bluuebunny/crossref_metadata_2025_split huggingface dataset:
Video-assisted thoracic surgery in critically ill COVID-19 patients on venovenous extracorporeal membrane oxygenation
Authors: Zwaenepoel Bert , Vandewiele Korneel , Peperstraete Harlinde , De Ryck Frederic , Vanpeteghem Caroline , Malfait Thomas , Herck Ingrid , Vandenberghe Wim , Van Laethem Lien , Defreyne Luc , Van Braeckel Eva , Depuydt Pieter , Schaubroeck Hannah 
Published: August 2022

Introduction Coronavirus disease 2019 (COVID-19) leads to thoracic complications requiring surgery. This is challenging, particularly in patients supported with venovenous extracorporeal membrane oxygenation (VV-ECMO) due to the need for continuous therapeutic anticoagulation. We aim to share our experience regarding the safety and perioperative management of video-assisted thoracic surgery for this specific population. Methods Retrospective, single-center study between November 2020 and January 2022 at the ICU department of a 1.061-bed tertiary care and VV-ECMO referral center during the COVID-19 pandemic. Results 48 COVID-19 patients were supported with VV-ECMO. A total of 14 video-assisted thoracic surgery (VATS) procedures were performed in seven patients. Indications were mostly hemothorax (85.7%). In eight procedures heparin was stopped at least 1 h before incision. A total of 10 circuit changes due to clot formation or oxygen transfer failure were required in six patients (85.7%). One circuit replacement seemed related to the preceding VATS procedure, although polytransfusion might be a contributing factor. None of the mechanical complications was fatal. Four VATS-patients (57.1%) died, of which two (50%) immediately perioperatively due to uncontrollable bleeding. All three survivors were treated with additional transarterial embolization. Conclusion (1) Thoracic complications in COVID-19 patients on VV-ECMO are common. (2) Indication for VATS is mostly hemothorax (3) Perioperative mortality is high, mostly due to uncontrollable bleeding. (4) Preoperative withdrawal of anticoagulation is not directly related to a higher rate of ECMO circuit-related complications, but a prolonged duration of VV-ECMO support and polytransfusion might be. (5) Additional transarterial embolization to control postoperative bleeding may further improve outcomes.
Weekend Admission Increases Risk of Readmissions Following Elective Thoracolumbar Spinal Fusion
Authors: Rosenberg Ashley , Dominy Calista , Bueno Brian T. , Pasik Sara , Yeshoua Brandon , Cho Brian , Arvind Varun , Valliani Aly A. , Markowitz Jonathan , Kim Jun S. , Cho Samuel K. 
Published: August 2022

Study Design Retrospective database study. Objectives The goal of this study was to assess the influence of weekend admission on patients undergoing elective thoracolumbar spinal fusion by investigating hospital readmission outcomes and analyzing differences in demographics, comorbidities, and postoperative factors. Methods The 2016-2018 Nationwide Readmission Database was used to identify adult patients who underwent elective thoracolumbar spinal fusion. The sample was divided into weekday and weekend admission patients. Demographics, comorbidities, complications, and discharge status data were compiled. The primary outcomes were 30-day and 90-day readmission. Univariate logistic regression analyzed the relationship between weekday or weekend admission and 30- or 90-day readmission, and multivariate regression determined the impact of covariates. Results 177,847 patients were identified in total, with 176,842 in the weekday cohort and 1005 in the weekend cohort. Multivariate regression analysis found that 30-day readmissions were significantly greater for the weekend cohort after adjusting for sex, age, Medicare or Medicaid status, and comorbidity status (OR 2.00, 95% CI: 1.60-2.48; P < .001), and 90-day readmissions were also greater for the weekend cohort after adjustment (OR 2.01, 95% CI: 1.68-2.40, P < .001). Conclusions Patients undergoing elective thoracolumbar spinal fusion surgery who are initially admitted on weekends are more likely to experience hospital readmission. These patients have increased incidence of deep vein thrombosis, postoperative infection, and non-routine discharge status. These factors are potential areas of focus for reducing the impact of the “weekend effect” and improving outcomes for elective thoracolumbar spinal fusion.
Geography vs. past climate: the drivers of population genetic structure of the Himalayan langur
Authors: Arekar Kunal , Tiwari Neha , Sathyakumar Sambandam , Khaleel Mehreen , Karanth Praveen 
Published: August 2022

