bluuebunny/crossref_metadata_2025_split huggingface dataset:
Construction of an Antibiotic-Free Vector and its Application in the Metabolic Engineering of Escherichia Coli for Polyhydroxybutyrate Production
Authors: Liao Ying-Cheng , Saengsawang Boonyawee , Chen Jun-Wei , Zhuo Xiao-Zhen , Li Si-Yu 
Published: June 2022

An antibiotic- and inducer-free culture condition was proposed for polyhydroxybutyrate (PHB) production in recombinant Escherichia coli. First, antibiotic-free vectors were constructed by installing the plasmid maintenance system, alp7, hok/sok, and the hok/sok and alp7 combination into the pUC19 vector. The plasmid stability test showed that pVEC02, the pUC19 vector containing the hok/sok system, was the most effective in achieving antibiotic-free cultivation in the E. coli B strain but not in the K strain. Second, the putative phaCAB operon derived from Caldimonas manganoxidans was inserted into pVEC02 to yield pPHB01 for PHB production in E. coli BL21 (DE3). The putative phaCAB operon was first shown function properly for PHB production and thus, inducer-free conditions were achieved. However, the maintenance of pPHB01 in E. coli requires antibiotics supplementation. Finally, an efficient E. coli ρ factor-independent terminator, thrLABC (ECK120033737), was inserted between the phaCAB operon and the hok/sok system to avoid possible transcriptional carry-over. The newly constructed plasmid pPHB01-1 facilitates an antibiotic- and inducer-free culture condition and induces the production of PHB with a concentration of 3.0 on0.2 g/L, yield of 0.26 /L0.07 g/g-glucose, and content of 44 /g3%. The PHB production using E. coli BL21 (DE3)/pPHB01-1 has been shown to last 84 and 96 h in the liquid and solid cultures.
Carbamazepine Increases the Risk of Sudden Cardiac Arrest by a Reduction of the Cardiac Sodium Current
Authors: Jia Lixia , Eroglu Talip E. , Wilders Ronald , Verkerk Arie O. , Tan Hanno L. 
Published: June 2022

Aim: To assess the risk of sudden cardiac arrest (SCA) associated with the use of carbamazepine (CBZ) and establish the possible underlying cellular electrophysiological mechanisms.Methods: The SCA risk association with CBZ was studied in general population cohorts using a case–control design (n = 5,473 SCA cases, 21,866 non-SCA controls). Effects of 1–100 µM CBZ on action potentials (APs) and individual membrane currents were determined in isolated rabbit and human cardiomyocytes using the patch clamp technique.Results: CBZ use was associated with increased risk of SCA compared with no use (adjusted odds ratio 1.90 [95% confidence interval: 1.12–3.24]). CBZ reduced the AP upstroke velocity of rabbit and human cardiomyocytes, without prominent changes in other AP parameters. The reduction occurred at ≥30 µM and was frequency-dependent with a more pronounced reduction at high stimulus frequencies. The cardiac sodium current (INa) was reduced at ≥30 μM; this was accompanied by a hyperpolarizing shift in the voltage-dependency of inactivation. The recovery from inactivation was slower, which is consistent with the more pronounced AP upstroke velocity reduction at high stimulus frequencies. The main cardiac K+ and Ca2+ currents were unaffected, except reduction of L-type Ca2+ current by 100 µM CBZ.Conclusion: CBZ use is associated with an increased risk of SCA in the general population. At concentrations of 30 µM and above, CBZ reduces AP upstroke velocity and INa in cardiomyocytes. Since the concentration of 30 µM is well within the therapeutic range (20–40 µM), we conclude that CBZ increases the risk of SCA by a reduction of the cardiac INa.
Prognostic Impact of Blood Pressure Change Patterns on Patients With Aortic Dissection After Admission
Authors: Wu Zhaoyu , Li Yixuan , Qiu Peng , Liu Haichun , Liu Kai , Li Weimin , Wang Ruihua , Chen Tao , Lu Xinwu 
Published: June 2022

