bluuebunny/crossref_metadata_2025_split huggingface dataset:
Definitions of low cardiac output syndrome after cardiac surgery and their effect on the incidence of intraoperative LCOS: A literature review and cohort study
Authors: Schoonen Anna , van Klei Wilton A. , van Wolfswinkel Leo , van Loon Kim 
Published: September 2022

ObjectivesLow cardiac output syndrome (LCOS) is a serious complication after cardiac surgery. Despite scientific interest in LCOS, there is no uniform definition used in current research and clinicians cannot properly compare different study findings. We aimed to collect the LCOS definitions used in literature and subsequently applied the definitions obtained to existing data to estimate their effect on the intraoperative LCOS incidences in adults, children and infants.DesignThis is a literature review, followed by a retrospective cohort study.SettingThis is a single-institutional study from a university hospital in the Netherlands.ParticipantsPatients from all ages undergoing cardiac surgery with cardiopulmonary bypass between June 2011 and August 2018.InterventionsWe obtained different definitions of LCOS used in the literature and applied these to data obtained from an anesthesia information management system to estimate intraoperative incidences of LCOS. We compared intraoperative incidences of LCOS in different populations based on age (infants, children and adults).Measurements and main resultsThe literature search identified 262 LCOS definitions, that were applied to intraoperative data from 7,366 patients. Using the 10 most frequently published LCOS definitions, the obtained incidence estimates ranged from 0.4 to 82% in infants, from 0.6 to 56% in children and from 1.5 to 91% in adults.ConclusionThere is an important variety in definitions used to describe LCOS. When applied to data obtained from clinical care, these different definitions resulted in large distribution of intraoperative LCOS incidence rates. We therefore advocate for standardization of the LCOS definition to improve clinical understanding and enable adequate comparison of outcomes and treatment effects both in daily care and in research.
Revisiting exercise-induced premature ventricular complexes as a prognostic factor for mortality in asymptomatic patients: A systematic review and meta-analysis
Authors: Iqbal Mohammad , Putra Iwan Cahyo Santosa , Kamarullah William , Pranata Raymond , Achmad Chaerul , Karwiky Giky , Pramudyo Miftah , Goenawan Hanna , Akbar Mohammad Rizki , Kartasasmita Arief Sjamsulaksan , Kim Young Hoon 
Published: September 2022

BackgroundRecent investigations suggest that premature ventricular complexes (PVCs) during an exercise test are associated with an elevated risk of mortality in asymptomatic individuals. However, given the small number of studies included, the association between these two entities in the asymptomatic population remains obscure. Our aim was to evaluate this matter.MethodsA comprehensive literature search was conducted utilizing several online databases up to April 2022. The study comprised cohort studies examining the relationship between exercise-induced premature ventricular complexes (EI-PVCs) and all-cause mortality (ACM) as well as cardiovascular mortality (CVM) in asymptomatic populations. To provide diagnostic values across the statistically significant parameters, we additionally calculated sensitivity, specificity, and area under the curve (AUC).ResultsA total of 13 studies consisting of 82,161 patients with a mean age of 49.3 years were included. EI-PVCs were linked to an increased risk of ACM (risk ratio (RR) = 1.30 (95% confidence interval (CI) = 1.18–1.42); p &lt; 0.001; I2 = 59.6%, p-heterogeneity &lt; 0.001) and CVM (RR = 1.67 (95% CI = 1.40–1.99); p &lt; 0.001; I2 = 7.5%, p-heterogeneity = 0.373). Subgroup analysis based on the frequency of PVCs revealed that frequent PVCs were similarly related to a higher risk of ACM and CVM, but not infrequent PVCs. Moreover, diagnostic test accuracy meta-analysis showed that recovery phase EI-PVCs have a higher overall specificity than exercise phase EI-PVCs regarding our outcomes of interest.ConclusionEI-PVCs are correlated with a higher risk of ACM and CVM. When compared to the exercise phase, the specificity of PVCs generated during the recovery period in predicting interest outcomes is higher. As a result, we propose that the exercise ECG be utilized on a regular basis in middle-aged asymptomatic individuals to measure the frequency of PVCs and stratify the risk of mortality.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=328852], identifier [CRD42022328852].
Earth model-space exploration in Southern California: Influence of topography, geotechnical layer, and attenuation on wavefield accuracy
Authors: Ajala Rasheed , Persaud Patricia , Juarez Alan 
Published: September 2022

