bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noninvasive Monitoring to Demonstrate Postoperative Differences in Regional Hemodynamics in Newborn Infants With d-Transposition of the Great Arteries and Hypoplastic Left Heart Syndrome
Authors: Sahni Prateek V , Krishnamurthy Ganga , Sahni Rakesh 
Published: December 2022

Background The adequacy of tissue O2 delivery in infants receiving intensive care is difficult to measure directly. Regional O2 (rSO2) and fractional tissue O2 extraction (FTOE), the ratio of O2 consumption to O2 delivery, obtained from newer noninvasive tools, such as near-infrared spectroscopy (INVOS) and microvascular tissue oximetry (T-Stat) can provide important information on the adequacy of tissue oxygenation and aid in managing critically ill infants. Methods We prospectively evaluated differences in rSO2 and FTOE in 26 infants with hypoplastic left heart syndrome (HLHS) (n = 12) or d-transposition of the great arteries (d-TGA) (n = 14). Continuous noninvasive monitoring of SpO2, heart rate, and perfusion index with pulse oximetry, cerebral-rSO2 and renal-rSO2 with INVOS, and buccal tissue oxygenation using T-Stat were performed during immediate postoperative period for 24 hours. Results The SpO2 and rSO2 in infants with d-TGA were higher compared with the infants with HLHS at all measured sites (buccal mucosa, cerebral, and renal). Significant regional differences were also observed in FTOE across all infants with the highest at the buccal mucosa tissue level, followed by cerebral and renal measurement sites. As compared with infants with d-TGA, infants with HLHS had higher regional FTOE and heart rate, with a lower arterial O2 content and perfusion index. Conclusions Our study demonstrates the utility of noninvasive hemodynamic monitoring to assess regional oxygenation and perfusion, as evidenced by significant differences in infants with HLHS and d-TGA, conditions with different circulation physiologies. Such comprehensive monitoring can potentially aid in evaluating treatment strategies aimed at preventing organ damage from O2 insufficiency.
Marine facies differentiation along complex paleotopography: an example from the Middle Miocene (Serravallian) of Lower Austria
Authors: Piller Werner E. , Auer Gerald , Graber Hugo , Gross Martin 
Published: December 2022

AbstractIn the area of Bad Deutsch-Altenburg (Hainburg Mountains, Lower Austria) a Middle Miocene transgression over Mesozoic basement was explored in the course of the Danube power plant project “Hainburg”. The Mesozoic basement forms a narrow ridge dipping to the northeast towards the Vienna Basin, covered by various Miocene sediments. The ridge represents a specific paleotopography that required a detailed study with 78 shallow, fully cored drill holes in an area of c. 0.5 km2. Ten drillings were selected for this study based on sedimentary composition and position relative to the Mesozoic ridge. These 10 cores, ranging in drilling depth from 26.5 to 96.4 m, were studied in respect to sedimentology, corallinacean algae, calcareous nannoplankton, foraminifers and ostracodes to reconstruct sediment distribution and paleoenvironment. Sediment distribution clearly shows that the Mesozoic ridge formed a physical barrier with siliciclastics dominating in the SW of the ridge and carbonate sediments prevailing in the NE. Based on biostratigraphy (calcareous nannoplankton, foraminifera, ostracodes, dinoflagellates) the majority of the sediments can be dated to the late Badenian (early Serravallian) only in some drillholes lower Sarmatian (upper Serravallian) sediments were detected. In terms of sequence stratigraphy, the Badenian sediments represent the transgressive and highstand systems tract of 3rdorder sequence TB 2.5 (bound by the lowstands Ser 2 and Ser 3), the lower Sarmatian sediments can be correlated to sequence TB 2.6. Carbonate sediments show a wide spectrum of 13 facies which are mostly dominated by coralline algae. According to the relative positions of the drill holes a water depth between 0 and about 50 m can be reconstructed what is supported by the occurrence of the benthic biota. This biota indicates that the sedimentary succession started from the very beginning under full marine conditions. Except of basal conglomerates/breccias water energy conditions were low and turbidity high. Close to the Sarmatian boundary a reduction in salinity and depth may have occurred which is also observed in the Sarmatian sediments. Carbonate sediments and, in particular, larger benthic foraminifers indicate tropical to warm-temperate conditions for the late Badenian of the studied sections. The siliciclastic sediments NW of the Mesozoic ridge reflect riverine input indicated by the occurrence of freshwater ostracodes and characean oogonias. Calcareous nannoplankton and dinoflagellates show a high share of reworking from Upper Cretaceaous and Paleogene sediments.
Graph4Med: a web application and a graph database for visualizing and analyzing medical databases
Authors: Schäfer Jero , Tang Ming , Luu Danny , Bergmann Anke Katharina , Wiese Lena 
Published: December 2022

