bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nasal airflow patterns in a patient with septal deviation and comparison with a healthy nasal cavity using computational fluid dynamics
Authors: Corda John Valerian , Shenoy B. Satish , Lewis Leslie , K. Prakashini , Khader S. M. Abdul , Ahmad Kamarul Arifin , Zuber Mohammad 
Published: November 2022

Background and objective: Causes for nasal airway obstruction (NAO) are many but septum deviation is the most prevalent etiology. A deviated septum affects the airflow dynamics in the human nasal cavity, which in turn affects the physiological functions of the nasal cavity like heating, humidification, and filtration capabilities. The present study investigates and compares the airflow patterns in a healthy nasal cavity to a septal deviated nasal cavity.Methods: Two nasal airway models are considered and compared in this study. One with a septal deviation and the second with a healthy patent nasal cavity. Airflow analysis is carried out by developing the CT scans into 3D models using Materialise MIMICS (Materialise, Ann Arbor, MI), and then using the FLUENT solver of ANSYS 2020R2. The simulations are carried out for airflows ranging in laminar and turbulent flows using the SST k-ω turbulence model. Polyhedral meshes are used and the mesh check using Grid Convergence Index studies is adopted.Results: The pressure and velocity profiles are assessed for a wide range of mass flow rates. The results indicate a turbulent flow pattern for mass flow rates over 15 LPM. The velocity profiles show aberrated flow profiles in a septal deviated nasal cavity where the peak velocity is observed at the mid-nasal region rather than the nasal valve region. There was a 38% to 55% higher nasal resistance in the septal deviated nasal cavity as compared to a normal and healthy nasal cavity. The pressure drop in the septal deviated nasal cavity is higher by 60%–120% when compared to a healthy nasal cavity.Conclusion: The septal deviated nasal cavity greatly affects the nasal airflow distribution resulting in higher velocities in the mid-nasal region, increased pressure drop and higher nasal resistance. Hence the NAO with septal deviation has to be rectified with proper surgical procedures.
Nordic survey on assessment and treatment of fluid overload in intensive care
Authors: Zeuthen Emilie , Wichmann Sine , Schønemann-Lund Martin , Järvisalo Mikko J. , Rubenson-Wahlin Rebecka , Sigurðsson Martin I. , Holen Erling , Bestle Morten H. 
Published: November 2022

IntroductionFluid overload in patients in the intensive care unit (ICU) is associated with higher mortality. There are few randomized controlled trials to guide physicians in treating patients with fluid overload in the ICU, and no guidelines exist. We aimed to elucidate how ICU physicians from Nordic countries define, assess, and treat fluid overload in the ICU.Materials and methodsWe developed an online questionnaire with 18 questions. The questions were pre-tested and revised by specialists in intensive care medicine. Through a network of national coordinators. The survey was distributed to a wide range of Nordic ICU physicians. The distribution started on January 5th, 2022 and ended on May 6th, 2022.ResultsWe received a total of 1,066 responses from Denmark, Norway, Finland, Sweden, and Iceland. When assessing fluid status, respondents applied clinical parameters such as clinical examination findings, cumulative fluid balance, body weight, and urine output more frequently than cardiac/lung ultrasound, radiological appearances, and cardiac output monitoring. A large proportion of the respondents agreed that a 5% increase or more in body weight from baseline supported the diagnosis of fluid overload. The preferred de-resuscitation strategy was diuretics (91%), followed by minimization of maintenance (76%) and resuscitation fluids (71%). The majority declared that despite mild hypotension, mild hypernatremia, and ongoing vasopressor, they would not withhold treatment of fluid overload and would continue diuretics. The respondents were divided when it came to treating fluid overload with loop diuretics in patients receiving noradrenaline. Around 1% would not administer noradrenaline and diuretics simultaneously and 35% did not have a fixed upper limit for the dosage. The remaining respondents 63% reported different upper limits of noradrenaline infusion (0.05–0.50 mcg/kg/min) when administering loop diuretics.ConclusionSelf-reported practices among Nordic ICU physicians when assessing, diagnosing, and treating fluid overload reveals variability in the practice. A 5% increase in body weight was considered a minimum to support the diagnosis of fluid overload. Clinical examination findings were preferred for assessing, diagnosing and treating fluid overload, and diuretics were the preferred treatment modality.
Memory decline in young stroke survivors during a 9-year follow-up: A cohort study
Authors: Laari Siiri , Turunen Katri , Kauranen Tatu , Mustanoja Satu , Lahti-Pulkkinen Marius , Tatlisumak Turgut , Poutiainen Erja 
Published: November 2022