Accurately predicting the seismic wavefield is important for physics-based earthquake hazard studies and is dependent on an accurate source model, a good model of the subsurface geology, and the full physics of wave propagation. Here, we conduct numerical experiments to investigate the effect of different representations of the Southern California Earthquake Center and Harvard community velocity models on seismic waveform predictions in the vicinity of the San Andreas fault in Salton Trough. We test general preconceptions about the importance of topography, near-surface geotechnical layering, and anelastic attenuation up to a maximum frequency of 0.5 Hz. For the Southern California Earthquake Center model developed without topography, we implement 1D and linear model extensions that preserve the geologic structure and a pull-up approach that adapts the original model to topographic variations and distorts the subsurface. The Harvard model includes an elevation model, so we test the squashed topography representation, which flattens it. For both community models, we modify the top 350 m by partially applying the Ely geotechnical layer using a minimum shear wave velocity of 600 m/s and incorporate an Olsen attenuation model using a ratio of 0.05. We evaluate the resulting 24 model representations using the classical waveform misfit and five moderate-magnitude earthquakes. Only the inclusion of attenuation consistently improves the wavefield predictions. It becomes more impactful at higher frequencies, where it significantly improves the performance levels of the crude 1D and linear extension models close to that of the original version. The pull-up topography representation also enhances the waveform prediction ability of the original model. Squashing the topography of the elevation-referenced Harvard model produces better seismogram fits, suggesting that seismic imagers construct community tomographic models without topography to avoid issues related to missing model parameters near the free surface or discrepancies with a different elevation model. Although full implementation of the Ely geotechnical layer that would permit shear wave velocities as low as 90 m/s proves computationally expensive, our partial implementation provides slightly better results in some cases. Our results can serve as recommendations for implementing these community models for future validation or optimization studies.
External validation and clinical application of the predictive model for severe hypoglycemia
Authors: Yun Jae-Seung , Han Kyungdo , Choi Soo-Yeon , Cha Seon-Ah , Ahn Yu-Bae , Ko Seung-Hyun 
Published: September 2022

ObjectiveAn internally validated, one-year risk prediction model for severe hypoglycemia (SH) in type 2 diabetes was evaluated in a general hospital setting to externally verify and validate its performance.Research design and methodsBetween December 2017 to December 2019, 2,645 adult patients with type 2 diabetes who visited the diabetes center were enrolled. The receiver operating characteristics curve and Harrell C-statistics were compared to identify the discrimination of the model. The predicted and actual incidence of SH for one year in the development and validation cohorts were compared by ranking participants by deciles of predicted risk.ResultsThe concordance index was 0.878 in the external validation cohort. The sensitivity and specificity of the predictive model were 0.833 and 0.847, respectively. Based on the predicted risk, we stratified the groups into four categories: low (&lt;0.05%), intermediate (0.05% to &lt;0.5%), high (0.5% to &lt;2.0%), and very high-risk group (≥2.0%). The actual annual incidence of SH gradually increased with the increased risk score level for the decile group (P for trend &lt;0.001). The actual annual SH incidence significantly increased with increase in SH risk scores, which proportionately increased with age, duration of diabetes, glycated hemoglobin, and albuminuria and decreased with body mass index, renal function (p for trends &lt;0.001 for all) in type 2 diabetes.ConclusionOn external validation, the novel one-year SH prediction model showed excellent discrimination in participants with type 2 diabetes and can effectively screen high-risk patients for SH, even in the general hospital setting.
Benchmarking marine renewable energy technologies through LCA: Wave energy converters in the Mediterranean
Authors: Bruno Morena , Maccanti Matteo , Pulselli Riccardo Maria , Sabbetta Alessio , Neri Elena , Patrizi Nicoletta , Bastianoni Simone 
Published: September 2022

