bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of Right Ventricular Blood Flow in Patients With Chronic Thromboembolic Pulmonary Hypertension: An Analysis With 4-Dimensional Flow Cardiovascular Magnetic Resonance Imaging
Authors: Xu Wenqing , Sun Xuebiao , Tao Xincao , Wang Dingyi , Zhen Yanan , Liu Xiaopeng , An Jing , Xie Wanmu , Liu Min 
Published: June 2022

BackgroundBlood flow is closely related to function, but currently, the relationship of right ventricular (RV) blood flow components with RV function and hemodynamics in patients with chronic thromboembolic pulmonary hypertension (CTEPH) remains unclear. Our objective is to qualify RV function with 4-dimensional flow cardiovascular magnetic resonance (4D-Flow CMR) imaging and to investigate the correlation between RV flow and hemodynamics in patients with CTEPH.MethodsRetrospective enrollment included 67 patients with CTEPH (mean age 47.8±14.2 years, 47 men) who underwent CMR and right heart catheterization (RHC) within 2 days. RHC was used to evaluate hemodynamics. RV flow components including the percentages of direct flow (PDF), retained inflow (PRI), delayed ejection flow (PDEF), and residual volume (PRVo) were quantified on 4D-Flow sequence. RV functional metrics were determined with the CINE balanced steady-state free precession sequence. The sum of PDF and PDEF was compared with RV eject fraction (RVEF). The correlation among RV flow components, RV functional metrics and hemodynamics was analyzed with spearman correlation analysis.ResultsThe median (interquartile range) of RVEF, PDF, PDEF, PRI, and PRVo, respectively was 35.5% (18.2, 45.6%), 18% (8.4, 21.4%), 15.1% (13.5, 19.0%), 15.9% (13.8, 20.8%), and 50.6% (35.6, 60.4%). The sum of PDF and PDEF is 35.1% (24.8, 46.6%), which was similar to RVEF (z = 0.58, p = 0.561). PDF negatively correlated with right ventricular end-systolic volume index (RVESVI), right ventricular myocardial mass index (RVMI) and right ventricular global longitudinal strain (r = −0.61, −0.65, −0.64, p &lt; 0.001). PRVo positively correlated with RVESVI and RVMI (r = 0.50, 0.58, p &lt; 0.001). PDF negatively correlated with pulmonary vascular resistance (PVR) (r = −0.72, p &lt; 0.001) while it positively correlated with cardiac output (CO) and cardiac index (CI) (r = 0.64 &amp; 0.52, p &lt; 0.001). PRVo positively correlated with mean pulmonary pressure and PVR (r = 0.57&amp;0.54, p &lt; 0.001). Total five patients died in the perioperative period. RVEF in the deceased patients was similar to survivors (z = −1.163, p = 0.092). In comparison with the survivors, RVPDF in the deceased patients significantly reduced (z = −2.158, p = 0.029) while RVPDEF, RVPRI, and RVPRVo in deceased patients were similar to survivors.Conclusion4D-Flow CMR can provide simultaneous quantification of RV function and hemodynamics in the assessment of CTEPH without breath-holding. The reduced PDF and increased PRVo were the main characteristics of RV flow in CTEPH.
