bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of dorsal penile nerve block alone and in combination with lidocaine–prilocaine cream in neonates undergoing circumcision: a randomized controlled study
Authors: Ogundele Ibukunolu Olufemi , Nwokoro Chigbundu Collins , Adedeji Tewogbade Adeoye , Igwe Arua Obasi , Adumah Collins Chijioke , Talabi Ademola Olusegun , Shonubi Aderibigbe Modupe , Sowande Oludayo Adedapo 
Published: November 2022

BackgroundSuboptimal neonatal circumcision analgesia causes a significant stress response. There is continued search for more effective analgesia for neonatal circumcision. We aimed to determine whether lidocaine–prilocaine cream (LPC) prior to dorsal penile nerve block (DPNB) offers better analgesia than DPNB alone.MethodsA prospective randomized study of 72 neonates undergoing plastibell circumcision was randomized into two groups of 36 each. Group I received DPNB alone with 4 mg/kg plain lidocaine. Group II had 1 g LPC applied to the phallus 1 hour before DPNB. Serum cortisol levels were measured 30 min preoperatively and 30 min postoperatively. Heart rate (HR) and peripheral arterial oxygen saturation (SpO2) were noted at 30 min preoperatively, after DPNB injection, after excising the prepuce, and at 30 min thereafter. The primary outcome measure was change in serum cortisol levels, while secondary outcomes were changes in HR and SpO2.ResultsBoth groups had increased mean serum cortisol levels, decreased mean SpO2and increased mean HR from baseline. The rise in mean serum cortisol level was significantly lower in group II (8.09±4.53 µg/dL) than that in group I (11.42±7.83 µg/dL) (p=0.034). Changes in SpO2and HR were significantly less in group II than that in group I patients (p<0.05), except for HR changes at 30 min after excision of the prepuce (p=0.086).ConclusionThese data suggest that neonates who received LPC prior to DPNB experienced significantly less pain from plastibell circumcision than those who had DPNB alone.Trial registration numberPACTR201906554747665.
Definability Results for Top-Down Tree Transducers
Authors: Maneth Sebastian , Seidl Helmut , Vu Martin 
Published: November 2022

Top-down tree transducers are well established formalism for describing tree translations. Such transducers can be further enhanced with look-ahead allowing them to inspect input subtrees before processing them. Oftentimes it is advantageous to know when the look-ahead can be eliminated and the translation be implemented by a simpler transducer. We show that for a given top-down transducer with look-ahead it is decidable whether or not its translation is definable (1) by a linear deterministic top-down tree transducer or (2) by a tree homomorphism. We present algorithms that construct equivalent such transducers if they exist. Our results also apply to bottom-up transducers as well as compositions of transducers.
An Efficient Blood Pressure Estimation and Risk Analysis System of PPG Signals Using IDA and MPPIW-DLNN Algorithms
Authors: Thakkar Priyanka Bibay , Talwekar R. H. 
Published: November 2022

The non-invasive Blood Pressure Estimation (BPE) utilizing the technology of photoplethysmography (PPG) gains significant interest because PPG could be extensively employed to wearable sensors. Here, a method for estimating Systolic Blood pressure (SBP), as well as Diastolic Blood pressure (DBP), grounded only on a PPG signal utilizing the Image Denoising Algorithms (IDA) algorithms is proposed. Also, a classification methodology to execute the risk analysis (RA) of the BP patients utilizing Moore–Penrose Pseudo-Inverse Matrix-Deep Learning Neural Network (MPPIW-DLNN) is proposed. The preprocessing is then done on the input PPG signal utilizing the Modified–Chebyshev Filter (CF) to eradicate the unwanted information existent in the signal. Afterward, the BPE is done utilizing IDA, which categorizes those components into (i) SBP and (ii) DBP. The MPPIW-DLNN provides the results of four sorts of risk classes like (i) stroke, (ii) heart failure (HF), (iii) heart attack (HA), and (iv) aneurysm identified from the inputted PPG signal.
Histopathological Features of Cancer-Associated Venous Thromboembolism: Presence of Intrathrombus Cancer Cells and Prothrombotic Factors
Authors: Gi Toshihiro , Kuwahara Aya , Yamashita Atsushi , Matsuda Shuntaro , Maekawa Kazunari , Moriguchi-Goto Sayaka , Sato Yuichiro , Asada Yujiro 
Published: November 2022

Background:
Cancer-associated venous thromboembolism (VTE) is a critical complication in patients with cancer. However, the pathological findings of VTE are limited. Here, we investigated the histopathological features of cancer-associated VTE in human autopsy cases.