Abstract
Background
Contemporary species distribution, genetic diversity and evolutionary history in many taxa are shaped by both historical and current climate as well as topography. The Himalayas show a huge variation in topography and climatic conditions across its entire range, and have experienced major climatic fluctuations in the past. However, very little is known regarding how this heterogenous landscape has moulded the distribution of Himalayan fauna. A recent study examined the effect of these historical events on the genetic diversity of the Himalayan langurs in Nepal Himalaya. However, this study did not include the samples from the Indian Himalayan region (IHR). Therefore, here we revisit the questions addressed in the previous study with a near complete sampling from the IHR, along with the samples from the Nepal Himalaya. We used the mitochondrial Cytochrome-b (Cyt-b, 746 bp) region combined with multiple phylogeographic analyses and palaeodistribution modelling.

Results
Our dataset contained 144 sequences from the IHR as well as the Nepal Himalaya. Phylogenetic analysis showed a low divergent western clade nested within high divergent group of eastern lineages and in the network analysis we identified 22 haplotypes over the entire distribution range of the Himalayan langurs. Samples from the Nepal Himalaya showed geographically structured haplotypes corresponding to different river barriers, whereas samples from IHR showed star-like topology with no structure. Our statistical phylogeography analysis using diyABC supported the model of east to west colonisation of these langurs with founder event during colonisation. Analysis of demographic history showed that the effective population size of the Himalayan langurs decreased at the onset of last glacial maximum (LGM) and started increasing post LGM. The palaeodistribution modelling showed that the extent of suitable habitat shifted from low elevation central Nepal, and adjoining parts of north India, during LGM to the western Himalaya at present.

Conclusion
The current genetic diversity and distribution of Himalayan langurs in the Nepal Himalaya has been shaped by river barriers, whereas the rivers in the IHR had relatively less time to act as a strong genetic barrier after the recent colonisation event. Further, the post LGM expansion could have had confounding effect on Himalayan langur population structure in both Nepal Himalaya and IHR.
Trachway® flexible stylet facilitates the correct placement of double-lumen endobronchial tube: a prospective, randomized study
Authors: Hsu Hung-Te , Kuo Yi-Wei , Ma Chao-Wei , Su Miao-Pei , Tseng Kuang-Yi , Li Chin-Ling , Cheng Kuang-I 
Published: August 2022

Abstract
Background
The mainstream facilitation of one-lung ventilation is using double-lumen endobronchial tubes. However, it is more difficult to be positioned properly and more likely to cause airway injuries. How to place double-lumen endobronchial tubes rapidly and correctly is important for thoracic anesthesiologists.

Methods
One hundred eight patients with an American Society of Anesthesiologists physical status of I to III were 20 years of age or over, and required one-lung ventilation for thoracic surgery. They were randomly assigned to the conventional technique group (n = 36), the flexible fiberoptic bronchoscopy group (n = 36), or the Trachway® flexible stylet group (n = 36). The primary endpoint was the time needed for intubation. T1, the time from the tip of the blade passing between the patient’s lips to identification of the vocal cords; and T2, the time from identification of the vocal cords to the bronchial lumen was in the correct position.

Results
T1 had no significant difference between groups, but T2 was significantly shorter in the Trachway® flexible stylet group (p < 0.0001) and longer in the conventional technique group (p < 0.0001).

Conclusions
Using Trachway® flexible stylet for correct placement of double-lumen endobronchial tubes not only significantly shortened the intubation time, but also reduced incidence of carinal injuries. It is an alternative, and a choice with good safety.

Trial registration
ClinicalTrials.gov Identifier: NCT02364622, 18/02/2015, Retrospectively registered.
Ultrasound-guided esophageal compression during mask ventilation in small children: a prospective observational study
Authors: Kim Eun-Hee , Cho Sung-Ae , Kang Pyoyoon , Song In-Sun , Ji Sang-Hwan , Jang Young-Eun , Lee Ji-Hyun , Kim Jin-Tae , Kim Hee-Soo 
Published: August 2022