IntroductionA decade after stroke, young stroke survivors continue to suffer from cognitive impairment. However, it is not known whether this long-term cognitive outcome is caused in part by further cognitive decline or solely by incomplete recovery from the acute effects of ischemic stroke. We studied changes in three cognitive domains over a 9-year follow-up period after first-ever and only ischemic stroke.Patients and methodsIn this prospective, two-center cohort study, we recruited consecutive 18–65 year-old patients with acute stroke between 2007 and 2009, along with demographically matched stroke-free controls. We performed comprehensive neuropsychological assessments at 3 months, 2, and 9 years after stroke, and we also performed neurological examinations at the time of inclusion and at the 9-year follow-up. We assessed the associations among stroke, follow-up time and long-term cognitive outcomes using repeated-measures analysis of variance.ResultsThe subjects comprised 85 patients who had had their first-ever and only ischemic stroke (mean age 53 years at inclusion), along with 31 stroke-free demographic controls. We compared the cognitive changes in patients to those in controls over a 9-year follow-up. After initial recovery between 3 months and 2 years after stroke, patients showed a decline in memory between 2 and 9 years after stroke compared to controls within the same time interval (immediate recall p &lt; 0.001; delayed recall p &lt; 0.001; list learning p &lt; 0.001). Other than memory, we found no difference in cognitive changes between poststroke patients and controls.DiscussionOur main finding was memory decline over a decade in young first-ever stroke patients with no further stroke or neurodegenerative disease. Our study extends the previous results of further memory decline in elderly stroke survivors to young stroke survivors.ConclusionYoung stroke survivors might be at risk of memory decline over the decade following the stroke.
Spectacles with highly aspherical lenslets for myopia control do not change visual sensitivity in automated static perimetry
Authors: Gao Yi , Spiegel Daniel P. , Muzahid Izzah Al Ilma , Lim Ee Woon , Drobe Björn 
Published: November 2022

PurposeSpectacle lenses with arrays of lenslets have gained popularity in myopia control due to their high efficacy, low impact on visual performance, and non-invasiveness. One of the questions regarding their impact on visual performance that still remain is that: do the lenslets impact visual field sensitivity? The current study aims to investigate the impact of wearing spectacle lenses with highly aspherical lenslets (HAL) on the visual field sensitivity.MethodsAn automated static perimetry test (Goldman perimeter target III) was employed to measure the detection sensitivity in the visual field. Targets were white light dots of various luminance levels and size 0.43°, randomly appearing at 76 locations within 30° eccentricity. Twenty-one adult subjects (age 23–61, spherical equivalent refractive error (SER) −8.75 D to +0.88 D) participated in the study. Sensitivities through two lenses, HAL and a single vision lens (SVL) as the control condition, were measured in random order.ResultsThe mean sensitivity differences between HAL and SVL across the 76 tested locations ranged between −1.14 decibels (dB) and 1.28 dB. Only one location at 30° in the temporal visual field reached statistical significance (p &lt; 0.00065) whereby the sensitivity increased by 1.1 dB with HAL. No significant correlation was found between the difference in sensitivity and age or SER. Such a difference is unlikely to be clinically relevant.ConclusionCompared to the SVL, the HAL did not change detection sensitivity to static targets in the whole visual field within 30° eccentricity.
The effect of fiber supplementation on the prevention of diarrhea in hospitalized patients receiving enteral nutrition: A meta-analysis of randomized controlled trials with the GRADE assessment
Authors: Kaewdech Apichat , Sripongpun Pimsiri , Wetwittayakhlang Panu , Churuangsuk Chaitong 
Published: November 2022