ObjectivesHypertension is a predominant risk factor for aortic dissection (AD), and blood pressure (BP) control plays a vital role in the management of AD. However, the correlation between BP change and the prognosis for AD remains unclear. This study aims to demonstrate the impact of BP change patterns on AD prognosis.MethodsThis retrospective study included AD patients at two institutions (Shanghai Ninth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine and the Vascular Department of the First Affiliated Hospital of Anhui Medical University) between 2004 and 2018. The systolic BP (SBP) change patterns of these patients were analyzed by functional data analysis (FDA). The relationship between BP change patterns and the risk of adverse events (AEs) was assessed using survival analysis.ResultsA total of 458 patients with AD were eligible for analysis. The logistic regression analysis indicated that compared with that in patients with low SBP variation (SBPV), the incidence of AEs in patients with high SBPV was significantly higher (35.84 vs. 20.35%, OR 2.19, P &lt; 0.001). The patients were divided into four categories (accelerating rise, accelerating drop, decelerating rise, and decelerating drop) based on their SBP patterns after FDA fitting. The results of Kaplan–Meier analysis showed that at the 15- and 20-min time points, the incidence of AEs in the decelerating-drop group was significantly lower than that in the accelerating-rise group (OR 0.19, P = 0.031 and OR 0.23, P = 0.050). However, at the 25- and 30-min time points, the difference between these four groups was not significant (OR 0.26, P = 0.08 and OR 0.29, P = 0.10).ConclusionsThis study classified AD patients into four groups according to the SBP change patterns the first 30 min following admission, of which those with accelerating rises in SBP are at the highest risk of AEs, while those with decelerating drops have the best prognosis in the first 24 h after admission. Clinical practitioners may benefit from analyzing patterns of in-hospital SBP.
Pre-infarction Angina: Time Interval to Onset of Myocardial Infarction and Comorbidity Predictors
Authors: Sotomi Yohei , Ueda Yasunori , Hikoso Shungo , Okada Katsuki , Dohi Tomoharu , Kida Hirota , Oeun Bolrathanak , Sunaga Akihiro , Sato Taiki , Kitamura Tetsuhisa , Mizuno Hiroya , Nakatani Daisaku , Sakata Yasuhiko , Sato Hiroshi , Hori Masatsugu , Komuro Issei , Sakata Yasushi 
Published: June 2022

AimsAs part of efforts to identify candidates for patient education aimed at decreasing mortality from acute myocardial infarction, we investigated the prevalence of pre-infarction angina and its predictors among comorbidities in patients who were hospitalized with acute myocardial infarction (MI).MethodsWe conducted a prospective multicenter observational registry of MI patients from 1998 to 2014 (N = 12,093). The present study investigated the prevalence of pre-infarction angina and its predictors among comorbidities with a logistic regression model. Pre-infarction angina was defined as chest pain/oppression observed within 1 month before the onset of MI but which lasted &lt;30 min.ResultsAfter excluding 976 (8.1%) patients with missing data on pre-infarction angina, 11,117 patients [66.4 ± 12.0 years, 9,096 (75.2%) male] were analyzed. Of these, 5,428 patients (48.8%) experienced pre-infarction angina before the onset of MI, while 5,689 (51.2%) experienced sudden onset of acute MI. Most patients experienced the first episode of angina &gt;6 h before the onset of MI, while 15% did so ≤6 h before. Patients with hypertension, diabetes, dyslipidemia, or a family history of MI had a higher probability of pre-infarction angina than those without. Elderly patients and those with a history of cerebrovascular disease were less likely to experience pre-infarction angina.ConclusionsAlmost half of MI patients in our registry experienced pre-infarction angina before MI onset. Patients with hypertension, diabetes, dyslipidemia, or a family history of MI had a higher probability of experiencing pre-infarction angina than those without.
Extracorporeal Membrane Oxygenation—First Strategy for Acute Life-Threatening Pulmonary Embolism
Authors: Liu Zhenjie , Chen Jinyi , Xu Xin , Lan Fen , He Minzhi , Shao Changming , Xu Yongshan , Han Pan , Chen Yibing , Zhu Yongbin , Huang Man 
Published: June 2022