Intracytoplasmic Sperm Injection May Not Improve Clinical Outcomes Despite Its Positive Effect on Embryo Results: A Retrospective Analysis of 1130 Half-ICSI Treatments
Authors: Peng Nan , Ma Shuiying , Li Cheng , Liu Hui , Zhao Haibin , Li Lian-Jie , Li Qing , Li Mei 
Published: June 2022

ObjectiveTo explore the clinical application value of half-ICSI treatment for infertility in assisted reproductive technology.MethodA retrospective analysis of 1130 half-ICSI treatments was conducted at the Affiliated Reproductive Hospital of Shandong University from January 2011 to December 2015. Patients with low fertilization rates in previous cycles, primary infertility for &gt;5 years with unexplained reason, or secondary infertility for &gt;5 years without fallopian tube factor were involved in this study. The 2PN rate, high-quality embryo rate, oocyte utilization rate, and clinical outcomes were compared between IVF insemination group (IVF group) and ICSI insemination group (ICSI group). The clinical outcome of half-ICSI insemination treatment, grouped according primary and secondary infertility, was also analyzed.ResultsCompared with IVF, ICSI resulted in a significantly higher 2PN rate (74.8% vs. 62.9%), high-quality embryo rate (54.6% vs. 51.7%), and oocyte utilization rate (35.9% vs. 32.8%; P&lt;0.05). Among the 884 fresh-embryo transfer cycles, there were no notable differences in clinical pregnancy rate, live birth rate, or neonatal abnormality rate between the IVF and ICSI groups. Among the 792 primary infertility cycles, ICSI resulted in a significantly higher 2PN rate, high-quality embryo rate, and oocyte utilization rate compared with IVF (75.3% vs. 62.4%, 54.3% vs. 50.8%, 36.4% vs. 32.6%, P&lt;0.05). For the 338 secondary infertility cycles, ICSI resulted in a significantly higher 2PN rate (73.6% vs. 63.9%, P&lt;0.05) compared with IVF, but there were no notable differences in other laboratory results. Moreover, the biochemical pregnancy rate of the ICSI group was significantly lower than for IVF in secondary infertility cycles (49.3% vs. 65.6%; P&lt;0.05). A total of 89 cycles (7.9%) with complete IVF fertilization failure showed a low second polar body (2PB) rate (33.6%) after a 5-h short-time fertilization period, including 34 cycles (3.0%) with no 2PB oocytes observed in the IVF group.ConclusionICSI insemination improved laboratory results compared with IVF insemination, however, fresh-embryo transfer of ICSI originated embryos did not improve clinical pregnancy and live birth rates. Rescue ICSI has been successfully applied in clinical IVF insemination to avoid fertilization failure. Therefore, as an extra intervention, it is suggested that ICSI be used judiciously.
The Burden of Diabetes-Related Chronic Kidney Disease in China From 1990 to 2019
Authors: Pan Xiaowen , Lin Xiling , Huang Xin , Xu Jingya , Ye Lingxia , Zhang Tianyue , Hu Shaoning , Jiang Hongwei , Ren Yuezhong , Shan Peng-Fei 
Published: June 2022

ObjectiveTo analyze the trends in disease burden of diabetes-related chronic kidney disease (CKD) by year, age, gender and types of diabetes in China from 1990 to 2019.MethodsData on prevalence, deaths and disability-adjusted life years (DALYs) for diabetes-related CKD were extracted from the Global Burden of Disease (GBD) 2019 study. Analyses were performed by year, age, gender and types of diabetes.ResultsIn China, the numbers of deaths and DALYs of diabetes-related CKD continuously increased but the age-standardized rates (per 100,000 population) decreased over 30 years, in which the numbers of deaths and DALYs attributable to type 1 diabetes mellitus (T1DM)-related CKD barely changed and the age-standardized rates decreased over the years; and the number of deaths and DALYs attributable to type 2 diabetes mellitus (T2DM)-related CKD continuously increased, but the age-standardized rates also decreased. In 2019, 76.03 (58.24-95.61) thousand deaths and 2.13 (1.65–2.67) million DALYs were attributable to diabetes-related CKD, of which, T2DM accounted for 83.32% and 77.0% respectively, and T1DM accounted for the rest. Increasing gender disparity was seen, with males being more heavily impacted. The burden of diabetes-related CKD varied among different age groups, with the numbers of deaths and DALYs attributable to T1DM-related CKD peaking between 45 and 54 years of age and T2DM-related CKD peaking between 75 and 79 years of age; and the crude rates of deaths and DALYs attributable to T1DM-related CKD peaking between 70 and 79 years of age and 40 to 54 years of age, respectively, and T2DM-related CKD peaking over 90 years of age. Among neighboring and G20 countries, the burden of diabetes-related CKD in China was relatively controlled reflected by the ranking of adjusted death and DALYs rates.ConclusionsThe burden of diabetes-related CKD in China worsens and shows gender disparities and different age distribution. Greater efforts are needed to improve the health outcomes of these patients, especially among males.
