bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of two surgical approaches for acute type A aortic dissection: hybrid debranching versus total arch replacement
Authors: Huang Feng , Li Xiaofeng , Zhang Zili , Li Chunping , Ren Fei 
Published: June 2022

Abstract
Background
The goal of this study was to determine the clinical outcomes of total arch replacement with frozen elephant trunk surgery and hybrid debranching surgery for acute type A aortic dissection patients.

Methods
From January 2017 to December 2019, the clinical data of acute type A aortic dissection patients were retrospectively collected and analyzed. There were 142 patients underwent total arch replacement with frozen elephant trunk surgery and 35 patients underwent hybrid debranching surgery.

Result
The age, the body mass index and the renal insufficiency of patients in the hybrid group were higher than those in the total arch replacement (TAR) group (all P < 0.01). The operation time, the cardiopulmonary bypass time and the aortic occlusion time of patients in the TAR group were significantly longer than those in the hybrid group (all P < 0.01). Patients in the debranching group had shorter ventilator-assisted breathing time, shorter postoperative hospital stay time and shorter intensive care unit (ICU) stay time. The incidence of pulmonary infection and transient neurological dysfunction were lower, and the transfusions of red blood cells and plasma during the perioperative period were smaller. The survival rates at 2 years were 91.9% and 85.9% in the TAR and hybrid groups, respectively.

Conclusion
Hybrid debranching operation is a safe and effective method for acute type A aortic dissection. Compared with TAR surgery, hybrid debranching surgery has the characteristics of less trauma, rapid recovery and lower incidence of complication.
Fecal fermentation characteristics of Rheum tanguticum polysaccharide and its effect on the modulation of gut microbial composition
Authors: Wu Ding-Tao , Yuan Qin , Feng Kang-Lin , Zhang Jinming , Gan Ren-You , Zou Liang , Wang Shengpeng 
Published: June 2022

Abstract
Background
Rheum tanguticum is utilized as one of the well known traditional Chinese medicine for the treatment of gastrointestinal diseases. Recently, R. tanguticum polysaccharides (RP) have received increasing attention due to their diversely pharmacological activities. Usually, the pharmacological activities of polysaccharides are closely correlated to their metabolic properties from the stomach to the intestine. However, the digestive behavior and fecal fermentation characteristics of RP are unknown, which need to be fully investigated.

Methods
In this study, an in vitro simulated gastrointestinal model was carried out for the investigation of the digestive behavior and fecal fermentation characteristics of RP. The possible changes in physicochemical properties of RP, such as molecular weight, monosaccharide composition, reducing sugar released, chemical composition, pH value, and short chain fatty acids, were determined during in vitro simulated digestion and human fecal fermentation, and its effect on the modulation of gut microbial composition was also evaluated.

Results
The results revealed that RP was indigestible under the in vitro simulated digestion conditions according to its stabilities in physicochemical properties. Conversely, the indigestible RP (RPI) could be notably utilized by colonic microbiota in human feces after the in vitro fermentation, especially, at the initial fermentation stage (0–6 h). The fecal fermentation characteristics of RPI were revealed. Results showed that the content of reducing sugars obviously increased from 0.177 to 0.778 mg/mL at the initial stage of fermentation, and its molecular weight notably declined from 2.588 × 105 to 0.828 × 105 Da at the end stage of fermentation. Notably, the utilization of arabinose and galactose in RPI by colonic bacteria was faster than that of galacturonic acid. Besides, RPI could obviously modulate gut microbial composition via promoting the relative abundances of several beneficial bacteria, such as genera Bacteroides, Bifidobacterium, and Megamonas, resulting in the promoted production of several short-chain fatty acids, such as acetic, propionic, and butyric acids.

Conclusions
Results from this study showed that RP was indigestible in the human upper gastrointestinal tract in vitro, but could be easily utilized by colonic microbiota in human feces at the initial stage of fermentation. RP could be used as potential prebiotics for the improvement of intestinal health.
Users' passivity in accessing digested scientific evidence through social media: cross-sectional insights
Authors: Machado Gabriela M. , Braga Mariana M. 
Published: June 2022

Abstract
Objectives
This manuscript provides novel insights about the potential use of social media (a Facebook page, the first strategic attempt by EviDent initiative) to share evidence-based dentistry content and empowerment strategies for professionals, using quantifiable usage metrics, besides exposing the strengths and weaknesses of this knowledge translation strategy. One year-long gathered metrics were analyzed to understand information about usage patterns.

