pashang Mina , Bagheri Jamshid , Ahmadi Tafti Seyed Hossein , Hosseini Kaveh 
Published: August 2022

BackgroundAs the era of big data analytics unfolds, machine learning (ML) might be a promising tool for predicting clinical outcomes. This study aimed to evaluate the predictive ability of ML models for estimating mortality after coronary artery bypass grafting (CABG).Materials and methodsVarious baseline and follow-up features were obtained from the CABG data registry, established in 2005 at Tehran Heart Center. After selecting key variables using the random forest method, prediction models were developed using: Logistic Regression (LR), Support Vector Machine (SVM), Naïve Bayes (NB), K-Nearest Neighbors (KNN), Extreme Gradient Boosting (XGBoost), and Random Forest (RF) algorithms. Area Under the Curve (AUC) and other indices were used to assess the performance.ResultsA total of 16,850 patients with isolated CABG (mean age: 67.34 ± 9.67 years) were included. Among them, 16,620 had one-year follow-up, from which 468 died. Eleven features were chosen to train the models. Total ventilation hours and left ventricular ejection fraction were by far the most predictive factors of mortality. All the models had AUC &gt; 0.7 (acceptable performance) for 1-year mortality. Nonetheless, LR (AUC = 0.811) and XGBoost (AUC = 0.792) outperformed NB (AUC = 0.783), RF (AUC = 0.783), SVM (AUC = 0.738), and KNN (AUC = 0.715). The trend was similar for two-to-five-year mortality, with LR demonstrating the highest predictive ability.ConclusionVarious ML models showed acceptable performance for estimating CABG mortality, with LR illustrating the highest prediction performance. These models can help clinicians make decisions according to the risk of mortality in patients undergoing CABG.
Modelling Debris-Covered Glacier Ablation Using the Simultaneous Heat and Water Transport Model. Part 1: Model Development and Application to North Changri Nup
Authors: Winter-Billington Alex , Dadić Ruzica , Moore R. D. , Flerchinger Gerald , Wagnon Patrick , Banerjee Argha 
Published: August 2022

Modelling ablation of glacier ice under a layer of mineral debris is increasingly important, because the extent of supraglacial debris is expanding worldwide due to glacier recession. Physically based models have been developed, but the uncertainty in predictions is not yet well constrained. A new one-dimensional model of debris-covered ice ablation that is based on the Simultaneous Heat and Water transfer model is introduced here. SHAW-Glacier is a physically based, vertically integrated, fully coupled, water and energy balance model, which includes the advection of heat by rainwater and lateral flow. SHAW-Glacier was applied to North Changri Nup, a high elevation alpine glacier in the monsoon-dominated Central Himalaya. Simulations were compared with observed debris temperature profiles, snow depth, and ablation stake measurements for debris 0.03–0.41 m thick, in a 2500 m2 study area. Prediction uncertainty was estimated in a Monte Carlo analysis. SHAW-Glacier simulated the characteristic pattern of decreasing ablation with increasing debris thickness. However, the observations of ablation did not follow the characteristic pattern; annual ablation was highest where the debris was thickest. Recursive partitioning revealed a substantial, non-linear sensitivity to the snow threshold air temperature, suggesting a sensitivity to the duration of snow cover. Photographs showed patches of snow persisting through the ablation season, and the observational data were consistent with uneven persistence of snow patches. The analyses indicate that patchy snow cover in the ablation season can overwhelm the sensitivity of sub-debris ablation to debris thickness. Patchy snow cover may be an unquantified source of uncertainty in predictions of sub-debris ablation.
Oocytes With Smooth Endoplasmic Reticulum Aggregates May Not Impact Blastocyst Euploidy Rate
Authors: Xu Jian , Yang Li , Chen Zhi-Heng , Yin Min-Na , Chen Juan , Sun Ling 
Published: August 2022