Methods:
We clinically examined the autopsy cases of VTE with (n=114) and without cancer (n=66) and immunohistochemically analyzed the expression of prothrombotic factors in intrathrombus cancer cells, the thrombus contents of erythrocytes, fibrin, platelets, citrullinated histone H3, and degree of organization.

Results:
Vascular wall invasion or small cell clusters of cancer cells was observed in thrombi in 27.5% of deep vein thrombosis and 25.9% of pulmonary embolism cases. The majority of the cancer cells in deep vein thrombi appeared to be invading the vessel wall, whereas the majority of pulmonary thrombi had cancer cell clusters, consistent with embolization via blood flow. These cancer cells were immunohistochemically positive for TF (tissue factors) or podoplanin in up to 88% of VTE cases. The frequency of TF-positive monocyte/macrophages in thrombi was higher in cancer-associated VTE than that in VTE without cancer. Citrullinated histone H3 was predominantly observed in the early stages of organizing thrombi. There was no significant difference in thrombus components between VTE with cancer and without cancer groups.

Conclusions:
Vascular wall invasion or cancer cell clusters in thrombi might influence thrombogenesis of cancer-associated VTE. TF and podoplanin in cancer cells and in monocyte/macrophages may induce coagulation reactions and platelet aggregation. Neutrophil extracellular traps may play a role in the early stages of VTE, regardless of cancer status.
Targeting VEGF-A/VEGFR2 Y949 Signaling-Mediated Vascular Permeability Alleviates Hypoxic Pulmonary Hypertension
Authors: Zhou Weibin , Liu Keli , Zeng Lei , He Jiaqi , Gao Xinbo , Gu Xinyu , Chen Xun , Jing Li Jing , Wang Minghui , Wu Duoguang , Cai Zhixiong , Claesson-Welsh Lena , Ju Rong , Wang Jingfeng , Zhang Feng , Chen Yangxin 
Published: November 2022

Background:
Pulmonary hypertension (PH) is associated with increased expression of VEGF-A (vascular endothelial growth factor A) and its receptor, VEGFR2 (vascular endothelial growth factor 2), but whether and how activation of VEGF-A signal participates in the pathogenesis of PH is unclear.

Methods:

VEGF-A/VEGFR2 signal activation and VEGFR2 Y949–dependent vascular leak were investigated in lung samples from patients with PH and mice exposed to hypoxia. To study their mechanistic roles in hypoxic PH, we examined right ventricle systolic pressure, right ventricular hypertrophy, and pulmonary vasculopathy in mutant mice carrying knock-in of phenylalanine that replaced the tyrosine at residual 949 of VEGFR2 (

Vefgr2
Y949F

) and mice with conditional endothelial deletion of
Vegfr2
after chronic hypoxia exposure.

Results:

We show that PH leads to excessive pulmonary vascular leak in both patients and hypoxic mice, and this is because of an overactivated VEGF-A/VEGFR2 Y949 signaling axis. In the context of hypoxic PH, activation of Yes1 and c-Src and subsequent VE-cadherin phosphorylation in endothelial cells are involved in VEGFR2 Y949-induced vascular permeability. Abolishing VEGFR2 Y949 signaling by

Vefgr2
Y949F

point mutation was sufficient to prevent pulmonary vascular permeability and inhibit macrophage infiltration and Rac1 activation in smooth muscle cells under hypoxia exposure, thereby leading to alleviated PH manifestations, including muscularization of distal pulmonary arterioles, elevated right ventricle systolic pressure, and right ventricular hypertrophy. It is important that we found that VEGFR2 Y949 signaling in myeloid cells including macrophages was trivial and dispensable for hypoxia-induced vascular abnormalities and PH. In contrast with selective blockage of VEGFR2 Y949 signaling, disruption of the entire VEGFR2 signaling by conditional endothelial deletion of
Vegfr2
promotes the development of PH.