BackgroundBoth venoarterial extracorporeal membrane oxygenation (VA-ECMO) and percutaneous mechanical thrombectomy (PMT) are increasingly used to treat acute life-threatening pulmonary embolism (PE). However, there are little data regarding their effectiveness. This study aimed to present the short-term outcomes after managing nine patients with acute life-threatening massive or submassive PE by VA-ECMO with or without complemented PMT and propose a preliminary treatment algorithm.MethodsThis study was a single-center retrospective review of a prospectively maintained registry. It included nine consecutive patients with massive or submassive pulmonary embolism who underwent VA-ECMO for initial hemodynamic stabilization, with or without PMT, from August 2018 to November 2021.ResultsMean patient age was 54.7 years. Four of nine patients (44.4%) required cardiopulmonary resuscitation before or during VA-ECMO cannulation. All cannulations (100%) were successfully performed percutaneously. Overall survival was 88.9% (8 of 9 patients). One patient died from a hemorrhagic stroke. Of the survivors, the median ECMO duration was 8 days in patients treated with ECMO alone and 4 days in those treated with EMCO and PMT. Five of nine patients (55.6%) required concomitant PMT to address persistent right heart dysfunction, with the remaining survivors (44.4%) receiving VA-ECMO and anticoagulation alone. For survivors receiving VA-ECMO plus PMT, median hospital lengths of stay were 7 and 13 days, respectively.ConclusionsAn ECMO-first strategy complemented with PMT can be performed effectively and safely for acute life-threatening massive or submassive PE. VA-ECMO is feasible for initial stabilization, serving as a bridge to therapy primarily in inoperable patients with massive PE. Further evaluation in a larger cohort of patients is warranted to assess whether VA-ECMO plus PMT may offer an alternative or complementary therapy to thrombolysis or surgical thrombectomy.Type of ResearchSingle-center retrospective review of a prospectively maintained registry.
D-Dimer Is a Diagnostic Biomarker of Abdominal Aortic Aneurysm in Patients With Peripheral Artery Disease
Authors: Cai Huoying , Pan Baihong , Xu Jie , Liu Shuai , Wang Lei , Wu Kemin , Yang Pu , Huang Jianhua , Wang Wei 
Published: June 2022