ObjectiveTo investigate whether the euploidy rate of blastocysts derived from smooth endoplasmic reticulum aggregates (SERa) positive cycles and oocytes are impacted.DesignRetrospective cohort study.Method(s)A total of 601 preimplantation genetic testing (PGT) cycles with at least one oocyte retrieved in our center between April 2017 and May 2021 were initially included in the study. Women&gt;35 years and PGT cycles with chromosomal structural rearrangements (PGT-SR) were excluded. Embryological and blastocyst ploidy outcomes were compared among SERa+ oocyte, sibling SERa- oocytes and oocytes in SERa- cycles.ResultsNo significant difference was observed among the SERa+ oocyte group, sibling SERa- oocyte group, and SERa- cycle group in the normal fertilization rate (82.1% vs. 77.8% vs. 83.1%, respectively, P=0.061), blastocyst formation rate (71.0% vs. 72.5% vs. 68.4%, respectively, P=0.393), good quality blastocyst formation rate (46.4% vs. 48.3% vs. 42.6%, respectively, P=0.198). No significant difference was observed in the euploidy rate (50.0% vs. 62.5% vs. 63.3%, respectively, P=0.324), mosaic rate (12.5% vs. 9.7% vs. 13.4%, respectively, P=0.506), and aneuploidy rate (37.5% vs. 27.8% vs. 23.2%, respectively, P=0.137) among the three groups.ConclusionOur results suggest that the euploidy rate of blastocysts derived from SERa+ cycles and oocytes may not be impacted.
Economically optimizing elevation of new, single-family residences for flood mitigation via life-cycle benefit-cost analysis
Authors: Gnan Ehab , Friedland Carol J. , Mostafiz Rubayet Bin , Rahim Md Adilur , Gentimis Thanos , Taghinezhad Arash , Rohli Robert V. 
Published: August 2022

Construction with freeboard—vertical height of a structure above the minimum required—is commonly accepted as a sound investment for flood hazard mitigation. However, determining the optimal height of freeboard poses a major decision problem. This research introduces a life-cycle benefit-cost analysis (LCBCA) approach for optimizing freeboard height for a new, single-family residence, while incorporating uncertainty, and, in the case of insured homes, considering the costs from losses, insurance, and freeboard (if any) to the homeowner and National Flood Insurance Program (NFIP) separately. Using a hypothetical, case study home in Metairie, Louisiana and U.S. Army Corps of Engineers design depth-damage functions for generic inland flooding, results show that adding 2 ft of freeboard at the time of construction might be considered the optimal option given that it yields the highest net benefit, but the highest net benefit-cost ratio occurs for the 1 ft freeboard. Even if flood loss reduction is not considered when adding freeboard, the savings in annual insurance premiums alone are sufficient to recover the construction costs paid by the homeowner if at least one foot of freeboard is included at construction. Collectively, these results based on conservative assumptions suggest that at the time of construction, even a small amount of freeboard provides a huge savings for the homeowner and (especially) for the financially-strapped National Flood Insurance Program. For community planners, the results suggest that wise planning with reasonable expectations on the front end makes for a more sustainable community.
The Plastic Pathfinder: A macroplastic transport and fate model for terrestrial environments
Authors: Mellink Y. , van Emmerik T. , Kooi M. , Laufkötter C. , Niemann H. 
Published: August 2022

Land-based plastic waste is the major source for freshwater and marine plastic pollution. Yet, the transport pathways over land remain highly uncertain. Here, we introduce a new conceptual model to forecast plastic transport on land: the Plastic Pathfinder; a numerical model that simulates the spatiotemporal distribution of macroplastic (&gt;0.5 cm) at a river basin scale. The plastic transport driving forces are wind and surface runoff, while plastic transport is resisted by terrain surface friction. The terrain surface friction, a function of the slope and land use, is converted into thresholds that define the critical wind and surface runoff conditions required to mobilize and transport macroplastic waste. When the wind and/or surface runoff conditions exceed their respective thresholds, the model simulates the transport and (re)distribution of plastics, resulting in plastic accumulation hotspots maps and high probability transport route maps. The Plastic Pathfinder contributes to a better mechanistic understanding of plastic transport through terrestrial environments, and upon future calibration and validation, can serve as a practical tool to optimize plastic waste prevention, mitigation, and reduction strategies.
Clinical and immunological characteristics of five patients with immune dysregulation, polyendocrinopathy, enteropathy, X-linked syndrome in China–expanding the atypical phenotypes
Authors: Huang Yu , Fang Shuyu , Zeng Ting , Chen Junjie , Yang Lu , Sun Gan , Dai Rongxin , An Yunfei , Tang Xuemei , Dou Ying , Zhao Xiaodong , Zhou Lina 
Published: August 2022

