bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mouse mesenchymal stem cell-derived exosomal miR-466f-3p reverses EMT process through inhibiting AKT/GSK3β pathway via c-MET in radiation-induced lung injury
Authors: Li Yi , Shen Zhufu , Jiang Xiao , Wang Yuanyuan , Yang Zuozhang , Mao Yuchi , Wu Zhixian , Li Gaofeng , Chen Hong 
Published: April 2022

Abstract
Background
Radiation-induced lung fibrosis (RILF) is a common complication of thoracic radiotherapy. Alveolar epithelial cells play a crucial role in lung fibrosis via epithelial-mesenchymal transition (EMT). Exosomes derived from mesenchymal stem cells own the beneficial properties to repair and regeneration of damaged tissues, however the underlying mechanisms remain poorly understood.

Methods
Mouse mesenchymal stem cells-derived exosomes (mMSCs-Exo) were isolated by differential centrifugation, and their protective effects were assessed in vivo and in vitro, respectively. EMT-associated proteins were measured via western blot assay and/or immunofluorescence staining. The miRNA expression was measured by microarray assay and qPCR. Furthermore, bioinformatics prediction with KEGG analysis, luciferase assay, and rescue experiments were performed to explore the molecular mechanism underlying miR-466f-3p.

Results
mMSCs-Exos were efficiently isolated ranging from 90-150 nm with high expression of exosomal markers (CD63, TSG101, and CD9). mMSCs-Exos administration efficiently relieved radiation-induced lung injury with less collagen deposition and lower levels of IL-1β and IL-6. Meanwhile, in vitro results showed mMSCs-Exos treatment obviously reversed EMT process induced by radiation. Among enriched miRNA cargo in exosomes, miR-466f-3p was primarily responsible for the protective effects via inhibition of AKT/GSK3β pathway. Our mechanistic study further demonstrated that c-MET was the direct target of miR-466f-3p, whose restoration partially abrogated mMSCs-Exo-mediated inhibition in both EMT process and AKT/GSK3β signaling activity induced by radiation.

Conclusions
Our findings indicated that exosomal miR-466f-3p derived from mMSCs may possess anti-fibrotic properties and prevent radiation-induced EMT through inhibition of AKT/GSK3β via c-MET, providing a promising therapeutic modality for radiation-induced lung fibrosis.
Short term high-intensity interval training in patients scheduled for major abdominal surgery increases aerobic fitness
Authors: Michel Anna , Gremeaux Vincent , Muff Guillaume , Pache Basile , Geinoz Sandrine , Larcinese Ana , Benaim Charles , Kayser Bengt , Demartines Nicolas , Hübner Martin , Martin David , Besson Cyril 
Published: April 2022

Abstract
Background
Prehabilitation may improve postoperative clinical outcomes among patients undergoing major abdominal surgery. This study evaluated the potential effects of a high-intensity interval training (HIIT) program performed before major abdominal surgery on patients’ cardiorespiratory fitness and functional ability (secondary outcomes of pilot trial NCT02953119).

Methods
Patients were included before surgery to engage in a low-volume HIIT program with 3 sessions per week for 3 weeks. Cardiopulmonary exercise and 6-min walk (6MWT) testing were performed pre- and post-prehabilitation.

Results
Fourteen patients completed an average of 8.6 ± 2.2 (mean ± SD) sessions during a period of 27.9 ± 6.1 days. After the program, $$\dot{\mathrm{V}}$$

V
˙

O2 peak (+ 2.4 ml min−1 kg−1, 95% CI 0.8–3.9, p = 0.006), maximal aerobic power (+ 16.8 W, 95% CI 8.2–25.3, p = 0.001), $$\dot{\mathrm{V}}$$

V
˙

O2 at anaerobic threshold (+ 1.2 ml min−1 kg−1, 95%CI 0.4–2.1, p = 0.009) and power at anaerobic threshold (+ 12.4 W, 95%CI 4.8–20, p = 0.004) were improved. These changes were not accompanied by improved functional capacity (6MWT: + 2.6 m, 95% CI (− 19.6) to 24.8, p = 0.800).