Low Serum Dehydroepiandrosterone Is Associated With Diabetic Kidney Disease in Men With Type 2 Diabetes Mellitus
Authors: Zhang Xinxin , Xiao Jinfeng , Li Xin , Cui Jingqiu , Wang Kunling , He Qing , Liu Ming 
Published: June 2022

BackgroundThe associations of dehydroepiandrosterone (DHEA) and dehydroepiandrosterone sulfate (DHEAS) with diabetic kidney disease (DKD) remained unclear. Thus, this cross-sectional study aimed to explore the associations of DHEA and DHEAS with the risk of DKD in patients with T2DM.MethodsThe information of 1251 patients with T2DM were included in this study. Serum DHEA and DHEAS were quantified using liquid chromatography-tandem mass spectrometry assays. Multivariate logistic regression analyses were used to assess the associations of DHEA and DHEAS with DKD as well as high urine albumin to creatinine ratio (ACR).ResultsIn men with T2DM, the risk of DKD decreased with an increasing DHEA concentration after adjustment for traditional risk factors; the fully adjusted OR (95% CI) for tertile3 vs tertile1 was 0.37 (0.19-0.70; P = 0.010 for trend). Similarly, when taking high ACR as the outcome, low DHEA levels were still significantly associated with increased odds of high ACR (OR, 0.37; 95% CI, 0.19–0.72 for tertile3 vs tertile1; P = 0.012 for trend). The restricted cubic spline showed that the risk of DKD gradually decreased with the increment of serum DHEA levels (P-overall = 0.007; P-nonlinear = 0.161). DHEAS was not independently associated with the risk of DKD in men. In contrast, no significant relationships were found between DHEA and DHEAS and the risk of DKD in women (all P &gt; 0.05).ConclusionsIn men with T2DM, low serum DHEA levels were independently related to the risk of DKD after adjustment for traditional risk factors. Our finding highlights the potential role of DHEA in the development of DKD in men with T2DM.
Polyethylene Glycol Loxenatide Injection (GLP-1) Protects Vascular Endothelial Cell Function in Middle-Aged and Elderly Patients With Type 2 Diabetes by Regulating Gut Microbiota
Authors: Chen Fengwu , He Lina , Li Jilin , Yang Shuhui , Zhang Bangzhou , Zhu Dan , Wu Zezhen , Zhang Shuo , Hou Ducheng , Ouyang Cong , Yi Jianfeng , Xiao Chuanxing , Hou Kaijian 
Published: June 2022

Objective: To evaluate the protective effect of Polyethylene Glycol Loxenatide Injection (Glucagon-like peptide-1, GLP-1) on endothelial cells from middle-aged and elderly patients with newly diagnosed or poorly controlled type 2 diabetes mellitus (T2DM). GLP-1 weekly formulation was analyzed for cardiovascular disease protection and correlated with intestinal flora.Design: Stool samples were collected from middle-aged and elderly patients with new-onset or poorly controlled type 2 diabetes in Longhu People’s Hospital and Shantou Central Hospital from June 2019 to November 2019. Samples were collected at week 0, 4, and 8 of treatment with GLP-1 weekly formulations. Samples were analyzed for metagenomic sequencing. Analysis was performed to compare the characteristics of the gut microbiota at week 0, 4, and 8 of GLP-1 treatment and to correlate different microbiota with characteristic clinical parameters.Results: Statistical differences were found in blood glucose lowering, cardiovascular endothelial, and inflammation-related indices between week 0 and W4 and in blood glucose lowering and cardiovascular endothelial indices from week 0 to 8 in the newly diagnosed or poorly controlled type 2 diabetic patients treated with GLP-1. Changes in gut microbiota at week 0, 4, and 8 after using GLP-1 were not statistically different, but had an overall trend of rising and then falling, and with different bacteria, that were correlated with different clinical indicators.Conclusion: GLP-1 improves endothelial cell function indicators in middle-aged and elderly diabetic patients, which may be related to its alteration of the population numbers of gut microbiota such as Acinetobacter, Eubacterium ramulus ATCC 29099, and Bacteroides_faecis. This study provides a guidance for the treatment of type 2 diabetic patients.