Results
Publications were potentially exposed to 4784 users, and subsequent interaction with the page occurred in 18% of cases. Users' involvement with page content was associated with the number of page visitors (P = .005). However, users' interaction with the page was not associated with the potential number of users that could have seen the page (P = .25). Even considering the users that approved the posts, only 7%, on average, interacted with the post's links. Although social media has effectively disseminated scientific content, our experience revealed the user's passivity in interacting with the content. We expect to overcome these barriers by developing a mobile app to offer a more interactive and dynamic interface associated with a more attractive format for posting, including images and infographics.
Effect of positioning and expiratory rib-cage compression on atelectasis in a patient who required prolonged mechanical ventilation: a case report
Authors: Hosoe Takuya , Tanaka Tsuyoshi , Hamasaki Honoka , Nonoyama Kotomi 
Published: June 2022

Abstract
Background
Pulmonary complications can be caused by intraoperative mechanical ventilation. In particular, prolonged mechanical ventilation is associated with a high mortality rate, a risk of pulmonary complications, prolonged hospitalization, and an unfavorable discharge destination. Pre- and postoperative rehabilitation are important for the resolution of pulmonary complications in acute cases. However, there has been a lack of studies on interventions for pulmonary rehabilitation of patients with chronic pulmonary complications caused by prolonged mechanical ventilation. Accordingly, we describe the effect of pulmonary rehabilitation in such a patient.

Case presentation
We examined a 63-year-old Japanese woman with hypoxic–ischemic encephalopathy after subarachnoid hemorrhage who required prolonged mechanical ventilation. Radiographic and computed tomographic images revealed atelectasis of the right upper lobe. In addition, this atelectasis reduced the tidal volume, minute volume, and oxygen saturation and caused an absence of breath sounds in the right upper lobe during auscultation. We aimed to ameliorate the patient’s atelectasis and improve her ventilation parameters by using positioning and expiratory rib-cage compression after endotracheal suctioning. Specifically, the patient was seated in Fowler’s position, and mild pressure was applied to the upper thorax during expiration, improving her inspiratory volume. Immediately, breath sounds were audible in the right upper lobe. Furthermore, resolution of the patient’s atelectasis was confirmed with chest radiography performed on the same day. In addition, her ventilation parameters (tidal volume, minute volume, and oxygen saturation) improved.

Conclusions
Our results indicate that physical therapists should consider application of specific positioning and expiratory rib-cage compression in patients who exhibit atelectasis because of prolonged mechanical ventilation.
A patient with familial Mediterranean fever mimicking diarrhea-dominant irritable bowel syndrome who successfully responded to treatment with colchicine: a case report
Authors: Kumei Shima , Ishioh Masatomo , Murakami Yuki , Ando Katsuyoshi , Nozu Tsukasa , Okumura Toshikatsu 
Published: June 2022

Abstract
Background
Irritable bowel syndrome is a functional gastrointestinal disease. Visceral hypersensitivity is the most important pathophysiology in irritable bowel syndrome. Currently, diagnosis of irritable bowel syndrome is based on symptoms and exclusion of other organic diseases. Although the diagnosis of irritable bowel syndrome can be made based on the Rome IV criteria, one may speculate that complete exclusion of other organic diseases is not so easy, especially in cases uncontrolled with standard therapies.

Case presentation
We present herein a case of familial Mediterranean fever in a young Japanese patient who had been suffering from an irritable bowel syndrome-like clinical course. A 25-year-old Japanese male had been diagnosed as having diarrhea-predominant irritable bowel syndrome 5 years earlier. Unfortunately, standard therapies failed to improve irritable bowel syndrome symptoms. After careful medical history-taking, we understood that he had also experienced periodic fever since 10 years ago. Although no mutation was identified in the Mediterranean fever gene, not only periodic fever but abdominal symptoms improved completely after colchicine administration. He was therefore diagnosed as having familial Mediterranean fever and that the abdominal symptoms may be related to the disease.