BackgroundEtiology and risk factors of peripheral artery disease (PAD) include age, smoking, and hypertension, etc. , which are shared by an abdominal aortic aneurysm (AAA). Concomitance with AAA in patients with PAD is not rare but is easily overlooked in the clinical situation, though management strategies are altered totally. This study aims to investigate diagnostic biomarkers for the prediction of AAA in patients with PAD.MethodsA total of 684 patients diagnosed with AAA and/or PAD were enrolled and analyzed retrospectively. Each patient with PAD and AAA was gender and age-matched. Demographic data, medical history, and serum laboratory test profiles were obtained. Statistical analysis was performed to determine diagnostic biomarkers of AAA in patients with PAD.ResultsFirstly, 320 patients with PAD-only and 320 patients with AAA-only were compared. Levels of bilirubin and D-Dimer were decreased, while the incidence of diabetes mellitus, levels of fibrinogen, and platelet count were increased significantly in patients with PAD-only compared with those in patients with AAA-only (P &lt; 0.001). Next, 364 patients with PAD (44 patients with AAA) and 364 patients with AAA (44 patients with PAD) were compared. Multivariate logistic regression analysis confirmed the differential distribution of bilirubin, D-dimer, fibrinogen, and platelet count between patients with AAA and patients with PAD (P &lt; 0.05). Receiver operator curves (ROC) showed that the area under the curve (AUC) of total bilirubin, direct bilirubin, D-dimer, fibrinogen, and platelet count was 0.6113, 0.5849, 0.7034, 0.6473, and 0.6785, respectively. Finally, to further validate the predictive efficacy of mentioned markers, a multivariable logistics regression analysis was performed between the PAD only group and the PAD with AAA group. The results suggested increased levels of D-dimer in the PAD with AAA group compared to the PAD only group (OR: 2.630, 95% CI:1.639–4.221; P &lt; 0.001). In particular, the Youden index suggested that the cut-off value of D-dimer for predicting AAA in patients with PAD was 0.675 mg/L with a sensitivity of 76.9% and a specificity of 84.9% (AUC = 0.8673; 95% CI, 0.8106–0.9240, P &lt; 0.001). In all 364 patients with PAD, 41.46% patients were diagnosed AAA when D-dimer is &gt;0.675 mg/L, while only 3.55% patients were diagnosed AAA when D-dimer ≤ 0.675 mg/L.ConclusionsPAD and AAA exert different clinical and serum profiles; D-dimer (&gt;0.675 mg/L) is a reliable biomarker for the prediction of AAA in patients with PAD.
Economic Evaluation of Transcatheter Aortic Valve Replacement Compared to Surgical Aortic Valve Replacement in Chinese Intermediate-Risk Patients
Authors: Zhang Weicong , Lou Yake , Liu Yujiang , Wang Hongwei , Zhang Chun , Qian Linxue 
Published: June 2022

BackgroundAortic stenosis (AS) is a severe disease that causes heart failure and sudden death. Transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) are both recommended for patients with intermediate surgical risk, but the cost-effectiveness of TAVR compared to SAVR in China has not been investigated.MethodsA combined decision tree and Markov model were conducted to compare the cost-effectiveness of TAVR versus SAVR with a 5-year simulation. The primary outcome was the incremental cost-effectiveness ratio (ICER), a ratio of incremental costs to incremental quality-adjusted life-year (QALY). One-way sensitive analysis and probabilistic sensitivity analysis (PSA) were conducted to test the robustness of the model.ResultsAfter a simulation of 5 years, the costs of TAVR and SAVR were 54,573 and 35,002 USD, respectively, and the corresponding effectiveness was 2.826 versus 2.712 QALY, respectively. The ICER for the TAVR versus SAVR comparison was 170,056 USD/QALY, which was three times higher than the per capita gross domestic product (GDP) in China. One-way sensitive analysis showed that the cost of the TAVR device impacted the ICER. The TAVR could be cost-effective only in the case where its cost is lowered to 29,766 USD.ConclusionTAVR is currently not cost-effective in China, but it could be cost-effective with a reduction of costs to 29,766 USD, which is approximately 65% of the current price.
Case Report: Multimodal Imaging Guides the Management of an Eosinophilic Leukemia Patient With Eosinophilic Myocarditis and Intracardiac Thrombus
Authors: Si Jinping , Zhang Xinxin , Chen Na , Sun Fangfang , Du Ping , Li Zhiyong , Tian Di , Sun Xiuli , Sun Guozhen , Cong Tao , Du Xuemei , Liu Ying 
Published: June 2022