BackgroundImmune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare disorder of the immune regulatory system caused by forkhead box P3 (FOXP3) mutations. Abnormal numbers or functions of regulatory T (Treg) cells account for the various autoimmune symptoms. We aimed to explore the molecular genetics and phenotypic spectra of patients with atypical IPEX syndrome in China.MethodsWe analyzed the molecular, clinical and immune phenotype characteristics of five Chinese patients with FOXP3 mutations.ResultsWe summarized the molecular and phenotypic features of five patients with FOXP3 mutations, including two novel mutations. Four of the five patients displayed atypical phenotypes, and one developed immune-related peripheral neuropathy. Three of the five patients showed normal frequencies of Treg cells, but the proportions of subsets of Treg cells, CD4+ T cells and B cells were out of balance.ConclusionsOur report broadens the understanding of the clinical features of atypical IPEX syndrome. Our detailed analyses of the immunological characteristics of these patients enhance the understanding of the possible mechanisms underlying the clinical manifestations.
Associations of chronic diarrheal symptoms and inflammatory bowel disease with sleep quality: A secondary analysis of NHANES 2005–2010
Authors: Zhang Jingyun , Yu Senhai , Zhao Gang , Jiang Xiaoyan , Zhu Yimin , Liu Zuyun 
Published: August 2022

ObjectivePoor sleep quality is highly prevalent in patients with chronic diarrheal symptoms or inflammatory bowel disease (IBD). This study aimed to evaluate the associations of chronic diarrheal symptoms and IBD with sleep quality in the general US population.Methods14,696 adults (≥20 years) from the National Health and Nutrition Examination Survey (2005–2010) were included in the study. Chronic diarrheal symptoms and IBD were defined by self-reports. Sleep quality was assessed by sleep disorder, sleep trouble, and sleep duration. Multivariable logistic regression models were used to examine the associations.ResultsAfter adjustment of a series of covariates, we found that participants with chronic diarrheal symptoms or IBD had higher odds of sleep disorder [chronic diarrheal symptoms: odds ratio (OR) = 1.20, 95% confidence interval (CI) = 1.04–1.38; IBD: OR = 3.86, 95% CI = 1.92–7.77] and sleep trouble (chronic diarrheal symptoms: OR = 1.19, 95% CI = 1.09–1.30; IBD: OR = 2.32, 95% CI = 1.30–4.14), respectively. Sleep duration for participants with IBD was significantly shorter than that for those without IBD (β = −0.39, 95% CI = −0.78 to 0.01, P = 0.045). Subgroup analyses revealed that the associations of chronic diarrheal symptoms and IBD with sleep disorder and sleep trouble were more pronounced among women.ConclusionsIn this large sample of US adults, we found that chronic diarrheal symptoms and IBD were significantly associated with sleep quality, particularly in women. The findings highlight the importance of managing bowel health to promote high quality of sleep; and thus, improve quality of life in this subpopulation.
Platelet reactivity after clopidogrel loading in patients with acute ischemic stroke
Authors: Enomoto Yukiko , Shoda Kenji , Mizutani Daisuke , Matsubara Hirofumi , Egashira Yusuke , Iwama Toru 
Published: August 2022

ObjectiveIt remains unclear when sufficient antiplatelet effect is achieved after administration of a loading dose of clopidogrel in patients with acute ischemic stroke (AIS). This study aimed to evaluate the clopidogrel response in patients with AIS identified by the platelet function test (PFT).MethodsP2Y12 reaction unit (PRU) values measured using VerifyNow at baseline and at 6, 24, and 72 h after administration of a loading dose (300 mg) of clopidogrel were compared between patients with AIS and those of other cerebrovascular diseases (CVD). The prevalence of clopidogrel abnormal response and its associated factors were examined.ResultsThe PRU value was significantly reduced with time in the other CVD group (p &lt; 0.0001), and also in the AIS group (p = 0.0073). The PRU values were significantly higher in the AIS group than in the other CVD group (p &lt; 0.0001 between the groups, baseline: 314 ± 53 vs. 284 ± 62, p = 0.35; 6 h: 290 ± 66 vs. 214 ± 71, p = 0.016; 24 h: 270 ± 75 vs. 190 ± 70, p &lt; 0.0001; and 72 h: 231 ± 76 vs. 163 ± 93, p = 0.105). The prevalence of clopidogrel hypo-responder (PRU &gt; 240 at 24 h after administration) was higher in the AIS group (79 vs. 33%, p &lt; 0.0001) and associated with the baseline PRU value but not with the cytochrome P450 2C19 genotype or clinical ischemic events.ConclusionsResidual platelet reactivity at 24 h after clopidogrel loading was substantially higher in patients with AIS than in patients with other CVD. In addition, most patients with AIS were judged to be hypo-responders on PFT. This should be carefully interpreted in patients with AIS because of poor specificity for predicting clinical ischemic events.