Conclusions:
Our results support the notion that VEGF-A/VEGFR2 Y949–dependent vascular permeability is an important determinant in the pathogenesis of PH and might serve as an attractive therapeutic target pathway for this disease.
From correlation to communication: Disentangling hidden factors from functional connectivity changes
Authors: Yu Yuhua , Gratton Caterina , Smith Derek M. 
Published: November 2022

Abstract
While correlations in the BOLD fMRI signal are widely used to capture functional connectivity (FC) and its changes across contexts, its interpretation is often ambiguous. The entanglement of multiple factors including local coupling of two neighbors and nonlocal inputs from the rest of the network (affecting one or both regions) limits the scope of the conclusions that can be drawn from correlation measures alone. Here we present a method of estimating the contribution of nonlocal network input to FC changes across different contexts. To disentangle the effect of task-induced coupling change from the network input change, we propose a new metric, “communication change,” utilizing BOLD signal correlation and variance. With a combination of simulation and empirical analysis, we demonstrate that (1) input from the rest of the network accounts for a moderate but significant amount of task-induced FC change and (2) the proposed “communication change” is a promising candidate for tracking the local coupling in task context-induced change. Additionally, when compared to FC change across three different tasks, communication change can better discriminate specific task types. Taken together, this novel index of local coupling may have many applications in improving our understanding of local and widespread interactions across large-scale functional networks.
Women and Femininity under the Metaxas Regime in Greece
Authors: Vasilaki Rosa 
Published: November 2022

Abstract
Authoritarian regimes place significant emphasis on gender roles as part of their ‘imagined communities’, where everyone has their place attributed through evocation of the nation’s ‘history’ and ‘mission’. By placing gender at the core of historical analysis, this article examines the antinomies related to the role of women, and the shifting perceptions of femininity, under the Metaxas regime. It examines the female branch of the National Youth Organisation (EON), a laboratory of a ‘new femininity’, analyses the regime’s discourses and idealised representations of femininity and masculinity, and offers critical exploration of affinities between the Metaxist understanding of womanhood and pre-existing aspects of Greek interwar feminism. The article interprets from these fields the oscillations and contradictions marking Metaxist ideology and practices via-à-vis the role of women, and in doing so sheds new light upon the character of the regime itself.
Consenso di Irmandade: Reading Bissau-Guinean Political Thought on Community and Consensus
Authors: Favarato Claudia 
Published: November 2022

Abstract
This paper explores the political thought of Guinea-Bissau, focusing on the endogenous notions of community and consensus. The analysis turns on discerning the principles underpinning political power and power relations in the organicist setting. The paper considers the indigenous polity and its underlying tenets, by unveiling the centrality of the past, land (tchon), and kinship (djorson) in conceptualizations of the political community. These determine a polity ruled by participatory politics and “brotherhood consensus” (consenso di irmandade, in local creole). As this notion of “brotherhood” is tightly linked to the foundations of the political community, the Bissau-Guinean polity pins consensual politics to ontology. This ontological basis fosters commitment to engage in and reach consensus.
This analysis adds to studies on African political thought and theories of consensual democracy. Moreover, the insights offered, however spatial-specific, exemplify the potential of renewed analysis of notions of the political community in Africa and beyond, enriching the repertoire of political theory research.
Efficacy, safety, and molecular response predictors of oral ixazomib and short-course rituximab in untreated iNHL
Authors: Graf Solomon A. , Lynch Ryan C. , Ujjani Chaitra S. , Gooley Ted A. , Rasmussen Heather , Coffey David G. , Cowan Andrew J. , Smith Stephen D. , Shadman Mazyar , Warren Edus H. , Libby Edward N. , Greninger Alexander L. , Fromm Jonathan R. , Gopal Ajay K. 
Published: November 2022

Abstract
Patients with indolent B-cell non-Hodgkin lymphoma (iNHL) generally require treatment but experience normal survival, emphasizing the need for simpler, safer therapies. Proteasome inhibitors target aberrant signaling pathways within iNHL and have manageable toxicities. We evaluated the oral proteasome inhibitor ixazomib as initial monotherapy, and combined with rituximab, for first-line treatment of iNHL. Treatment-naïve patients with iNHL needing therapy received oral ixazomib 4 mg weekly until progressive disease or unacceptable adverse events. A 4-week course of rituximab was added during month 7. The primary end point was overall response rate (ORR) during the ixazomib monotherapy window. Correlations included gene expression profiling and response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Thirty-three patients with follicular lymphoma (FL) (n = 20), marginal zone lymphoma (n = 7), and other iNHL were treated with a median follow-up of 30.3 months. During the 6-month ixazomib window, the ORR was 24%, including 35% in FL. The best ORR over the entire study period was 52% overall and 65% in FL; complete response was achieved in 33% and 45%, respectively. The median duration of response was 25.8 months (range, 0-49.7), and the 24-month progression-free and overall survival rates were 51% (95% confidence interval [CI], 32-67) and 91% (95% CI, 74-97), respectively. Ixazomib was well tolerated. Baseline downregulation of proteasome genes, PSMB9 (P = .03) and PSMB8 (P = .007), were associated with response. All evaluated patients generated anti-S antibodies to SARS-CoV-2 vaccination, with a median of 254.9 binding arbitrary unit per mL. Ixazomib demonstrated efficacy alone and with short-course rituximab in untreated iNHL while exhibiting favorable toxicity, convenience, and retention of the B-cell immune response. This trial is registered at www.clinicaltrials.gov as NCT02339922.
Comparative analysis of detoxification-related gene superfamilies across five hemipteran species
Authors: Volonté Mariano , Traverso Lucila , Estivalis Jose Manuel Latorre , Almeida Francisca Cunha , Ons Sheila 
Published: November 2022