AbstractBackgroundThe use of cricoid compression to prevent insufflation remains controversial, and its use in children is limited. This study aimed to examine the effect of real-time ultrasound-guided esophageal compression on the prevention of gastric insufflation.MethodThis prospective observational study was conducted with fifty children aged < 2 years undergoing general anesthesia. Patients were excluded if they were at an increased risk for gastric regurgitation or pulmonary aspiration. Following anesthetic induction under spontaneous breathing, ultrasound-guided esophageal compression was performed during pressure-controlled face-mask ventilation using a gradual increase in peak inspiratory pressure from 10 to 24 cm H2O to determine the pressure at which gastric insufflation occurred. The primary outcome was the incidence of gastric insufflation during anesthetic induction with variable peak inspiratory pressure after real-time ultrasound-guided esophageal compression was applied.ResultsData from a total of 42 patients were analyzed. Gastric insufflation was observed in 2 (4.7%) patients. All patients except one had their esophagus on the left side of the trachea. Applying ultrasound-guided esophageal compression did not affect the percentage of glottic opening scores (P = 0.220).ConclusionsThe use of real-time ultrasound-guided esophageal compression pressure can aid preventing gastric insufflation during face-mask ventilation in children less than 2 years old.Trial registrationClinicaltrials.gov identifier: NCT04645043.
Translation and initial validation of Chinese (Cantonese) version of Modified Fatigue Impact Scale (MFIS-C) in people with stroke
Authors: Ng Shamay S. M. , Liu Tai Wa , Tsoh Joshua 
Published: August 2022

Abstract
Purpose
To translate and culturally adapt the Modified Fatigue Impact Scale (MFIS) to Chinese version, and to psychometrically test it in stroke population.

Methods
This study consisted of 2 phases. In phase one, we translated and culturally adopted the original English version of MFIS into Chinese (Cantonese) (MFIS-C). In phase two, the MFIS was psychometrically tested using a cohort of community-dwelling people with stroke (n = 101) and healthy control (n = 50). Among the stroke participants, 52 of them were reassessed after a 1-week interval.

Results
The MFIS-C demonstrated satisfactory content validity and good to excellent internal consistency. The overall MFIS-C and its subscales have good test-retest reliability. The MDC95 were 14.86, 7.49, and 9.70 for the overall MFIS-C physical, cognitive and psychosocial subscales, respectively. The overall MFIS-C and its 2 subscales have significant weak to moderate negative correlations with the Community Integration Measure and the 12-item Short Form Health Survey Version 2. Our findings revealed that the people with chronic stroke living in Hong Kong were reported to have high level of fatigue.

Conclusion
The MFIS-C is a reliable and valid measure for assessing the level of fatigue in people with stroke.
The relationship between the ‘‘Fujisawa point’’ and anatomical femorotibial angle following simulated open wedge high tibial osteotomy
Authors: Kobayashi Hideo , Saito Suguru , Akamatsu Yasushi , Kumagai Ken , Nejima Shuntaro , Inaba Yutaka 
Published: August 2022

Abstract
Background
We evaluated the relationship between the weight-bearing line (WBL) ratio and anatomical femorotibial angle (FTA) by simulated open wedge high tibial osteotomy (OWHTO). This study evaluated the correlation between the ‘‘Fujisawa point’’ and FTA, and identified factors which caused deviations between the two measurement methods. We hypothesized that the Fujisawa point corresponded with 170° of the FTA.

Methods
Preoperative antero-posterior full-length lower limb radiographs of 82 patients were obtained for the OWHTO to place the WBL ratio at a target of 62.5% of the width of the tibial plateau (Fujisawa point). The coronal alignment was measured pre- and post-planning. The patients were divided into two groups by the post-planning FTA: a correspondence group (168.5°≦FTA≦171.5°) and a non-correspondence group (FTA < 168.5°, 171.5° < FTA). The relationship between the Fujisawa point and the FTA was analyzed with multivariate regression analysis.

Results
The post-planning FTA was 169.8 ± 1.1° and within 170 ± 1.5° in 69 cases (84.1%) when the WBL ratio was 62.5%. The neck shaft angle was 128.1 ± 5.2° in the correspondence group, and 122.3 ± 6.3° in the non-correspondence group. The multivariate linear regression analysis revealed that the neck shaft angle was the only factor that predicted the correspondence of the Fujisawa point with the FTA at 170° (p = 0.006, odd 1.28).