Comparative Efficacy of Different Repetitive Transcranial Magnetic Stimulation Protocols for Stroke: A Network Meta-Analysis
Authors: Xia Yuan , Xu Yuxiang , Li Yongjie , Lu Yue , Wang Zhenyu 
Published: June 2022

BackgroundAlthough repetitive transcranial magnetic stimulation (rTMS) has been proven to be effective in the upper limb motor function and activities of daily living (ADL), the therapeutic effects of different stimulation protocols have not been effectively compared. To fill this gap, this study carried out the comparison of the upper limb motor function and ADL performance of patients with stroke through a network meta-analysis.MethodsRandomized controlled trials (RCTs) on the rTMS therapy for stroke were searched from various databases, including PubMed, web of science, Embase, Cochrane Library, ProQuest, Wanfang database, the China National Knowledge Infrastructure (CNKI), and VIP information (www.cqvip.com). The retrieval period was from the establishment of the database to January 2021. Meanwhile, five independent researchers were responsible for the study selection, data extraction, and quality evaluation. The outcome measures included Upper Extremity Fugl-Meyer Assessment (UE-FMA), Wolf Motor Function Test (WMFT), Modified Barthel Index (MBI), the National Institute of Health stroke scale (NIHSS), and adverse reactions. The Gemtc 0.14.3 software based on the Bayesian model framework was used for network meta-analysis, and funnel plots and network diagram plots were conducted using Stata14.0 software.ResultsNinety-five studies and 5,016 patients were included ultimately. The intervention measures included were as follows: placebo, intermittent theta-burst stimulation (ITBS), continuous theta-burst stimulation (CTBS),1 Hz rTMS,3–5 Hz rTMS, and ≥10 Hz rTMS. The results of the network meta-analysis show that different rTMS protocols were superior to placebo in terms of UE-FMA, NIHSS, and MBI outcomes. In the probability ranking results, ≥10 Hz rTMS ranked first in UE-FMA, WMFT, and MBI. For the NIHSS outcome, the ITBS ranked first and 1 Hz rTMS ranked the second. The subgroup analyses of UE-FMA showed that ≥10 Hz rTMS was the best stimulation protocol for mild stroke, severe stroke, and the convalescent phase, as well as ITBS was for acute and subacute phases. In addition, it was reported in 13 included studies that only a few patients suffered from adverse reactions, such as headache, nausea, and emesis.ConclusionOverall, ≥10 Hz rTMS may be the best stimulation protocol for improving the upper limb motor function and ADL performance in patients with stroke. Considering the impact of stroke severity and phase on the upper limb motor function, ≥10 Hz rTMS may be the preferred stimulation protocol for mild stroke, severe stroke, and for the convalescent phase, and ITBS for acute and subacute phases.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier [CRD42020212253].