Conclusions
Familial Mediterranean fever should be considered as a cause of irritable bowel syndrome-like symptoms.
Metabolic sensor O-GlcNAcylation regulates erythroid differentiation and globin production via BCL11A
Authors: Luanpitpong Sudjit , Kang Xing , Janan Montira , Thumanu Kanjana , Li Jingting , Kheolamai Pakpoom , Issaragrisil Surapol 
Published: June 2022

AbstractBackgroundHuman erythropoiesis is a tightly regulated, multistep process encompassing the differentiation of hematopoietic stem cells (HSCs) toward mature erythrocytes. Cellular metabolism is an important regulator of cell fate determination during the differentiation of HSCs. However, howO-GlcNAcylation, a posttranslational modification of proteins that is an ideal metabolic sensor, contributes to the commitment of HSCs to the erythroid lineage and to the terminal erythroid differentiation has not been addressed.MethodsCellularO-GlcNAcylation was manipulated using small molecule inhibition or CRISPR/Cas9 manipulation of catalyzing enzymeO-GlcNAc transferase (OGT) and removing enzymeO-GlcNAcase (OGA) in two cell models of erythroid differentiation, starting from: (i) human umbilical cord blood-derived CD34+hematopoietic stem/progenitor cells (HSPCs) to investigate the erythroid lineage specification and differentiation; and (ii) human-derived erythroblastic leukemia K562 cells to investigate the terminal differentiation. The functional and regulatory roles ofO-GlcNAcylation in erythroid differentiation, maturation, and globin production were investigated, and downstream signaling was delineated.ResultsFirst, we observed that two-step inhibition of OGT and OGA, which were established from the observed dynamics ofO-GlcNAc level along the course of differentiation, promotes HSPCs toward erythroid differentiation and enucleation, in agreement with an upregulation of a multitude of erythroid-associated genes. Further studies in the efficient K562 model of erythroid differentiation confirmed that OGA inhibition and subsequent hyper-O-GlcNAcylation enhance terminal erythroid differentiation and affect globin production. Mechanistically, we found that BCL11A is a key mediator ofO-GlcNAc-driven erythroid differentiation and β- and α-globin production herein. Additionally, analysis of biochemical contents using synchrotron-based Fourier transform infrared (FTIR) spectroscopy showed unique metabolic fingerprints upon OGA inhibition during erythroid differentiation, supporting that metabolic reprogramming plays a part in this process.ConclusionsThe evidence presented here demonstrated the novel regulatory role ofO-GlcNAc/BCL11A axis in erythroid differentiation, maturation, and globin production that could be important in understanding erythropoiesis and hematologic disorders whose etiology is related to impaired erythroid differentiation and hemoglobinopathies. Our findings may lay the groundwork for future clinical applications toward an ex vivo production of functional human reticulocytes for transfusion from renewable cell sources, i.e., HSPCs and pluripotent stem cells.
Impact of volcanic ash from Cotopaxi-2015 and Tungurahua-2016 eruptions on the dielectric characteristics of suspension insulators, Ecuador
Authors: Ramírez Juan , Vasconez Francisco J. , López Alex , Valencia Fausto , Quilumba Franklin , Vásconez Müller Anais , Hidalgo Silvana , Bernard Benjamin 
Published: June 2022

AbstractIn Ecuador, a country with several active volcanoes and with four eruptions in the last decade in the continental arc, it is very likely that high-voltage transmission lines cross volcanic hazard zones on their routes. Here, we quantify the impact of fresh volcanic ash from the hydromagmatic Cotopaxi-2015 and the magmatic Tungurahua-2016 eruptions on the dielectric characteristics of ANSI 52–3 suspension insulators made of porcelain and glass, under moist conditions. The experiments include two methodologies to measure the performance of the insulators in real-time: the minimum insulator flashover voltage (FOVmin) and the dielectric loss factor angle. Both allow quantifying i) the critical voltage that the insulators can withstand prior to flashover occurrence and, ii) the strong fluctuating behavior that the insulators undergo in an ashy environment. Based on six contamination scenarios, we found that there is a higher chance of flashover if the insulators are completely blanketed (top and bottom) even with a fine ash layer (1 mm), than if they are covered just at the top. Our results further show that the ash of Cotopaxi-2015 eruption has a higher chance of leading to insulator failure because of its higher conductivity (i.e. higher leachate content) than that of Tungurahua-2016. Additionally, we identify two critical voltages prior to electrical flashover on the insulators of 28.25 kV and 17.01 kV for the 230 kV and 138 kV Ecuadorian transmission lines, respectively. Finally, we present a simple impact evaluation for the main Ecuadorian transmission lines based on the outcomes of this research and the official volcanic hazard maps for Cotopaxi and Tungurahua volcanoes.
Gene variations of glutamate metabolism pathway and epilepsy
Authors: Feng Yan , Zhang Cuirong , Wei Zihan , Li Guoyan , Gan Yajing , Liu Chao , Deng Yanchun 
Published: June 2022