AbstractBackgroundMedical databases normally contain large amounts of data in a variety of forms. Although they grant significant insights into diagnosis and treatment, implementing data exploration into current medical databases is challenging since these are often based on a relational schema and cannot be used to easily extract information for cohort analysis and visualization. As a consequence, valuable information regarding cohort distribution or patient similarity may be missed. With the rapid advancement of biomedical technologies, new forms of data from methods such as Next Generation Sequencing (NGS) or chromosome microarray (array CGH) are constantly being generated; hence it can be expected that the amount and complexity of medical data will rise and bring relational database systems to a limit.DescriptionWe present Graph4Med, a web application that relies on a graph database obtained by transforming a relational database. Graph4Med provides a straightforward visualization and analysis of a selected patient cohort. Our use case is a database of pediatric Acute Lymphoblastic Leukemia (ALL). Along routine patients’ health records it also contains results of latest technologies such as NGS data. We developed a suitable graph data schema to convert the relational data into a graph data structure and store it in Neo4j. We used NeoDash to build a dashboard for querying and displaying patients’ cohort analysis. This way our tool (1) quickly displays the overview of patients’ cohort information such as distributions of gender, age, mutations (fusions), diagnosis; (2) provides mutation (fusion) based similarity search and display in a maneuverable graph; (3) generates an interactive graph of any selected patient and facilitates the identification of interesting patterns among patients.ConclusionWe demonstrate the feasibility and advantages of a graph database for storing and querying medical databases. Our dashboard allows a fast and interactive analysis and visualization of complex medical data. It is especially useful for patients similarity search based on mutations (fusions), of which vast amounts of data have been generated by NGS in recent years. It can discover relationships and patterns in patients cohorts that are normally hard to grasp. Expanding Graph4Med to more medical databases will bring novel insights into diagnostic and research.
In-hospital mortality and SpO2 incritical care patients with cerebral injury: data from the MIMIC‑IV Database
Authors: Yin Haoyang , Yang Rui , Xin Yun , Jiang Tao , Zhong Dong 
Published: December 2022

Abstract
Background
Evidence regarding the relationship between in-hospital mortality and SpO2 was low oxygen saturations are often thought to be harmful, new research in patients with brain damage has found that high oxygen saturation actually enhances mortality. However, there is currently no clear study to point out the appropriate range for oxygen saturation in patients with craniocerebral diseases.

Methods
By screening all patients in the MIMIC IV database, 3823 patients with craniocerebral diseases (according to ICD-9 codes and ICD-10) were selected, and non-linear regression was used to analyze the relationship between in-hospital mortality and oxygen saturation. Covariates for all patients included age, weight, diagnosis, duration of ICU stay, duration of oxygen therapy, etc.

Results
In-hospital mortality in patients with TBI and SAH was kept to a minimum when oxygen saturation was in the 94–96 range. And in all patients, the relationship between oxygen saturation and in-hospital mortality was U-shaped. Subgroup analysis of the relationship between oxygen saturation and mortality in patients with metabolic encephalopathy and other encephalopathy also draws similar conclusions In-hospital mortality and oxygen saturation were all U-shaped in patients with subarachnoid hemorrhage, metabolic and toxic encephalopathy, cerebral infarction, and other encephalopathy, but the nonlinear regression was statistically significant only in patients with cerebral infarction (p for nonlinearity = 0.002).

Conclusion
Focusing too much on the lower limit of oxygen saturation and ignoring too high oxygen saturation can also lead to increase in-hospital mortality. For patients with TBI and SAH, maintaining oxygen saturation at 94–96% will minimize the in-hospital mortality of patients.
Methodological guidance for the evaluation and updating of clinical prediction models: a systematic review
Authors: Binuya M. A. E. , Engelhardt E. G. , Schats W. , Schmidt M. K. , Steyerberg E. W. 
Published: December 2022

Abstract
Background
Clinical prediction models are often not evaluated properly in specific settings or updated, for instance, with information from new markers. These key steps are needed such that models are fit for purpose and remain relevant in the long-term. We aimed to present an overview of methodological guidance for the evaluation (i.e., validation and impact assessment) and updating of clinical prediction models.

Methods
We systematically searched nine databases from January 2000 to January 2022 for articles in English with methodological recommendations for the post-derivation stages of interest. Qualitative analysis was used to summarize the 70 selected guidance papers.

Results
Key aspects for validation are the assessment of statistical performance using measures for discrimination (e.g., C-statistic) and calibration (e.g., calibration-in-the-large and calibration slope). For assessing impact or usefulness in clinical decision-making, recent papers advise using decision-analytic measures (e.g., the Net Benefit) over simplistic classification measures that ignore clinical consequences (e.g., accuracy, overall Net Reclassification Index). Commonly recommended methods for model updating are recalibration (i.e., adjustment of intercept or baseline hazard and/or slope), revision (i.e., re-estimation of individual predictor effects), and extension (i.e., addition of new markers). Additional methodological guidance is needed for newer types of updating (e.g., meta-model and dynamic updating) and machine learning-based models.