The Relationship Between Daily Dietary Intake of Fiber and Short Sleep Duration in the Presence of Di(2-Ethylhexyl) Phthalate: A Population-Based Study
Authors: Lin Jilei , Cheng Siying , Zhang Jing , Yuan Shuhua , Zhang Lei , Wu Jinhong , Chen Jiande , Tang Mingyu , Zhao Liebin , Yin Yong 
Published: June 2022

ObjectiveThis study aimed to evaluate the relationship between daily dietary intake of fiber (DDIF) and short sleep duration (SSD) in the presence of di(2-ethylhexyl) phthalate.MethodsData of 13,634 participants in this study were collected from the National Health and Nutrition Examination Survey (NHANES). The sum of urinary mono-2-ethyl-5-carboxypentyl phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl)-hexyl phthalate, and mono-(2-ethyl-5-oxohexyl) phthalate was used to evaluate the level of di(2-ethylhexyl) phthalate (DEHP) exposure. The ln-transformed urinary creatinine-corrected DEHP [ln(DEHP/UCr)] level was used in the statistical models. DDIF was divided into tertiles (&lt;5.77 g/1,000 kcal, 5.77–9.04 g/1,000 kcal, and ≥9.04 g/1,000 kcal).ResultsThe 13,634 participants included in this study were classified into two groups according to sleep duration. The dose response analysis showed that higher ln(DEHP/UCr) was related to a higher risk of SSD (&lt;7 h and &lt;6 h). Participants in the highest vs. the lowest quartile of DEHP were found to be at increased risk of SSD (&lt;7 h, &lt;6 h, and &lt;5 h). The result of risk of SSD &lt;7 h was OR 1.57, 95% CI, 1.40–1.76; Ptrend &lt;0.001, of SSD &lt;6 h was OR 1.38, 95% CI, 1.18–1.61; Ptrend &lt;0.001, and of SSD &lt;5 h was OR 1.45, 95% CI, 1.13–1.86; Ptrend &lt;0.001. DEHP exposure was found to be associated with SSD &lt;7 h in a sex-specific manner (Pinteraction = 0.033). A significant interaction between ln(DEHP/UCr) and DDIF(tertiles1 vs. tertiles2) (Pinteraction = 0.02) was detected for SSD &lt;7 h.ConclusionOur results showed that there was a harmful association between DEHP exposure and SSD (&lt;7 h, &lt;6 h, and &lt;5 h). The ameliorative effects of median level of DDIF on SSD &lt;7 h in the presence of DEHP exposure were observed in this study.
Spina Bifida Occulta Is a Risk Factor for Spinal Cord Injury Without Fracture or Dislocation for Children Performing a Backbend During Dance
Authors: Liu Guoqing , Jiang Wei , Tang Xiang , Tan Shali , Zhang Mingqiang , Tao Liang , Xiao Nong , Chen Yuxia 
Published: June 2022

ObjectiveThis study aimed to explore the clinical features and outcomes of children with spinal cord injury (SCI) without fracture or dislocation.MethodsThe clinical data of children with SCI without fracture or dislocation in this retrospective study were collected in Chongqing, China (January 2010 to December 2021). We collected patient demographics at admission including age, gender, cause, level, and severity of the injury in admission and complications. Reports from radiologic imaging were reviewed to identify spina bifida occulta (SBO). Neurological function was evaluated using the American Spinal Injury Association (ASIA) Impairment Scale (AIS) for an SCI.ResultsA total of 74 children with SCI (male, 27%; female, 73%; male-to-female ratio, 1:2.7; average age, 5.7 years) were included. The main cause of injury was backbend during the dance (34 patients, 45.9%, including 2 patients who hugged back falling backward), followed by traffic accidents (17 patients, 23%). Children with backbend-related SCI were older than other children (6.9 vs. 4.9 years old, P &lt; 0.001). When reviewing all radiological images, it was found that 20 (27%) patients with SCI had SBO. The proportion of SCI with SBO caused by backbend was considerably higher than those caused by non-backbend (41.2 vs. 15%, P = 0.012). The AIS were 22 (29.7%), 4 (5.4%), 8 (10.8%), 31 (41.9%), and 9 (12.2%) in A, B, C, D, and E, respectively. The prognosis was poorer in the backbend during dancing than other causes of injury (p = 0.003).ConclusionThis study showed that backbend during the dance was the main cause of children's SCI without fracture or dislocation in Chongqing, China. The prognosis was poorer in those children than in other causes of injury. Meanwhile, we have established an association between SBO and SCI for children performing a backbend during the dance.