BackgroundEosinophilic leukemia (EL) is a rare, serious and potentially life-threatening condition characterized by the overproduction of eosinophils leading to tissue eosinophilic infiltration and damage. Although multiple organ systems may be involved, progressive eosinophilic myocarditis (EM) is the most common cause of morbidity and mortality. Early diagnosis and follow-up surveillance combined with multimodal imaging are crucial for appropriate treatment of EM.Case SummaryIt’s a rare case of EL with EM and intracardiac thrombus in a 59-year-old patient who presented with asthenia for 3 weeks. Full blood count analysis indicated significant eosinophilia. Bone marrow aspirate revealed dysplastic eosinophilia and a FIP1L1-PDGFRA fusion gene (4q12) was detected, confirming EL. Echocardiography revealed EM with intracardiac thrombus. This was later confirmed by cardiac magnetic resonance imaging. The patient was commenced on imatinib and prednisolone and good clinical response was obtained. Through 18F-FAPI PET/CT imaging, we obtained in vivo visualization of fibroblast activation changes in the early stage of cardiac structure remodeling. With anti-fibrotic therapy after heart failure, the patient achieved a good clinical response.ConclusionThis case demonstrates in vivo visualization of fibroblast activation after EM. Multimodality imaging can provide early diagnosis and may guide tailored antifibrotic therapy in early stage of EM.
Glacier Mass Balance Based on Two Digital Elevation Models and Ground Observation Records for the Baishui River Glacier No. 1 in Yulong Snow Mountain, Southeastern Qinghai–Tibet Plateau
Authors: Chen Lihua , Che Yanjun , Cao Yun , Wang Shijin , Ma Xinggang 
Published: June 2022

Glacier mass balance is a key idea in understanding the relationship between glaciers and climate. In this study, Landsat images, Shuttle Radar Topography Mission, and Advance Land Operation Satellite digital elevation models, and ground observation records for 2000–2010 and 2019–2020 were used to analyze a mass balance of the Baishui River Glacier No. 1 (BRG1) in Yulong Snow Mountain, southeastern Qinghai–Tibet Plateau. Both glaciological and geodetic methods were used to understand the spatial pattern of the mass balance. A mass balance contour line map of the glacier was created for the first time. From 2000 to 2010, the mean annual mass balance of the BRG1 was calculated to be -0.99 m w.e., -1.01 m w.e., and −1.18 m w.e. using the contour line, profile curve, and geodetic methods, respectively. In addition, the analysis revealed that strong melting of the glacier occurred from July 27 to 15 September 2019, with an averaged glacier mass balance of -1.75 m w.e. and a mean daily melting rate of 35 mm w.e. The annual mass balance was assessed to be −1.31 m w.e. during 2019/20 using the contour line method. In addition, the spatial patterns on the mass balance contour maps for 2000–2010 and the summer of 2019, and the climate change in this region were analyzed. The results indicate that the increased air temperature was the main cause of the accelerated glacial melting.
Quantitative Precipitation Estimation Model Integrating Meteorological and Geographical Factors at Multiple Spatial Scales
Authors: Tian Wei , Shen Kailing , Yi Lei , Zhang Lixia , Feng Yang , Chen Shiwei 
Published: June 2022

Heavy precipitation tends to cause mountain torrents, urban waterlogging and other disasters. It poses a serious threat to people’s life and property safety. Therefore, real-time quantitative precipitation estimation is especially important to keep track of precipitation changes and reduce negative impacts. However, high-resolution and high-accuracy quantitative precipitation estimation is a challenging task due to the complex spatial and temporal variability of microphysics in precipitation processes. Previous studies have focused only on small-scale radar reflectivity factors above rain gauges and did not pay enough attention to the contribution of covariates to model performance. Meteorological and geographical factors play an important role in rain process, so these factors are taken into account during our research. In this study, a quantitative precipitation estimation model that can employ multi-scale radar reflectivity factors and fuse meteorological and geographical factors is proposed to further improve precipitation accuracy. In addition, we propose the muti-scale self-attention (MS-SA) module that can further utilize information at multiple spatial scales to improve the accurate precipitation estimation. The proposed model reduced the root mean square error of precipitation estimation by 83.8% compared to the conventional Z-R relationship that correlates the rainfall and radar reflectivity factors, i.e., Z=aRb, and by 43.7, 24.6, and 22.7% compared to the back propagation neural network (BPNN), convolutional neural network (CNN), and convolutional neural network with the addition of meteorological factors and geographical factors as covariates in the proposed model, respectively. Therefore, we can conclude that multi-scale radar reflectivity factors fused with meteorological and geographical factors can produce more accurate precipitation estimation.
Comorbidities in Recent-Onset Adult Type 1 Diabetes: A Comparison of German Cohorts
Authors: Zaharia Oana P. , Lanzinger Stefanie , Rosenbauer Joachim , Karges Wolfram , Müssig Karsten , Meyhöfer Sebastian M. , Burkart Volker , Hummel Michael , Raddatz Dirk , Roden Michael , Szendroedi Julia , Holl Reinhard W. 
Published: June 2022