Conclusions
The post-planning FTA converged at 170° when the WBL ratio passed through the Fujisawa point and the neck shaft angle was the only predictor.
Determinants of fertility in Malawi: Does women autonomy dimension matter?
Authors: Forty James , Navaneetham Kannan , Letamo Gobopamang 
Published: August 2022

Abstract
Background
Power inequality within the household and sexual relationships is linked to poor reproductive health. Malawi Government through National Sexual and Reproductive Health and Rights policy is committed to women empowerment as well fertility reduction. However, there is limited evidence in Malawi regarding whether women’s autonomy in the household is an independent determinant of fertility. With this background, the aim of this study is to investigate whether women’s autonomy in the household is a determinant of fertility in a poor socioeconomic and cultural setting.

Methods
This study used Malawi Demographic and Health Survey, 2015–2016. A multivariable Poisson regression model was used to investigate if women’s autonomy in the household in Malawi determines fertility. The outcome measure, children ever born, was used as a measure of fertility. Women’s autonomy was measured with two dimensions, such as women’s household related decision makings and women’s sexual autonomy. The individual recode and household recode were merged for the analysis. The final study sample was 15,952 women who were cohabiting or married at the time of the survey.

Results
The level of autonomy among women in the household related decisions and sexual autonomy was 49.1% and 64.0% respectively. Controlling for covariates, the study found no significant association between women’s autonomy dimensions in the household and number of children ever born. On the other hand, living in urban area (IRR = 0.91, CI 0.88–0.93); having less than tertiary education thus, no education (IRR = 1.83, CI 1.67–1.99) or primary education (IRR = 1.55, CI 1.42–1.69) or secondary education (IRR = 1.23, CI 1.13–1.33); poor households (IRR = 1.05, CI 1.01–1.09), starting cohabiting at the age of 19 years or less (AIRR = 1.15, CI 1.13–1.18) and not using modern contraceptive methods (AIRR = 1.17, CI 1.15–1.19) were significantly associated with fertility.

Conclusions and recommendations
Though women’s autonomy does not have independent effect on fertility, it may be interacting with other sociocultural norms prevailing in the society. The study recommends that the Government of Malawi should come up with economic hardship emancipation policy for poor households. The government should also come up with a girl-child secondary school completion policy. Furthermore, the government should accelerate the implementation, monitoring and evaluation of National Gender Policy to ensure the women empowerment/autonomy is having positive effect at all level including the household.
The efficacy of metal nanocomposite (Fe3O4/CuO/ZnO) to ameliorate the toxic effects of ochratoxin in broilers
Authors: Al Shap Nagla F. , El-Sherbeny Eman M. El. , El Masry Dalia M. A. 
Published: August 2022

Abstract
Background
The study aimed to investigate the effectiveness of different doses of metal nanocomposite (MNc) (Fe3O4/CuO/ZnO) lower than its cytotoxic level in order to overcome or minimize the ochratoxin (OTA) adverse effects in broilers fed on contaminated ration.
The study conducted on 120 one-day old chicks which were divided into equal 6 groups; G1: negative control, G2: positive control (fed on OTA 17 ppb), G3& G4 (fed MNc only with low and high doses respectively). The rest two groups G5 & G6 (treatment groups) were fed on OTA, post induced ochratoxification, treated with low and high doses respectively.

Results
Body weight gain and heamatocellular elements in both treated groups increased significantly than control. Serum phagocytic nitric oxide levels were increased significantly in both treated groups than control groups.
Prothrombin time (PT), Alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) activities decreased significantly (P < 0.05) in both treated groups than intoxicated control group (G2) but still higher than non-intoxicated control group (G1). Total protein, albumin, globulin, calcium and phosphorus increased significantly in both treated groups than intoxicated control group. Kidney function tests showed significant improvement in both treated groups than intoxicated control group.
Antioxidant study revealed that malondialdehyde (MDA) decreased significantly in treated groups than intoxicated control group. Ochratoxin residue decreased significantly in treated groups. Metal residues in tested liver and muscle of treated groups showed no-significant difference with non-intoxicated control group (G1) at the experiment’s end.
In conclusion, feeding either low or high doses of MNc to broilers were significantly counteracting the negative impacts of OTA or its residue and increase their body weight.
High expression of serine and arginine-rich splicing factor 9 (SRSF9) is associated with hepatocellular carcinoma progression and a poor prognosis
Authors: Zhang Guoshun , Liu Bin , Shang Hua , Wu Guikai , Wu Diyang , Wang Liuqing , Li Shengnan , Wang Zhiyuan , Wang Suying , Yuan Juxiang 
Published: August 2022