Conclusion
Substantial guidance was found for model evaluation and more conventional updating of regression-based models. An important development in model evaluation is the introduction of a decision-analytic framework for assessing clinical usefulness. Consensus is emerging on methods for model updating.
Indications for resection of recurrent lesions in patients with distal cholangiocarcinoma based on prognostic factors: a single-institute retrospective study and brief literature review
Authors: Mashiko Taro , Ogasawara Toshihito , Masuoka Yoshihito , Ei Shigenori , Takahashi Shinichiro , Mori Masaki , Koyanagi Kazuo , Yamamoto Seiichiro , Nakagohri Toshio 
Published: December 2022

Abstract
Background
To evaluate the effectiveness of surgery for recurrent distal cholangiocarcinoma and determine surgical indications based on prognostic factors for the recurrence of distal cholangiocarcinoma.

Methods
We analysed the outcomes of 101 patients who underwent surgical resection for distal cholangiocarcinoma between 2000 and 2018. The clinicopathological factors and prognosis of primary and recurrent distal cholangiocarcinoma were investigated.

Results
Of the 101 patients with resected distal cholangiocarcinoma, 52 (51.5%) had relapsed. Seven (13.5%) and 45 patients (86.5%) underwent resection of recurrent lesions and palliative therapy, respectively. There were no major complications requiring therapeutic intervention after metastasectomy. The median overall survival in patients with and without surgery for recurrent lesions was 83.0 (0.0–185.6) and 34 months (19.0–49.0), respectively. Therefore, patients who had undergone surgery for recurrent lesions had a significantly better prognosis (p = 0.022). Multivariate analyses of recurrent distal cholangiocarcinoma revealed that recurrence within one year was an independent predictor of poor survival. Resection of recurrent lesions improved prognosis.

Conclusions
Radical resection in recurrent distal cholangiocarcinoma may improve the prognosis in selected patients. Although time to recurrence is considered an important factor, the small number of cases of recurrence and resection of recurrent lesions in this study makes it difficult to conclude which patients are best suited for resection of recurrent lesions. This issue requires clarification in a multicentre prospective study, considering patients’ background, such as the recurrence site and number of metastases.
Granulation tissue-type hemangioma in a 6-week-old puppy – a case report
Authors: Müller Janina , Henrich Manfred , Hoogen-Merkel Johanna , Hartung Svenja 
Published: December 2022

AbstractBackgroundHemangioma is a well-known neoplasia in veterinary and human medicine. Several subtypes have been described and are distinguished based on their histologic appearance. The classification schemes of hemangiomas in human and veterinary medicine are different, and various purpose-based schemes can be found in the literature.Case presentationA six-week-old puppy was presented that suffered from a neoplasia that extended to the musculature of the hind limb. After surgical excision, the mass was submitted for pathohistological examination. The mass was composed of endothelial cells forming vascular slits admixed with a fibrous stroma and spindle cells. Immunohistological examination was positive for factor VIII-related antigen and smooth muscle actin, supporting the diagnosis of hemangioma.ConclusionThe final diagnosis of granulation tissue-type hemangioma was given due to the histological appearance of the neoplasia. Granulation tissue-type hemangioma is a rare subtype of hemangioma. In this case an uncommonly young dog was affected.
Acidic ascites inhibits ovarian cancer cell proliferation and correlates with the metabolomic, lipidomic and inflammatory phenotype of human patients
Authors: Yang Qianlu , Bae Gyuntae , Nadiradze Giorgi , Castagna Arianna , Berezhnoy Georgy , Zizmare Laimdota , Kulkarni Aditi , Singh Yogesh , Weinreich Frank J. , Kommoss Stefan , Reymond Marc A. , Trautwein Christoph 
Published: December 2022