Abstract
Background
Epilepsy is a paroxysmal disorder of the brain, caused by an imbalance of neuronal excitation and inhibition. Glutamate is the most important excitatory neurotransmitter in the brain and plays an important role in epileptogenesis. Mutations in genes at any step/component of the glutamate metabolic pathway may lead to the development of epilepsy or epileptic encephalopathy.

Methods
Clinical history of 3 epilepsy patients with genetic variations of the glutamate metabolism pathway was collected. Electroencephalogram recording and magnetic resonance imaging were performed in each patient. We also reviewed recent literature for a variety of the genetic variations involved in epilepsy.

Results
Case 1 was a SLC1A2 mutation-carrier diagnosed with developmental and epileptic encephalopathy (DEE) 41, whose seizures decreased after start of the ketogenic diet. Case 2 carried a GRIN2A gene mutation and was seizure-free for three years after taking levetiracetam and vitamin B6. Case 3 was a GRIN2B mutation-carrier diagnosed with DEE 27, who seizures diminished after taking oxcarbazepine.

Conclusions
Preclinical and clinical evidence supports the therapeutic potential of glutamatergic signaling-targeting treatments for epilepsy. More studies are needed to discover novel DEE-related genetic mutations in the glutamate metabolic pathway.
Durvalumab Plus Olaparib in Previously Untreated, Platinum-Ineligible Patients With Metastatic Urothelial Carcinoma: A Multicenter, Randomized, Phase II Trial (BAYOU)
Authors: Rosenberg Jonathan E. , Park Se Hoon , Kozlov Vadim , Dao Tu V. , Castellano Daniel , Li Jian-Ri , Mukherjee Som D. , Howells Kathryn , Dry Hannah , Lanasa Mark C. , Stewart Ross , Bajorin Dean F. 
Published: June 2022

PURPOSEHomologous recombination repair gene mutations (HRRm) are common in urothelial carcinoma (UC), rendering tumor cells sensitive to poly (ADP-ribose) polymerase (PARP) inhibition. We assessed efficacy and safety of durvalumab (anti–programmed cell death ligand-1) plus olaparib (PARP inhibitor) in patients with metastatic UC (mUC).METHODSThis randomized, multicenter, double-blind, phase II trial enrolled untreated, platinum-ineligible patients with mUC. Patients (N = 154) were randomly assigned 1:1 to receive durvalumab (1,500 mg intravenously once every 4 weeks) plus olaparib (300 mg orally, twice daily) or durvalumab plus placebo. The primary end point was progression-free survival (PFS) assessed by investigators per RECIST version 1.1. Secondary end points included overall survival in all patients and PFS in patients with HRRm.RESULTSOverall, median PFS was 4.2 months (95% CI, 3.6 to 5.6) for durvalumab plus olaparib and 3.5 months (95% CI, 1.9 to 5.1) for durvalumab plus placebo (hazard ratio [HR], 0.94; 95% CI, 0.64 to 1.39; log-rank P value, .789). Median overall survival was 10.2 months (95% CI, 7.0 to 13.9) and 10.7 months (95% CI, 7.2 to 17.3), respectively (HR, 1.07; 95% CI, 0.72 to 1.61). In the 20% of patients with HRRm, median PFS was 5.6 months (95% CI, 1.9 to 8.1) and 1.8 months (95% CI, 1.7 to 2.2), respectively (HR, 0.18; 95% CI, 0.06 to 0.47). Treatment-related grade 3 or 4 adverse events occurred in 18% and 9% of patients, respectively.CONCLUSIONAdding olaparib to durvalumab did not improve survival outcomes in an unselected mUC population. Efficacy outcomes with durvalumab were similar to those reported for other anti–programmed cell death-1/programmed cell death ligand-1 agents. However, the results of secondary analyses suggest a potential role for PARP inhibition in patients with UC harboring HRRm.
Power Output Manipulation from Below to Above the Gas Exchange Threshold Results in Exacerbated Performance Fatigability
Authors: BROWNSTEIN CALLUM G. , PASTOR FREDERIC SABATER , MIRA JOSÉ , MURIAS JUAN M. , MILLET GUILLAUME Y. 
Published: June 2022