AbstractBackgroundHemiptera is one of the most speciose orders of insects, and the most speciose considering Hemimetabola. Through their evolutive history, hemipterans with different feeding habits have adapted to deal with different chemical challenges. Three major gene families are involved in xenobiotic detoxification in insects: the cytochromes P450 (CYPs), carboxyl/cholinesterases (CCEs), and glutathione transferases (GSTs). Here we perform a comparative analysis on the complement of these gene superfamilies across five hemipteran species; four heteropterans (the pentatomid plant feedersNezara viridulaandHalyomorpha halys; the hematophagousCimex lectularius, Cimicidae, andRhodnius prolixus,Reduviidae), and one Auchenorrhyncha plant feeder (Nilaparvata lugens).ResultsOur results point to an expansion of several enzyme families associated with xenobiotic detoxification in heteropterans with respect to other species and the existence of a dynamic evolution pattern including CYP3 clan, hormone and pheromone processing class in the CCE superfamily, and sigma class in GST superfamily. Other detoxification-related families are reduced in the hemipteran species analyzed here: reduction or even absence of epsilon class and reduced delta class in GST superfamily; absence of mitochondrial CYP12 family; absence of CYP9 family in CYP3 clan; and reduction or even absence of some dietary/detoxification groups of CCEs. Interestingly, the most polyphagous species analyzed here (H. halys) is also the one that presents the largest repertoire of detoxification enzymes. Gene cluster analysis suggests that this could be due to gene duplication events.ConclusionsThe evolutionary analysis performed here reveals characteristics that are both common and particular for heteropterans. The composition and organization of detoxification-related gene families could shed light on evolutionary forces that shaped their divergence. These families are important for both the detoxification of diet products and for conferring tolerance or resistance to synthetic insecticides. Furthermore, we present the first comprehensive analysis of detoxification gene superfamilies inN. viridula, an understudied species in spite of its economic relevance as a crop pest. The information obtained is of interest for basic insect science as well as for the control of harmful species and the management of insecticide resistance.
A risk scoring system for advanced colorectal neoplasia in high-risk participants to improve current colorectal cancer screening in Tianjin, China
Authors: Yuan Zhen , Wang Shuyuan , Liu Zhaoce , Liu Yanfei , Wang Yuqi , Han Youkui , Gao Weifeng , Liu Xinyu , Li Hongzhou , Zhang Qinghuai , Ma Hong , Wang Junying , Wei Xiaomeng , Zhang Xipeng , Cui Wei , Zhang Chunze 
Published: November 2022

Abstract
Background
Given the limited effectiveness of the current Chinese colorectal cancer (CRC) screening procedure, adherence to colonoscopy remains low. We aim to develop and validate a scoring system based on individuals who were identified as having a high risk in initial CRC screening to achieve more efficient risk stratification and improve adherence to colonoscopy.

Methods
A total of 29,504 screening participants with positive High-Risk Factor Questionnaire (HRFQ) or faecal immunochemical test (FIT) who underwent colonoscopy in Tianjin from 2012–2020 were enrolled in this study. Binary regression analysis was used to evaluate the association between risk factors and advanced colorectal neoplasia. Internal validation was also used to assess the performance of the scoring system.

Results
Male sex, older age (age ≥ 50 years), high body mass index (BMI ≥ 28 kg/m2), current or past smoking and weekly alcohol intake were identified as risk factors for advanced colorectal neoplasm. The odds ratios (ORs) for significant variables were applied to construct the risk score ranging from 0–11: LR, low risk (score 0–3); MR, moderate risk (score 4–6); and HR, high risk (score 7–11). Compared with subjects with LR, those with MR and HR had ORs of 2.47 (95% confidence interval, 2.09–2.93) and 4.59 (95% confidence interval, 3.86–5.44), respectively. The scoring model showed an outstanding discriminatory capacity with a c-statistic of 0.64 (95% confidence interval, 0.63–0.65).