Conclusion
A short low-volume HIIT program increases cardiorespiratory fitness but not walking capacity in patients scheduled for major abdominal surgery. These results need to be confirmed by larger studies.
Analysis of quality of knowledge structure and students’ perceptions in extension concept mapping
Authors: Prasetya Didik Dwi , Pinandito Aryo , Hayashi Yusuke , Hirashima Tsukasa 
Published: April 2022

AbstractExtension concept mapping is a technique to connect prior existing concept maps with new knowledge structures. It offers advantages in each stage of the knowledge-integrating process and encourages learners to improve their performance. While previous studies have confirmed that the extended kit-build concept map outperformed the extended scratch-build approach in terms of comprehension test scores and map size, they have yet to evaluate the quality of concept maps and students' perceptions. Although the size of the concept map components could represent the breadth of personal knowledge, it does not constantly describe the good knowledge structure. In addition, the student's degree of acceptance after the concept mapping demonstrates their intention to use systems in the future. The present study aims to compare the effect of extended scratch-build and extended kit-build on the students' quality of knowledge structures and perceptions. Fifty-five second-year university students were involved and divided into two groups: control and experimental. The control group utilized the extended scratch-build map, while the experimental group used the extended kit-build concept mapping tool. Quality of propositions and structural map scores as learning outcomes were used to measure the students' knowledge structures. The possibility of a relationship between quality scores was expressed using the Spearman correlation. This study involved the Technology Acceptance Model to confirm the students' perceptions of extension concept mapping tools. The perceived ease-of-use, perceived usefulness, and behavioral intention constructs were used to investigate users' intentions. The findings suggest that the quality of propositions and structural map scores in the experimental group were significantly higher than in the control group. This study also found that the extended kit-build method achieved better perceptions scores than the extended scratch-build.
Fogarty-assisted transcatheter embolization of a large renal high-flow arteriovenous fistula
Authors: Becker Lena S. , Hinrichs Jan B. 
Published: April 2022

Abstract
Background
Renal high-flow arteriovenous fistulas and its complications may involve high output heart failure, hematuria, hypertension or lethal hemorrhage.

Case presentation
This case report covers the case of a 65-year-old male patient with a large renal high-flow arteriovenous fistula of the right kidney (RAVF), treated with balloon-assisted coil and liquid (n-Butyl Cyanoacrylate) embolization. By use of ballon-occlusion with an over-the-wire Fogarty catheter and advancement of a microcatheter through the lumen distal to the balloon during the transcatheter embolization of a high-flow RAVF, control of arterial blood flow is feasible by temporary occlusion of the afferent artery. This technique of flow modulation facilitates controlled deployment of embolization materials and decreases the risk of inadvertent distal embolization by use of only one 6-French (F) arterial sheath.

Conclusions
Balloon-assisted embolization using a Fogarty occlusion catheter represents a feasible, safe and effective treatment option for the treatment of large, high-flow arteriovenous fistulas of the kidney.
The diagnostic process from primary care to child and adolescent mental healthcare services: the incremental value of information conveyed through referral letters, screening questionnaires and structured multi-informant assessment
Authors: Aydin Semiha , Siebelink Bart M. , Crone Matty R. , van Ginkel Joost R. , Numans Mattijs E. , Vermeiren Robert R. J. M. , Michiel Westenberg P. 
Published: April 2022

Background
A variety of information sources are used in the best-evidence diagnostic procedure in child and adolescent mental healthcare, including evaluation by referrers and structured assessment questionnaires for parents. However, the incremental value of these information sources is still poorly examined.

Aims
To quantify the added and unique predictive value of referral letters, screening, multi-informant assessment and clinicians’ remote evaluations in predicting mental health disorders.

Method
Routine medical record data on 1259 referred children and adolescents were retrospectively extracted. Their referral letters, responses to the Strengths and Difficulties Questionnaire (SDQ), results on closed-ended questions from the Development and Well-Being Assessment (DAWBA) and its clinician-rated version were linked to classifications made after face-to-face intake in psychiatry. Following multiple imputations of missing data, logistic regression analyses were performed with the above four nodes of assessment as predictors and the five childhood disorders common in mental healthcare (anxiety, depression, autism spectrum disorders, attention-deficit hyperactivity disorder, behavioural disorders) as outcomes. Likelihood ratio tests and diagnostic odds ratios were computed.