ABSTRACT

Introduction
Performance fatigability is substantially greater when exercising in the severe- versus heavy-intensity domain. However, the relevance of the boundary between moderate- and heavy-intensity exercise, the gas exchange threshold (GET), to performance fatigability is unclear. This study compared alterations in neuromuscular function during work-matched exercise above and below the GET.

Methods
Seventeen male participants completed work-matched cycling for 90, 110, and 140 min at 110%, 90%, and 70% of the GET, respectively. Knee extensor isometric maximal voluntary contraction (MVC), high-frequency doublets (Db100), low- to high-frequency doublet ratio (Db10:100), and voluntary activation were measured at baseline, 25%, 50%, 75%, and 100% of task completion. During the initial baseline visit and after each constant work rate bout, ramp-incremental exercise was performed, and peak power output and oxygen uptake (V̇O2peak) were determined.

Results
After the 70% and 90% GET trials, similar reductions in MVC (−14% ± 6% and −14% ± 8%, respectively, P = 0.175) and Db100 (−7% ± 9% and −6% ± 9%, respectively, P = 0.431) were observed. However, for a given amount of work completed, reductions in MVC (−25% ± 15%, P = 0.008) and Db100 (−12% ± 8%, P = 0.029) were up to 2.6-fold greater during the 110% than the 90% GET trial. Peak power output and V̇O2peak during ramp-incremental exercise were reduced by 7.0% ± 11.3% and 6.5% ± 9.3%, respectively, after the 110% GET trial relative to the baseline ramp (P ≤ 0.015), with no changes after the moderate-intensity trials (P ≥ 0.078).

Conclusions
The lack of difference in fatigability between the trials at 70% and 90% GET, coupled with the greater fatigability at 110% relative to 90% GET, shows that exceeding the moderate- to heavy-intensity boundary has implications for performance fatigability, while also impairing maximal exercise performance capacity.
Etiological factors and treatment of chylothorax in paediatric patients - a systematic review
Authors: Knop Kinga , Kochanowska Anna , Piasecka Zuzanna , Kosieradzka Karolina , Drozd Małgorzata , Bodajko-Grochowska Anna 
Published: June 2022

Chylothorax is an accumulation of chyle in the pleural cavity. It is a relatively rare cause of pleural effusion in children and its annual incidence is 14 cases per 100 000 children in Europe.
The pleural fluid triglyceride level greater than 110 mg/dl with a cholesterol level lower than 200 mg/dl confirms the diagnosis of chylothorax. Medical imaging are also necessary such as a non-invasive and easily accessible lung ultrasound. Symptoms of this disease are tachypnea, dyspnea, and in some cases dry cough.
This review aims to summarize the current literature regarding chylothorax in children, analyze its possible etiologies and treatments.
The causes of chylothorax are varied. It may appear after surgical interventions, traumas, infections and also be congenital. Iatrogenic factors are the most common cause of chylothorax in children with cardiothoracic surgeries. Management of chylothorax can be quite complex and highly variable, depending on patient’s condition and their response to the introduced treatment. Conservative treatment consisting of nutrition therapy, chest drain, and pharmacotherapy is typically a first-line of treatment. Diet modification consist in dietary supplements enriched with medium chain triglycerides (MCT) or starting the patient on a total parenteral nutrition (TPN). In most of the analyzed cases the conservative treatment alone proved sufficient in the management of chylothorax. In case of its failure, surgical treatment was a secondary therapy choice. One of the most common surgical procedures for pleural effusion is a thoracic duct ligation (TDL) or pleurodesis and both of these methods are highly effective therapy for chylothorax.
This review of the literature reveals a wide variety of causes and methods of treatment of chylothorax. There are no clear standards of management and the therapy is adjusted to the clinical condition of the patient.