Abstract
Background
Serine and arginine-rich splicing factor 9 (SRSF9) has been linked to the occurrence and progression of various cancers; however, its effects and mechanism of action hepatocellular carcinoma (HCC) have not been reported. In this study, we used a bioinformatics approach and in vitro assays to evaluate the expression of SRSF9 in HCC, its prognostic value, and its underlying regulatory mechanisms, including analyses of related pathways and the role of methylation.

Methods
Transcriptomic and DNA methylation data for 357 HCC cases and 50 paratumor tissues in The Cancer Genome Atlas database were obtained. Additionally, protein expression data for cell lines and tissue samples were obtained from the Human Protein Atlas. The CMap databased was used to predict candidate drugs targeting SRSF9. Various cell lines were used for in vitro validation.

Results
SRSF9 expression was significantly elevated in HCC and was negatively regulated by its methylation site cg06116271. The low expression of SRSF9 and hypermethylation of cg06116271 were both associated with a longer overall survival time. A correlation analysis revealed ten genes that were co-expressed with SRSF9; levels of CDK4, RAN, DENR, RNF34, and ANAPC5 were positively correlated and levels of RBP4, APOC1, MASP2, HP, and HPX were negatively correlated with SRSF9 expression. The knockdown of SRSF9 in vitro inhibited the proliferation and migration of HCC cells and significantly reduced the expression of proteins in the Wnt signaling pathway (DVL2 and β-catenin) and cell cycle pathway (Cyclin D and Cyclin E). A CMap analysis identified two drugs, camptothecin and apigenin, able to target and inhibit the expression of SRSF9.

Conclusions
This study expands our understanding of the molecular biological functions of SRSF9 and cg06116271 and provides candidate diagnostic and therapeutic targets for HCC.
Rational drug combination design in patient-derived avatars reveals effective inhibition of hepatocellular carcinoma with proteasome and CDK inhibitors
Authors: Lim Jhin Jieh , Hooi Lissa , Dan Yock Young , Bonney Glenn K. , Zhou Lei , Chow Pierce K.-H. , Chee Cheng Ean , Toh Tan Boon , Chow Edward K.-H. 
Published: August 2022

Abstract
Background
Hepatocellular carcinoma (HCC) remains difficult to treat due to limited effective treatment options. While the proteasome inhibitor bortezomib has shown promising preclinical activity in HCC, clinical trials of bortezomib showed no advantage over the standard-of-care treatment sorafenib, highlighting the need for more clinically relevant therapeutic strategies. Here, we propose that rational drug combination design and validation in patient-derived HCC avatar models such as patient-derived xenografts (PDXs) and organoids can improve proteasome inhibitor-based therapeutic efficacy and clinical potential.

Methods
HCC PDXs and the corresponding PDX-derived organoids (PDXOs) were generated from primary patient samples for drug screening and efficacy studies. To identify effective proteasome inhibitor-based drug combinations, we applied a hybrid experimental-computational approach, Quadratic Phenotypic Optimization Platform (QPOP) on a pool of nine drugs comprising proteasome inhibitors, kinase inhibitors and chemotherapy agents. QPOP utilizes small experimental drug response datasets to accurately identify globally optimal drug combinations.

Results
Preliminary drug screening highlighted the increased susceptibility of HCC PDXOs towards proteasome inhibitors. Through QPOP, the combination of second-generation proteasome inhibitor ixazomib (Ixa) and CDK inhibitor dinaciclib (Dina) was identified to be effective against HCC. In vitro and in vivo studies demonstrated the synergistic pro-apoptotic and anti-proliferative activity of Ixa + Dina against HCC PDXs and PDXOs. Furthermore, Ixa + Dina outperformed sorafenib in mitigating tumor formation in mice. Mechanistically, increased activation of JNK signaling mediates the combined anti-tumor effects of Ixa + Dina in HCC tumor cells.

Conclusions
Rational drug combination design in patient-derived avatars highlights the therapeutic potential of proteasome and CDK inhibitors and represents a feasible approach towards developing more clinically relevant treatment strategies for HCC.