The present work evaluates the environmental performance of three wave energy converters including on-shore oscillating water columns and oscillating floaters embedded in piers, and near-shore seabed-based buoys in the Mediterranean Basin. The life cycle assessment methodology was used to account for their potential environmental impact, in terms of carbon footprint (t CO2eq), considering four main phases, i.e., manufacturing of material components, assembling and installation on site, maintenance in time, and decommission end of life. Results show the greenhouse gas emission from different lifecycle processes, based on the inventory of main energy inputs and materials, highlighting the major impact of the manufacture of the structural components (52 %), especially due to the limited durability of materials. In order to compare the performances of the three different wave energy converters, the carbon intensity of electricity was evaluated considering a range of electricity production per technology based on data available in scientific literature. The results obtained for a single device (203–270 g CO2eq‧kWh−1 for the oscillating water column system; 94–374 g CO2eq‧kWh−1 for oscillating floater and 105–158 g CO2eq‧kWh−1 for the seabed-based buoy) highlight that wave energy converters are promising solutions to harvest wave energy, showing lower carbon intensity of electricity values compared to fossil energy sources; nevertheless, technological improvements are needed to increase efficiency and achieve the performances of other renewable energy sources. Moreover, the combination of wave energy converters with other solutions, such as offshore wind turbines, represents a valuable option in the future to increase productivity and foster energy transition of the Mediterranean regions.
Simultaneous detection of genomic imbalance in patients receiving preimplantation genetic testing for monogenic diseases (PGT-M)
Authors: Yang Lin , Xu Yan , Xia Jun , Yan Huijuan , Ding Chenhui , Shi Qianyu , Wu Yujing , Liu Ping , Pan Jiafu , Zeng Yanhong , Zhang Yanyan , Chen Fang , Jiang Hui , Xu Yanwen , Li Wei , Zhou Canquan , Gao Ya 
Published: September 2022

Background: Preimplantation genetic test for monogenic disorders (PGT-M) has been used to select genetic disease-free embryos for implantation during in vitro fertilization (IVF) treatment. However, embryos tested by PGT-M have risks of harboring chromosomal aneuploidy. Hence, a universal method to detect monogenic diseases and genomic imbalances is required.Methods: Here, we report a novel PGT-A/M procedure allowing simultaneous detection of monogenic diseases and genomic imbalances in one experiment. Library was prepared in a special way that multiplex polymerase chain reaction (PCR) was integrated into the process of whole genome amplification. The resulting library was used for one-step low-pass whole genome sequencing (WGS) and high-depth target enrichment sequencing (TES).Results: The TAGs-seq PGT-A/M was first validated with genomic DNA (gDNA) and the multiple displacement amplification (MDA) products of a cell line. Over 90% of sequencing reads covered the whole-genome region with around 0.3–0.4 × depth, while around 5.4%–7.3% of reads covered target genes with &gt;10000 × depth. Then, for clinical validation, 54 embryos from 8 women receiving PGT-M of β-thalassemia were tested by the TAGs-seq PGT-A/M. In each embryo, an average of 20.0 million reads with 0.3 × depth of the whole-genome region was analyzed for genomic imbalance, while an average of 0.9 million reads with 11260.0 × depth of the target gene HBB were analyzed for β-thalassemia. Eventually, 18 embryos were identified with genomic imbalance with 81.1% consistency to karyomapping results. 10 embryos contained β-thalassemia with 100% consistency to conventional PGT-M method.Conclusion: TAGs-seq PGT-A/M simultaneously detected genomic imbalance and monogenic disease in embryos without dramatic increase of sequencing data output.
Comprehensive analysis of m7G modification patterns based on potential m7G regulators and tumor microenvironment infiltration characterization in lung adenocarcinoma
Authors: Ma Shouzheng , Zhu Jun , Wang Mengmeng , Zhu Jianfei , Wang Wenchen , Xiong Yanlu , Jiang Runmin , Liu Lei , Jiang Tao 
Published: September 2022