IntroductionEnteral nutrition (EN) in hospitalized patients has several advantages. However, post-feeding diarrhea occurs frequently and has been linked to negative outcomes. The EN formula itself may have an impact on how diarrhea develops, and fiber supplements may theoretically help patients experience less diarrhea. This study aimed to thoroughly evaluate whether adding fiber to EN decreases the likelihood of developing diarrhea and whether different types of fibers pose different effects on diarrhea (PROSPERO CRD 42021279971).MethodsWe conducted a meta-analysis on fiber supplementation in hospitalized adult patients receiving EN. We thoroughly searched PubMed, Medline, Embase, Scopus, Web of Science, CENTRAL, and ClinicalTrials.gov databases from inception to 1 September 2022. Only randomized controlled trials (RCTs) were included. Pooled results on the incidence of diarrhea were calculated using a random-effects model. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was applied. Only fiber types from soy polysaccharides (n = 4), psyllium (n = 3), mixed soluble/insoluble fiber (mixed fiber, n = 3), pectin (n = 2), and partially hydrolyzed guar gum (PHGG, n = 2) were examined in the sensitivity analysis.ResultsAmong the 4,469 titles found, a total of 16 RCTs were included. Overall, compared to fiber-free formulas, fiber supplementation reduced the occurrence of diarrhea in patients receiving EN by 36% (pooled risk ratio [RR] of 0.64 [95% confidence interval (CI): 0.49–0.82, p = 0.005; I2 = 45%]), with GRADE showing the evidence of moderate certainty. Only mixed fiber and PHGG significantly decreased the incidence of diarrhea according to the sensitivity analyses for fiber types (RR 0.54, 95%CI: 0.39–0.75, I2 = 0% and RR 0.47, 95%CI: 0.27–0.83, I2 = 0%, respectively). The results for the remaining fiber types were unclear.ConclusionAccording to a meta-analysis, fiber supplements help lessen post-feeding diarrhea in hospitalized patients receiving EN. However, not all fiber types produced successful outcomes. Diarrhea was significantly reduced by PHGG and mixed soluble/insoluble fiber.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=279971, identifier: PROSPERO CRD 42021279971.
The characterization of tumor microenvironment infiltration and the construction of predictive index based on cuproptosis-related gene in primary lung adenocarcinoma
Authors: Li Kun , Wu Lei-Lei , Wang Hui , Cheng Hao , Zhuo Hui-Min , Hao Yun , Liu Zhi-Yuan , Li Chong-Wu , Qian Jia-Yi , Li Zhi-Xin , Xie Dong , Chen Chang 
Published: November 2022

ObjectiveWe aimed to use the cancer genome atlas and gene expression omnibus databases to explore the characterization of tumor microenvironment (TME) infiltration and construct a predictive index of prognosis and treatment effect based on cuproptosis-related genes (CRGs) in primary lung adenocarcinoma (LUAD).MethodsWe described the alterations of CRGs in 954 LUAD samples from genetic and transcriptional fields and evaluated their expression patterns from three independent datasets. We identified two distinct molecular subtypes and found that multi-layer CRG alterations were correlated with patient clinicopathological features, prognosis, and TME cell infiltrating characteristics. Then, a cuproptosis scoring system (CSS) for predicting the prognosis was constructed, and its predictive capability in LUAD patients was validated.ResultsTwo molecular subtypes of cuproptosis (Copper Genes cluster A and cluster B) in LUAD were identified. Copper Genes cluster B had better survival than those with Copper Genes cluster A (p &lt;0.01). Besides, we found that the infiltration of activated CD4+ T cells, natural killer T cells, and neutrophils was stronger in cluster A than in cluster B. Then, we constructed a highly accurate CSS to predict the prognosis, targeted therapy effect, and immune response. Compared with the low-CSS subgroup, the mutations of the TP53, MUC16, and TTN genes were more common in the high-CSS subgroup, while the mutation of TP53, TTN, and CSMD3 genes were more common in the low-CSS subgroup than in high-CSS subgroup. The low-score CSS group had an inferior survival than high-score CSS group (p &lt;0.01). In addition, CSS presented good ability to predict the immune response (area under curve [AUC], 0.726). Moreover, AZD5363 and AZD8186 were the inhibitors of AKT and PI3K, respectively, and had lower IC50 and AUC in the low-score CSS group than it in the high-score CSS group.ConclusionsCRGs are associated with the development, TME, and prognosis of LUAD. Besides, a scoring system based on CRGs can predict the efficacy of targeted drugs and immune response. These findings may improve our understanding of CRGs in LUAD and pave a new path for the assessment of prognosis and the development of more effective targeted therapy and immunotherapy strategies.
The risk of osteoporotic fractures after gastrectomy: Findings from the Korean national sample cohort database (2002-2019)
Authors: Yun Il , Hurh Kyungduk , Jeong Sung Hoon , Park Eun-Cheol , Jang Sung-In 
Published: November 2022