Obstructive Sleep Apnea and Cardiovascular Risk: The Role of Dyslipidemia, Inflammation, and Obesity
Authors: Zdravkovic Marija , Popadic Viseslav , Klasnja Slobodan , Milic Natasa , Rajovic Nina , Divac Anica , Manojlovic Andrea , Nikolic Novica , Lukic Filip , Rasiti Esma , Mircetic Katarina , Marinkovic Djordje , Nikolic Sofija , Crnokrak Bogdan , Lisulov Danica Popovic , Djurasevic Sinisa , Stojkovic Maja , Todorovic Zoran , Lasica Ratko , Parapid Biljana , Djuran Predrag , Brajkovic Milica 
Published: June 2022

Introduction: The present study aimed to establish the role of lipid abnormalities and inflammatory markers for developing cardiovascular risk, as well as to address the importance of obesity as a common comorbidity in patients with obstructive sleep apnea (OSA).Methods: The study was conducted as a prospective cohort study including 120 patients with newly diagnosed OSA between 2019 and 2020, at University Clinical Hospital Center “Bezanijska kosa”, Belgrade, Serbia. The diagnosis was established by polysomnography. In all patients, sociodemographic data, respiratory, lipid, and inflammatory parameters were collected and complete echocardiographic study and 24-h blood pressure monitoring were performed.Results: The mean patient age was 55.7 ± 13.8 years. Study population was mostly male (70.0%) and obese (56.7%). At least 30 apneas or hypopneas per hour were present in 39.0% of patients. A strong positive correlation was found between OSA severity and BMI (r = 0.562, p &lt; 0.001), both associated with lipid, inflammatory and respiratory parameters, and cardiovascular profile of patients with OSA (p &lt; 0.05 for all). Echocardiographic study and 24-h blood pressure monitoring parameters were in turn correlated with lipid and inflammatory markers (p &lt; 0.05 for all).Conclusion: The results of this study support the important role of dyslipidemia and inflammation, as well as coexistence of obesity in the pathogenesis of numerous conditions linked with an increased risk of cardiovascular morbidity and mortality in patients with OSA.
A Psychological Investigation of Selection Criteria for Learning Agents (Super Users) and Allocation of Responsibilities in the Implementation of Technological Change
Authors: Vaag Jonas R. , Sætren Gunhild B. , Halvorsen Thomas H. , Sørgård Stine D. 
Published: June 2022

PurposeIn the introduction of new technologies into organizations, there has been an increasing trend to recruit and make use of the so-called “super users” to help ensure the future use of the technology in question. Little is known about the criteria that should ideally be considered in the selection of these super users, or about the best way to carve up the roles and responsibilities in this process between super users and middle management. In this study, we investigated (1) which criteria should be emphasized in the selection of super users, and (2) how middle management and super users understand and negotiate the responsibilities of their respective roles during implementation of technological change.MethodsWe conducted 10 individual semi-structured interviews and used thematic analysis of this data set to identify selection criteria, roles, and responsibilities.ResultsWe found that the main selection criteria for super users should be: (1) availability and local knowledge, (2) technological skills, (3) pedagogical skills, and (4) proactiveness. The main roles and responsibilities that should be carved up between management and super users can be grouped into two overarching categories, each with several subcategories. Within theLearning culturecategory, the responsibilities are to (1) facilitate collective learning, (2) engage with criticism, and (3) promote collective sharing; and within theIndividual learningcategory, to (4) facilitate individual learning, (5) provide instrumental support, and (6) provide emotional support.Discussion and ConclusionBased on the findings, we propose a conceptual model of technological implementation and the construction of a culture of organizational learning, entitled ECo-System Of Learning in Organizations (ECSO-Learn); we additionally show how a learning agent (previously known as a super user) can be recruited to best fit into this model of long-term organizational learning.