Results
Each assessment tool significantly predicted the classified outcome. Successive addition of the assessment instruments improved the prediction models, with the exception of behavioural disorder prediction by the clinician-rated DAWBA. With the exception of the SDQ for depressive and behavioural disorders, all instruments showed unique predictive value.

Conclusions
Structured acquisition and integrated use of diverse sources of information supports evidence-based diagnosis in clinical practice. The clinical value of structured assessment at the primary–secondary care interface should now be quantified in prospective studies.
Relationship Between TSH Levels and Cognition in the Young Adult: An Analysis of the Human Connectome Project Data
Authors: Santhanam Prasanna , Nath Tanmay , Lindquist Martin A , Cooper David S 
Published: April 2022

Abstract

Context
The nature of the relationship between serum thyrotropin (TSH) levels and higher cognitive abilities is unclear, especially within the normal reference range and in the younger population.

Objective
To assess the relationship between serum TSH levels and mental health and sleep quality parameters (fluid intelligence [Gf], MMSE (Mini-Mental State Examination), depression scores, and, finally, Pittsburgh Sleep Quality Index (PSQI) scores (working memory, processing speed, and executive function) in young adults.

Methods
This was a retrospective analysis of the data from the Human Connectome Project (HCP). The HCP consortium is seeking to map human brain circuits systematically and identify their relationship to behavior in healthy adults. Included were 391 female and 412 male healthy participants aged 22-35 years at the time of the screening interview. We excluded persons with serum TSH levels outside the reference range (0.4-4.5 mU/L). TSH was transformed logarithmically (log TSH). All the key variables were normalized and then linear regression analysis was performed to assess the relationship between log TSH as a cofactor and Gf as the dependent variable. Finally, a machine learning method, random forest regression, predicted Gf from the dependent variables (including alcohol and tobacco use). The main outcome was normalized Gf (nGf) and Gf scores

Results
Log TSH was a significant co-predictor of nGF in females (β = 0.31(±0.1), P &lt; .01) but not in males. Random forest analysis showed that the model(s) had a better predictive value for females (r = 0.39, mean absolute error [MAE] = 0.81) than males (r = 0.24, MAE = 0.77).

Conclusion
Higher serum TSH levels might be associated with higher Gf scores in young women.
Heavier Weight of Resected Thyroid Specimen Is Associated With Higher Postoperative Morbidity in Benign Goiter
Authors: Mintziras Ioannis , Ringelband Rolf , Jähne Joachim , Vorländer Christian , Dotzenrath Cornelia , Zielke Andreas , Klinger Carsten , Holzer Katharina 
Published: April 2022

Abstract

Objective
The impact of heavier weight of resected thyroid specimen on postoperative morbidity after total thyroidectomy for multinodular benign goiter remains unclear.

Methods
Data from the prospective StuDoQ|Thyroid registry of the German Society of General and Visceral Surgery were analyzed regarding the weight of the resected thyroid specimen and perioperative morbidity (vocal cord palsy, hemorrhage, surgical site infection, and hypocalcemia). To achieve a homogeneous patient population, only patients with total thyroidectomy for multinodular benign goiter were included.

Results
A total of 7911 patients from 105 departments underwent total thyroidectomy for benign conditions (January 2017-July 2020). The median resected weight of the thyroid specimen in all patients was 53 g (interquartile range 32-92). In 1732 patients, the specimen weight exceeded 100 g. Intraoperative neuromonitoring was used in 99.5% of patients. Postoperative laryngoscopy revealed vocal cord dysfunction in 480 of 15 822 (3.03%) nerves at risk, with unilateral dysfunction in 454 (2.87%) of patients and bilateral dysfunction in 13 patients (0.08%). In multivariable analysis, a thyroid weight &gt;100 g was an independent predictor of early postoperative vocal cord dysfunction [odds ratio (OR) 1.462, 95% CI 1.108-1.930, P = 0.007). Heavier (&gt;100 g) thyroid weight was an independent predictor of surgical site infection (OR 1.861, 95% CI 1.203-2.880, P = 0.005) and also predicted postoperative hemorrhage in the univariate analysis (OR 1.723, 95% CI 1.027-2.889, P = 0.039). On the contrary, postoperative parathyroid function was not affected.