Background: The non-negligible role of epigenetic modifications in cancer development and tumor microenvironment (TME) has been demonstrated in recent studies. Nonetheless, the potential regulatory role of N7-methylguanosine (m7G) modification in shaping and impacting the TME remains unclear.Methods: A comprehensive analysis was performed to explore the m7G modification patterns based on 24 potential m7G regulators in 817 lung adenocarcinoma (LUAD) patients, and the TME landscape in distinct m7G modification patterns were evaluated. The m7G score was established based on principal component analysis (PCA) to quantify m7G modification patterns and evaluate the TME cell infiltrating characteristics of individual tumors. Further, correlation analyses of m7Gscore with response to chemotherapy and immunotherapy were performed.Results: We identified three distinct m7G modification patterns with the biological pathway enrichment and TME cell infiltrating characteristics corresponded to immune-desert, immune-inflamed and immune-excluded phenotype, respectively. We further demonstrated the m7Gscore could predict the TME infiltrating characteristics, tumor mutation burden (TMB), response to immunotherapy and chemotherapy, as well as prognosis of individual tumors. High m7Gscore was associated with increased component of immune cell infiltration, low TMB and survival advantage, while low m7Gscore was linked to decreased immune cell infiltration and increased TMB. Additionally, patients with lower m7Gscore demonstrated significant therapeutic advantages.Conclusion: This study demonstrated the regulatory mechanisms of m7G modification on TME formation and regulation of lung adenocarcinoma. Identification of individual tumor m7G modification patterns will contribute to the understanding of TME characterization and guiding more effective immunotherapy strategies.
Survival outcomes of surgical and non-surgical treatment in elderly patients with stage I pancreatic cancer: A population-based analysis
Authors: Nie Duorui , Lan Qingxia , Shi Bin , Xu Fei 
Published: September 2022

BackgroundDue to underrepresentation in randomized controlled trials among old people (≥65 years old), the effectiveness of clinical trial-based recommendations about the treatment for stage I pancreatic cancer remains controversial. In this research, we intended to investigate the different strategies of this population in surgery group and non-surgery group.Materials and methodsElderly patients aged 65 years or older with histologically diagnosed stage I pancreatic cancer from 2006 to 2017 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The included patients were divided into surgery group (receiving surgery with chemotherapy or chemoradiotherapy) and non-surgery group (receiving radiotherapy, chemotherapy, both, or neither). Overall survival (OS) and cancer-specific survival (CSS) were compared between groups by Kaplan–Meier analysis. Cox proportional hazards regression (Cox) proportional hazards regression was used to determine factors associated with survival.ResultsA total of 2,448 eligible patients were recruited. Among them, 18.4% were treated surgically and 81.6% were treated non-surgically. The median OS (mOS) was 26 months (95% CI: 24–30 months) in the surgery group and 7 months (95% CI: 7–8 months) in the non-surgery group. In multivariate analyses, surgery was an important factor in improving OS compared with non-surgical treatment (HR: 0.34, 95% CI: 0.29–0.39, p &lt; 0.001). In subgroup analysis, surgery plus chemotherapy was an independent factor for OS in the surgery group, while chemoradiotherapy, chemotherapy, and radiotherapy were independent prognostic factors for patients in the non-surgery group.ConclusionSurgical resection and post-operative chemotherapy are recommended for elderly patients with stage I pancreatic cancer who can tolerate treatment, but post-operative chemoradiotherapy does not bring survival benefits compared with post-operative chemotherapy. Moreover, radiotherapy, chemotherapy, or the combination of radiotherapy and chemotherapy are significantly related to the prognosis of elderly patients with untreated pancreatic cancer, but chemoradiotherapy has the most obvious benefit.
Real clinical experience after one year of treatment with tolvaptan in patients with autosomal dominant polycystic kidney disease
Authors: Naranjo Javier , Borrego Francisco , Rocha José Luis , Salgueira Mercedes , Martín-Gomez Maria Adoración , Orellana Cristhian , Morales Ana , Vallejo Fernando , Hidalgo Pilar , Rodríguez Francisca , Garófano Remedios , González Isabel , Esteban Rafael , Espinosa Mario 
Published: September 2022