ObjectiveThis study used a national sample cohort database to investigate the risk of osteoporotic fractures after gastrectomy is performed for gastric cancer.Materials and MethodsWe used data from the Korea National Health Insurance Service-National Sample Cohort between 2002 and 2019. After performing 1:3 propensity score matching, 28,328 individuals were analysed in the final study (7, 082 cases; 21, 246 controls). Gastrectomy data were extracted from the coded claims data, and osteoporotic fractures were defined as the occurrence of fractures in any of the vertebrae, distal radius, humerus, or hip, according to the 10th version of the International Classification of Diseases. A Cox proportional hazards regression model was generated to investigate the association between gastrectomy and risk of osteoporotic fractures.ResultsPatients with gastric cancer who underwent a gastrectomy had a higher risk of osteoporotic fractures as compared to the general population (men, hazard ratio [HR]: 1.13, 95% confidence interval [CI]: 1.00-1.27; women, HR: 1.18, 95% CI: 1.06-1.30). A significantly higher risk of osteoporotic fractures was observed with surgical resection than with endoscopic resection (men, surgical, HR: 1.28, 95% CI: 1.08-1.52, endoscopic, HR: 1.04, 95% CI: 0.90-1.21; women, surgical, HR: 1.34, 95% CI: 1.11-1.62, endoscopic, HR: 1.13, 95% CI: 1.01-1.27). In men, the risk of hip fracture was the highest among the four fracture sites (HR: 1.18, 95% CI:0.89-1.56), while in women, the risk of vertebral fracture after gastrectomy was the highest (HR: 1.16, 95% CI: 0.99-1.35).ConclusionPatients with gastric cancer who underwent gastrectomy had a higher risk of osteoporotic fractures as compared to the general population. This suggests the need for bone metabolism management in patients with gastric cancer to prevent post-gastrectomy complications.
Efficacy and safety of transarterial chemoembolization plus antiangiogenic- targeted therapy and immune checkpoint inhibitors for unresectable hepatocellular carcinoma with portal vein tumor thrombus in the real world
Authors: Feng Jin-Kai , Liu Zong-Han , Fu Zhi-Gang , Chai Zong-Tao , Sun Ju-Xian , Wang Kang , Cheng Yu-Qiang , Zhu Hong-Fei , Xiang Yan-Jun , Zhou Li-Ping , Shi Jie , Guo Wei-Xing , Zhai Jian , Cheng Shu-Qun 
Published: November 2022

PurposeThis study aimed to assess the efficacy and safety of a triple therapy that comprises transarterial chemoembolization (TACE), antiangiogenic-targeted therapy, and programmed death-1 (PD-1) inhibitors in a real-world cohort of patients with unresectable hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).MethodsConsecutive patients treated with TACE combined with antiangiogenic therapy and PD-1 inhibitors at the Eastern Hepatobiliary Surgery Hospital between June 2019 and May 2021 were enrolled. The baseline characteristics and treatment course of the patients were recorded. The tumor response was evaluated based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 and HCC-specific modified RECIST (mRECIST). The overall survival (OS) and progression-free survival (PFS) of the patients were analyzed using the Kaplan–Meier method. Adverse events (AEs) were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0.ResultsAs of the data cutoff on 30 August 2021, the median follow-up time was 10.0 (3.9–28.4) months. A total of 39 eligible patients were included. The objective response rate (ORR) and the disease control rate (DCR) were 35.9% and 74.4% according to the RECIST 1.1, and 48.7% and 84.6% according to mRECIST criteria, respectively. The median OS and PFS were 14.0 and 9.2 months, respectively. Moreover, 34 (87.2%) patients experienced at least one treatment-related AE and 8 (20.5%) patients experienced grade 3/4 treatment-related AEs. The most common treatment- and laboratory-related AEs were hypertension (46.2%) and decreased albumin (53.8%), respectively. No treatment-related mortality occurred during the study period.ConclusionsTACE combined with antiangiogenic-targeted therapy and immune checkpoint inhibitors may have promising anticancer activity in unresectable HCC patients with PVTT. AEs were manageable, with no unexpected overlapping toxicities.
In vivo efficacy assessment of the CDK4/6 inhibitor palbociclib and the PLK1 inhibitor volasertib in human chordoma xenografts
Authors: Passeri Thibault , Dahmani Ahmed , Masliah-Planchon Julien , El Botty Rania , Courtois Laura , Vacher Sophie , Marangoni Elisabetta , Nemati Fariba , Roman-Roman Sergio , Adle-Biassette Homa , Mammar Hamid , Froelich Sébastien , Bièche Ivan , Decaudin Didier 
Published: November 2022