Conclusions
Our results showed that the established scoring system could identify very high-risk populations with colorectal neoplasia. Combining this risk score with current Chinese screening methods may improve the effectiveness of CRC screening and adherence to colonoscopy.
A case of ischemic stroke with hemorrhagic transformation associated with essential thrombocythemia and JAK-2 V617F mutation
Authors: Yan Ran , Mi Donghua , Qiu Xin , Li Zixiao 
Published: November 2022

Abstract
Background
Essential thrombocythemia (ET) is a rare cause of stroke. The V617F mutation in the Janus kinase 2 (JAK2) gene is one of the most typical mutations in ET and has been shown to be a risk factor for stroke, especially in younger people. However, to date, there have been few reports of intracranial thrombotic and hemorrhagic complications in patients with ET. Herein, we present a case of JAK2 gene mutation-associated ET in a patient who developed both ischemic and hemorrhagic stroke, and discuss potential underlying mechanisms.

Case presentation
A 45-year-old Chinese male presented to our center with gradually developing weakness of the right limbs for 3 months. A computed tomography scan of the brain showed an area of infarction with hemorrhage in the left subcortical and corona radiata regions. High-resolution magnetic resonance imaging revealed a thrombosis on the surface of the atherosclerotic plaque. Digital subtraction angiography revealed an insect bite-like change in the C1 branch of the left internal carotid artery, which caused up to 50% stenosis. Blood tests showed continued elevation of the platelet and white blood cell counts. After consultation with a hematologist, a bone marrow biopsy was performed, which revealed proliferative bone marrow changes with numerous megakaryocytes and proliferative but mature granulocytes. Further genetic testing revealed a positive JAK2-V617F mutation. Therefore, the diagnosis of ET was confirmed according to the World Health Organization (WHO) 2016 diagnostic criteria. Finally, we decided to administer aspirin and hydroxyurea. The patient remained stroke free and the platelet levels were normal throughout the 1-year follow-up period.

Conclusions
JAK2 mutations affect the proliferation and differentiation of blood cells through the JAK, signal transducer and activator of transcription pathway, which leads to changes in platelets and macrophages, and an increase in neutrophil extracellular traps, which may explain the patient’s ischemic and hemorrhagic changes. Further investigation of the underlying mechanisms may change the treatment strategy for such patients in the future.
Higher reinfection rate after two-stage revision arthroplasty in patients with refractory diabetes mellitus: a retrospective analysis with a minimum ten-year follow up
Authors: Lin Yu-Chih , Lin Yi-Hsuan , Chou Jian-Hong , Lo Yu-Tai , Chang Chih-Hsiang , Lee Sheng-Hsun , Lin Sheng-Hsuan 
Published: November 2022

Abstract
Background
Treatment protocols for two-stage revision arthroplasty with diabetes mellitus (DM) have not yet been established. The control of glycated hemoglobin (HbA1c) in two-stage revision arthroplasty is still debated. This study aimed to clarify the importance of preoperative HbA1c levels before each stage of revision arthroplasty and to analyze the risk factors for reinfection.

Methods
Five hundred eighty-eight patients suffered from first-time PJI and was treated in our institute from January 1994 to December 2010 were reviewed. The mean follow-up time was 13.8 (range, 10.2–24.8) years. Patients underwent two-stage revision arthroplasty with DM at presentation were included. The endpoint of the study was reinfection of the revision arthroplasty. Demographic, survivorship, and surgical variables were also analyzed.

Results
Eighty-eight patients were identified and grouped by HbA1c level before the first stage surgery: Groups 1 and 2 had HbA1c levels < 7% and ≥ 7%, respectively. Reinfection was identified in 4.55% (2/44) and 18.18% (8/44) of the patients in Groups 1 and 2, respectively. Survivorship analysis revealed correction of the HbA1c before the final stage of revision arthroplasty as an independent factor (p < 0.001). The identified risks for reinfection were HbA1c levels ≥ 7% before final-stage surgery, ≥ 3 stages of revision arthroplasty, and extended-spectrum beta-lactamase (ESBL)-Escherichia coli PJI.

Conclusion
The HbA1c level before the final stage of revision arthroplasty could affect staged revision arthroplasty outcomes. Therefore, the necessity of postponing the elective final-stage revision arthroplasty procedure for HbA1c control should be further investigated in the future.