BackgroundTolvaptan (TV) is the first vasopressin-receptor antagonist approved for the treatment of autosomal dominant polycystic kidney disease (ADPKD). No publications report TV experience in real clinical practice during the first year of treatment.MethodsA prospective study of an initial cohort of 220 rapidly progressing patients treated with TV for 12 months. The tolerability of TV, the evolution of the estimated glomerular filtration rate (eGFR), analytical parameters, and blood pressure were analyzed.ResultsA total of 163 patients (78.2%) received TV for 1 year. The main causes of treatment withdrawal were the aquaretic effects (11%), eGFR deterioration (5%), and hepatic toxicity (2.3%). eGFR decreased significantly after 1 month of treatment without further changes. The decrease in eGFR in the first month was higher in patients with an initially higher eGFR. The eGFR drop during the first year of treatment with TV was lower than that reported by patients in the 2 years prior to TV treatment (–1.7 ± 7.6 vs. –4.4 ± 4.8 mL/min, p = 0.003). Serum sodium and uric acid concentrations increased, and morning urinary osmolality decreased in the first month, with no further changes. Blood pressure decreased significantly without changes in antihypertensive medication.ConclusionTV treatment is well tolerated by most patients. Liver toxicity is very rare and self-limited. TV reduces eGFR in the first month without showing further changes during the first year of treatment. Patients with a higher starting eGFR will suffer a greater initial drop, with a longer recovery. We suggest using the eGFR observed after a month of treatment as the reference for future comparisons and calculating the rate of eGFR decline in patients undergoing TV treatment.
The relationship between mild cognitive impairment and postoperative delirium undergoing total knee arthroplasty: The PNDABLE study
Authors: Wang Bin , Mu Chuanlin , Tang Xinhui , Wang Fei , Zhang Gaofeng , Wang Jiahan , Dong Rui , Lin Xu , Bi Yanlin 
Published: September 2022

BackgroundPatients undergoing surgery are at a higher risk of developing postoperative delirium (POD) as a result of anesthesia and surgical procedures. This study examined the association between POD and mild cognitive impairment (MCI) and whether MCI influences POD through the core pathology of POD.MethodsWe enrolled Chinese Han patients undergoing unilateral total knee arthroplasty (aged 50–90, weighing 50–80 kg, and using ASAI-II), combined with epidural anesthesia between October 2020 and June 2021. All the participants were assessed using Winblad's criteria for diagnosing MCI on pre-operation and using the Confusion Assessment Method (CAM) and the Memorial Delirium Assessment Scale (MDAS) postoperative 1–7 days (or before discharge) for diagnosing POD by an anesthesiologist. Cerebrospinal fluid (CSF) biomarkers of POD were measured by enzyme-linked immunosorbent assay (ELISA). To examine the mechanism by which POD pathologies affect cognition, causal mediation analyses were performed.ResultsPOD incidence was 20.2%, including 32.5% in the MCI group and 12.4% in the non-mild cognitive impairment (NMCI) group. The MCI and CSF levels of T-tau and P-tau were risk factors, and the CSF levels of Aβ42, Aβ42/ T-tau, and Aβ42/ P-tau were protective factors in POD (p &lt; 0.05). Part of the effects of MCI on cognition can be attributed to amyloid pathology and tau.ConclusionMCI may be a reasonably good prognostic factor in POD development. Overall, amyloid pathology and tau protein might partially mediate the influence of MCI on POD.Clinical trial registrationwww.clinicaltrials.gov, identifier: ChiCTR2000033439.
Lesions causing central sleep apnea localize to one common brain network
Authors: Yuan Taoyang , Zuo Zhentao , Xu Jianguo 
Published: September 2022

ObjectivesTo characterize the specific brain regions for central sleep apnea (CSA) and identify its functional connectivity network.MethodsWe performed a literature search and identified 27 brain injuries causing CSA. We used a recently validated methodology termed “lesion network mapping” to identify the functional brain network subtending the pathophysiology of CSA. Two separate statistical approaches, the two-sample t-test and the Liebermeister test, were used to evaluate the specificity of this network for CSA through a comparison of our results with those of two other neurological syndromes. An additional independent cohort of six CSA cases was used to assess reproducibility.ResultsOur results showed that, despite lesions causing CSA being heterogeneous for brain localization, they share a common brain network defined by connectivity to the middle cingulate gyrus and bilateral cerebellar posterior lobes. This CSA-associated connectivity pattern was unique when compared with lesions causing the other two neurological syndromes. The CAS-specific regions were replicated by the additional independent cohort of six CSA cases. Finally, we found that all lesions causing CSA aligned well with the network defined by connectivity to the cingulate gyrus and bilateral cerebellar posterior lobes.ConclusionOur results suggest that brain injuries responsible for CSA are part of a common brain network defined by connectivity to the middle cingulate gyrus and bilateral cerebellar posterior lobes, lending insight into the neuroanatomical substrate of CSA.