BackgroundManagement of advanced chordomas remains delicate considering their insensitivity to chemotherapy. Homozygous deletion of the regulatory gene CDKN2A has been described as the most frequent genetic alteration in chordomas and may be considered as a potential theranostic marker. Here, we evaluated the tumor efficacy of the CDK4/6 inhibitor palbociclib, as well as the PLK1 inhibitor volasertib, in three chordoma patient-derived xenograft (PDX) models to validate and identify novel therapeutic approaches.MethodsFrom our chordoma xenograft panel, we selected three models, two of them harboring a homozygous deletion of CDKN2A/2B genes, and the last one a PBRM1 pathogenic variant (as control). For each model, we tested the palbociclib and volasertib drugs with pharmacodynamic studies together with RT-PCR and RNAseq analyses.ResultsFor palbociclib, we observed a significant tumor response for one of two models harboring the deletion of CDKN2A/2B (p = 0.02), and no significant tumor response in the PBRM1-mutated PDX; for volasertib, we did not observe any response in the three tested models. RT-PCR and RNAseq analyses showed a correlation between cell cycle markers and responses to palbociclib; finally, RNAseq analyses showed a natural enrichment of the oxidative phosphorylation genes (OxPhos) in the palbociclib-resistant PDX (p = 0.02).ConclusionCDK4/6 inhibition appears as a promising strategy to manage advanced chordomas harboring a loss of CDKN2A/2B. However, further preclinical studies are strongly requested to confirm it and to understand acquired or de novo resistance to palbociclib, in the peculiar view of a targeting of the oxidative phosphorylation genes.
Constructing a critical thinking evaluation framework for college students majoring in the humanities
Authors: Li Suqi , Tang Shenyu , Geng Xingyu , Liu Qi 
Published: November 2022

IntroductionEducation for sustainable development (ESD) has focused on the promotion of sustainable thinking skills, capacities, or abilities for learners of different educational stages. Critical thinking (CT) plays an important role in the lifelong development of college students, which is also one of the key competencies in ESD. The development of a valuable framework for assessing college students’ CT is important for understanding their level of CT. Therefore, this study aimed to construct a reliable self-evaluation CT framework for college students majoring in the humanities.MethodsExploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Item analysis were conducted to explore the reliability and validity of the CT evaluation framework. Six hundred and forty-two college students majoring in the humanities were collected. The sample was randomly divided into two subsamples (n1 = 321, n2 = 321).ResultsThe Cronbach’s alpha coefficient for the whole scale was 0.909, and the values of the Cronbach’s alpha coefficients for individual factors of the scale ranged from 0.724 to 0.878. Then CFA was conducted within the scope of the validity study of the scale. In this way, the structure of the 7-factor scale was confirmed. Results indicated that the constructed evaluation framework performed consistently with the collected data. CFA also confirmed a good model fitting of the relevant 22 factors of the college students’ CT framework (χ2/df = 3.110, RMSEA = 0.056, GFI = 0.927, AGFI = 0.902, NFI = 0.923, and CFI = 0.946).DiscussionThese findings revealed that the CT abilities self-evaluation scale was a valid and reliable instrument for measuring the CT abilities of college students in the humanities. Therefore, the college students’ CT self-evaluation framework included three dimensions: discipline cognition (DC), CT disposition, and CT skills. Among them, CT disposition consisted of motivation (MO), attention (AT), and open-mindedness (OM), while CT skills included clarification skills (CS), organization skills (OS), and reflection (RE). Therefore, this framework can be an effective instrument to support college students’ CT measurement. Consequently, some suggestions are also put forward regarding how to apply the instrument in future studies.