Conclusions
Heavier (&gt;100 g) resected thyroid weight independently predicts higher postoperative morbidity, including early vocal cord palsy and surgical site infection after total thyroidectomy for benign multinodular goiter.
Machine Learning-Based Models Predicting Outpatient Surgery End Time and Recovery Room Discharge at an Ambulatory Surgery Center
Authors: Gabriel Rodney A. , Harjai Bhavya , Simpson Sierra , Goldhaber Nicole , Curran Brian P. , Waterman Ruth S. 
Published: April 2022

BACKGROUND:
Days before surgery, add-ons may be scheduled to fill unused surgical block time at an outpatient surgery center. At times, outpatient surgery centers have time limitations for end of block time and discharge from the postanesthesia care unit (PACU). The objective of our study was to develop machine learning models that predicted the following composite outcome: (1) surgery finished by end of operating room block time and (2) patient was discharged by end of recovery room nursing shift. We compared various machine learning models to logistic regression. By evaluating various performance metrics, including F1 scores, we hypothesized that models using ensemble learning will be superior to logistic regression.

METHODS:
Data were collected from patients at an ambulatory surgery center. The primary outcome measurement was determined to have a value of 1 (versus 0) if they met both criteria: (1) surgery ends by 5 pm and (2) patient is discharged from the recovery room by 7 pm. We developed models to determine if a procedure would meet both criteria if it were scheduled at 1 pm, 2 pm, 3 pm, or 4 pm. We implemented regression, random forest, balanced random forest, balanced bagging, neural network, and support vector classifier, and included the following features: surgery, surgeon, service line, American Society of Anesthesiologists score, age, sex, weight, and scheduled case duration. We evaluated model performance with Synthetic Minority Oversampling Technique (SMOTE). We compared the following performance metrics: F1 score, area under the receiver operating characteristic curve (AUC), specificity, sensitivity, precision, recall, and Matthews correlation coefficient.

RESULTS:
Among 13,447 surgical procedures, the median total perioperative time (actual case duration and PACU length stay) was 165 minutes. When SMOTE was not used, when predicting whether surgery will end by 5 pm and patient will be discharged by 7 pm, the average F1 scores were best with random forest, balanced bagging, and balanced random forest classifiers. When SMOTE was used, these models had improved F1 scores compared to no SMOTE. The balanced bagging classifier performed best with F1 score of 0.78, 0.80, 0.82, and 0.82 when predicting our outcome if cases were to start at 1 pm, 2 pm, 3 pm, or 4 pm, respectively.

CONCLUSIONS:
We demonstrated improvement in predicting the outcome at a range of start times when using ensemble learning versus regression techniques. Machine learning may be adapted by operating room management to allow for a better determination whether an add-on case at an outpatient surgery center could be appropriately booked.
Relationships Between Body Mass Index, Allogeneic Transfusion, and Surgical Site Infection After Knee and Hip Arthroplasty Surgery
Authors: Tanaka Kenichi A. , Pontikes Andrew E. , Van David , Vandyck Kofi , Butt Amir , Mazzeffi Michael A. , Thakral Rishi , Stewart Kenneth E. 
Published: April 2022

BACKGROUND:
Increased body mass index (BMI) is considered as an important factor that affects the need for total knee and hip arthroplasty (TKA/THA) and the rate of perioperative complications. Previous investigations have not fully established the relationship of BMI and perioperative transfusion with surgical site infection (SSI) or the relationship of BMI and perioperative transfusion after TKA or THA.

METHODS:
The National Surgical Quality Improvement Program database was used to perform a retrospective cohort study involving 333,223 TKA and 41,157 THA cases between 2011 and 2018. Multivariable regression assessed the associations of BMI (5 standard categories) and transfusion with SSI. Odds ratio (OR) of SSI was calculated relative to a normal BMI (18.5–24.9 kg/m2) after adjustment of potential confounding factors.