AimsRestrictive exclusion criteria from different study populations may limit the generalizability of the observations. By comparing two differently designed German cohorts, we assessed the prevalence of cardiovascular risk factors and diabetes-related complications in recent-onset adult type 1 diabetes.MethodsThis study evaluated 1511 persons with type 1 diabetes of the prospective diabetes follow-up registry (DPV) and 268 volunteers of the prospective observational German Diabetes Study (GDS) with a known diabetes duration &lt;1 year. Participants had similar age (36 years), sex distribution (41% female) and BMI (26 kg/m2) in both cohorts.ResultsThe average HbA1c was 6.4 ± 0.8% in the GDS and 7.0 ± 1.1% in the DPV. Prevalence of hypertension (24%) was similar, while more DPV participants had dyslipidemia and lipid-lowering medication than GDS participants (77% vs. 41% and 7% vs. 2%, respectively; p&lt;0.05). Prevalence of retinopathy and nephropathy was higher in DPV compared to GDS participants (10% vs. 3% and 18% vs. 7%, respectively; p&lt;0.001).ConclusionsDiabetic nephropathy and retinopathy are the most frequent complications in type 1 diabetes, affecting up to every 10th patient within the first year after diagnosis, underlining the need for more stringent risk factor management already at the time of diagnosis of type 1 diabetes.
The Association Between FT3 With the Outcome and Inflammation/Coagulopathy/Fibrinolysis of COVID-19
Authors: Deng Jiayi , Zhang Siye , Peng Fei , Zhang Quan , Li Yi , Zhong Yanjun 
Published: June 2022

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has caused substantial threats to people’s physical health and lives, claiming the lives of over 5 million people worldwide. It is imperative to identify the disease severity and intervene with effective therapy as early as possible. Previous studies have shown that low free triiodothyronine (FT3) may possess the predictive value on COVID-19 prognosis.MethodsIn this retrospective cohort study, 15-day clinical and laboratory data of 186 hospitalized patients of COVID-19 after admission were analyzed. Groups were based on the disease severity of COVID-19, survival or non-survival, and presence or absence of euthyroid sick syndrome (ESS). Categorical variables were compared with the chi-square test or Fisher’s exact test. Continuous variables were tested by Wilcoxon rank-sum test for the non-normal distribution. Spearman correlations were used to assess the correlations between FT3 with clinic parameters of multiple time points.ResultsThe non-survival patients had significant lower levels of FT3 (3.24 ± 0.42 vs. 4.19 ± 0.08 pmol/L, p &lt; 0.05) and thyroid-stimulating hormone (TSH) (0.69 ± 0.19 vs. 2.32 ± 0.2 uIU/ml, p &lt; 0.05), and the FT3 of severe patients was significantly lower than that of non-severe patients (3.67 ± 0.14 vs. 4.33 ± 0.09 pmol/L, p &lt; 0.05). Fifty-nine cases of COVID-19 patients were diagnosed with ESS. Compared with non-ESS patients, those with ESS were older and had higher proportions of fever, shortness of breath, hypertension, diabetes, severe disease, and mortality. In addition, the correlation analysis between FT3 and clinical parameters showed that FT3 were positively related to the lymphocyte count and albumin and negatively correlated with C-reactive protein, erythrocyte sedimentation rate, and D-dimer at all time points in the first 15 days after admission.ConclusionLow FT3 had a significant predictive value on the prognosis of COVID-19 patients, and FT3 was significantly related with clinic parameters of inflammation/coagulopathy/fibrinolysis.