AbstractBackgroundThe poor prognosis of ovarian cancer patients is strongly related to peritoneal metastasis with the production of malignant ascites. However, it remains largely unclear how ascites in the peritoneal cavity influences tumor metabolism and recurrence. This study is an explorative approach aimed at for a deeper molecular and physical–chemical characterization of malignant ascites and to investigate their effect on in vitro ovarian cancer cell proliferation.MethodsThis study included 10 malignant ascites specimens from patients undergoing ovarian cancer resection. Ascites samples were deeply phenotyped by1H-NMR based metabolomics, blood-gas analyzer based gas flow analysis and flow cytomertry based a 13-plex cytokine panel. Characteristics of tumor cells were investigated in a 3D spheroid model by SEM and metabolic activity, adhesion, anti-apoptosis, migratory ability evaluated by MTT assay, adhesion assay, flowcytometry and scratch assay. The effect of different pH values was assessed by adding 10% malignant ascites to the test samples.Results The overall extracellular (peritoneal) environment was alkaline, with pH of ascites at stage II-III = 7.51 ± 0.16, and stage IV = 7.78 ± 0.16. Ovarian cancer spheroids grew rapidly in a slightly alkaline environment. Decreasing pH of the cell culture medium suppressed tumor features, metabolic activity, adhesion, anti-apoptosis, and migratory ability. However, 10% ascites could prevent tumor cells from being affected by acidic pH. Metabolomics analysis identified stage IV patients had significantly higher concentrations of alanine, isoleucine, phenylalanine, and glutamine than stage II-III patients, while stage II-III patients had significantly higher concentrations of 3-hydroxybutyrate. pH was positively correlated with acetate, and acetate positively correlated with lipid compounds. IL-8 was positively correlated with lipid metabolites and acetate. Glutathione and carnitine were negatively correlated with cytokines IL-6 and chemokines (IL-8 & MCP-1).ConclusionAlkaline malignant ascites facilitated ovarian cancer progression. Additionally, deep ascites phenotyping by metabolomics and cytokine investigations allows for a refined stratification of ovarian cancer patients. These findings contribute to the understanding of ascites pathology in ovarian cancer.
Structural and functional distinctions of co-resident microglia and monocyte-derived macrophages after retinal degeneration
Authors: Ronning Kaitryn E. , Karlen Sarah J. , Burns Marie E. 
Published: December 2022

Abstract
Background
Both resident microglia and invading peripheral immune cells can respond to injury and degeneration in the central nervous system. However, after dead and dying neurons have been cleared and homeostasis is re-established, it is unknown whether resident immune cells fully resume normal functions and to what degree the peripheral immune cells take up residence.

Methods
Using flow cytometry, in vivo retinal imaging, immunohistochemistry, and single-cell mRNA sequencing, we assess resident microglia and monocyte-derived macrophages in the retina during and after the loss of photoreceptors in the Arr1−/− mouse model of inducible degeneration.

Results
We find that photoreceptor loss results in a small, sustained increase in mononuclear phagocytes and, after degeneration wanes, these cells re-establish a spatial mosaic reminiscent of healthy retinas. Transcriptomic analysis revealed the population remained unusually heterogeneous, with several subpopulations expressing gene patterns consistent with mildly activated phenotypes. Roughly a third of “new resident” cells expressed markers traditionally associated with both microglial and monocytic lineages, making their etiology ambiguous. Using an inducible Cre-based fluorescent lineage tracing paradigm to confirm the origins of new resident immune cells, we found approximately equal numbers of microglia and monocyte-derived macrophages after degeneration had subsided. In vivo retinal imaging and immunohistochemical analysis showed that both subpopulations remained functionally responsive to sites of local damage, though on average the monocyte-derived cells had less morphological complexity, expressed higher levels of MHCII, and had less migratory activity than the native resident population.

Conclusions
Monocytic cells that infiltrate the retina during degeneration differentiate into monocyte-derived macrophages that can remain in the retina long-term. These monocyte-derived macrophages adopt ramified morphologies and microglia-like gene expression. However, they remain distinguishable in morphology and gene expression from resident microglia and appear to differ functionally, showing less responsiveness to subsequent retinal injuries. These findings support the idea that persistent changes in the local immune population that occur in response to cell loss in aging and progressive retinal diseases may include the establishment of subpopulations of bone marrow-derived cells whose ability to respond to subsequent insults wanes over time.
Targeting neuroinflammation as a preventive and therapeutic approach for perioperative neurocognitive disorders
Authors: Cheng Chun , Wan Hanxi , Cong Peilin , Huang Xinwei , Wu Tingmei , He Mengfan , Zhang Qian , Xiong Lize , Tian Li 
Published: December 2022

AbstractPerioperative neurocognitive disorders (PND) is a common postoperative complication associated with regional or general anesthesia and surgery. Growing evidence in both patient and animal models of PND suggested that neuroinflammation plays a critical role in the development and progression of this problem, therefore, mounting efforts have been made to develop novel therapeutic approaches for PND by targeting specific factors or steps alongside the neuroinflammation. Multiple studies have shown that perioperative anti-neuroinflammatory strategies via administering pharmacologic agents or performing nonpharmacologic approaches exert benefits in the prevention and management of PND, although more clinical evidence is urgently needed to testify or confirm these results. Furthermore, long-term effects and outcomes with respect to cognitive functions and side effects are needed to be observed. In this review, we discuss recent preclinical and clinical studies published within a decade as potential preventive and therapeutic approaches targeting neuroinflammation for PND.