RESULTS:
Perioperative transfusion decreased significantly over time for both TKA and THA; however, SSI rates remained steady at just under 1% for TKA and 3% for THA. In TKA, a higher OR for SSI was associated only with a BMI of 40+ (OR, 1.86; 95% confidence interval [CI], 1.60–2.18) compared to a referent BMI. In THA, increased ORs of SSI were seen for all BMI levels above normal and were highest for a BMI 40+ (OR, 3.08; 95% CI, 2.47–3.83). In TKA, ORs of transfusion decreased with increasing BMI and were lowest for a BMI 40+ (OR, 0.51; 95% CI, 0.47–0.54). In THA, ORs of transfusion began to increase slightly in overweight patients, reaching an OR of 1.36 (95% CI, 1.21–1.54) for a BMI 40+.

CONCLUSIONS:
SSI incidence remained unchanged despite continuous reductions in blood transfusion in TKA and THA patients over 8 years. In TKA, ORs for SSI increased, but ORs for transfusion decreased with increasing BMI above normal. Conversely, in THA, ORs for SSI and transfusion both increased for a BMI 40+, but only OR for transfusion increased in underweight patients. These findings suggest the importance of controlling obesity in reducing SSI following TKA and THA.
Kim Namch’ŏn’s Barley: Architecture of Loss and Life in Late Colonial Korea
Authors: Park John 
Published: April 2022

Abstract
This study examines the aesthetic significance of the apartment building in Kim Namch’ŏn’s Barley in relationship to the novella’s narrative form. Actively directing the narrative movement, on the one hand, and representing the sense of alienation experienced by Korean intellectuals in the colonial period, on the other, the building is both realistic and allegorical. Its functional role in the narrative development, as well as its symbolic representation of the dominant presence of Western forms, both architectural and ideological, renders the figure of the apartment building essentially ambiguous. This study claims that this ambiguous quality of the building achieves the realist aesthetics that Kim theorized. To articulate this aesthetic and literary theoretical achievement, the article demonstrates how the architecture of the building shapes the narrative movement and describes how the building itself provides the interpretive frame for understanding the significant scenes of the narrative, whose contours the building shapes. The author concludes with an analysis of an unremarkable but critical turn toward the end of the narrative that challenges and resists the interpretive frame the building imposes. This turn grounds the possibility of the experience of alienation becoming art.
Delayed HSV-1 Encephalitis Relapse After Epilepsy Surgery: A Case Report
Authors: Johnson Gabrielle W. , Han Rowland H. , Gupta Vivek P. , Leuthardt Eric C. 
Published: April 2022

BACKGROUND AND IMPORTANCE:
Herpes simplex virus 1 encephalitis (HSVE) can be a rare postoperative complication after neurosurgery. We present the case of a patient with postoperative, twice recurrent HSVE after 20 years, the longest latency period reported after neurosurgery.

CLINICAL PRESENTATION:
A 21-year-old man with a history of HSVE at 13 months and intractable epilepsy presented for surgical resection of seizure focus. The patient underwent left temporal craniotomy and resection of left temporal encephalomalacia. Five days after discharge, the patient presented with fever and headache and was found to have herpes simplex virus 1 (HSV-1)–positive cerebral spinal fluid. The infection was treated with acyclovir, with subsequent symptomatic improvement. Six weeks later the patient represented with recurrent symptoms and HSV-1–positive cerebral spinal fluid. This recurrence was treated with a prolonged course of acyclovir, followed by suppressive valacyclovir therapy, resulting in symptomatic improvement.

CONCLUSION:
HSV-1 encephalitis is a rare but previously reported complication after neurosurgery procedures. In patients with relapse of HSVE, the latency period can range from weeks to years after primary infection, and multiple relapses are rare. We present the case of a patient with twice recurrent, postoperative HSV-1 encephalitis 20 years after initial infection. We aim to emphasize that HSV status should be considered during treatment planning in patients with a history of HSVE being treated for HSV-related illnesses, and HSVE should remain on the differential in these patients when presenting with fever and neurological symptoms after surgery, regardless of time since initial infection.