bluuebunny/crossref_metadata_2025_split huggingface dataset:
Population Abundance and Density Estimates for Costa Rica’s Endemic Sea Snake, Hydrophis platurus xanthos
Authors: Bessesen Brooke L. , Oedekoven Cornelia S. , Galbreath Gary J. , González-Suárez Manuela 
Published: July 2022

Population abundance and density estimates provide key information for conservation assessment and prioritization of efforts and management. However, data are still largely unavailable for many taxa, including sea snakes, which appear to be facing global declines. Here, we present the first quantitative abundance and density estimates for the geographically isolated sea snakeHydrophis platurus xanthosendemic to the inner basin of Golfo Dulce, Costa Rica. Using systematic distance sampling methods, we obtained and analyzed 199 snake detections from 46 transect lines covering the entire known distribution (totaling nine days and 469 km of effort). Our modeling methods accounted for (i) the probability of detecting a snake given it was available to be detected (ii) the average availability of snakes at the water surface during a 24-hr cycle, and (iii) the by-hour variance in the taxon’s activity pattern. The best estimate of population abundance was 29781 individuals (95% CI=20104–44115) with an estimated density of 76 snakes/km2. Without historical abundance estimates or minimum viable population size, it is unknown whether this number represents a healthy population. However, with all individuals inhabiting a relatively small inlet increasingly exposed to anthropogenic impacts, the long-term persistence ofH. p. xanthosmay be threatened by ongoing impacts (boat propeller strikes, agricultural runoff, and climate change), as well as unforeseen events in the future.
P1245 Polymorphic Variants of HSD3B1 Gene Confer Different Outcome in Specific Subgroups of Patients Infected With SARS-CoV-2
Authors: Epistolio Samantha , Ramelli Giulia , Ottaviano Margaret , Crupi Emanuele , Marandino Laura , Biggiogero Maira , Maida Pier Andrea , Ruinelli Lorenzo , Vogl Ursula , Mangan Dylan , Pascale Mariarosa , Cantù Marco , Ceschi Alessandro , Bernasconi Enos , Mazzucchelli Luca , Catapano Carlo , Alimonti Andrea , Garzoni Christian , Gillessen Sommer Silke , Stefanini Federico Mattia , Franzetti-Pellanda Alessandra , Frattini Milo , Pereira Mestre Ricardo 
Published: July 2022

Introduction: Severe respiratory syndrome coronavirus 2 (SARS-CoV-2) uses the androgen receptor (AR), through ACE2 receptor and TMPRSS2, to enter nasal and upper airways epithelial cells. Genetic analyses revealed that HSD3B1 P1245C polymorphic variant increases dihydrotestosterone production and upregulation of TMPRSS2 with respect to P1245A variant, thus possibly influencing SARS-CoV-2 infection. Our aim was to characterize the HSD3B1 polymorphism status and its potential association with clinical outcomes in hospitalized patients with COVID-19 in Southern Switzerland.Materials and Methods: The cohort included 400 patients hospitalized for COVID-19 during the first wave between February and May 2020 in two different hospitals of Canton Ticino. Genomic DNA was extracted from formalin-fixed paraffin-embedded tissue blocks, and HSD3B1 gene polymorphism was evaluated by Sanger sequencing. Statistical associations were verified using different test.Results:HSD3B1 polymorphic variants were not associated with a single classical factor related to worse clinical prognosis in hospitalized patients with SARS-CoV-2. However, in specific subgroups, HSD3B1 variants played a clinical role: intensive care unit admission was more probable in patients with P1245C diabetes compared with P1245A individuals without this comorbidity and death was more associated with hypertensive P1245A&gt;C cases than patients with P1245A diabetes without hypertension.Discussion: This is the first study showing that HSD3B1 gene status may influence the severity of SARS-CoV-2 infection. If confirmed, our results could lead to the introduction of HSD3B1 gene status analysis in patients infected with SARS-CoV-2 to predict clinical outcome.
Deep Learning Model for Predicting Intradialytic Hypotension Without Privacy Infringement: A Retrospective Two-Center Study
Authors: Kim Hyung Woo , Heo Seok-Jae , Kim Minseok , Lee Jakyung , Park Keun Hyung , Lee Gongmyung , Baeg Song In , Kwon Young Eun , Choi Hye Min , Oh Dong-Jin , Nam Chung-Mo , Kim Beom Seok 
Published: July 2022

ObjectivePreviously developed Intradialytic hypotension (IDH) prediction models utilize clinical variables with potential privacy protection issues. We developed an IDH prediction model using minimal variables, without the risk of privacy infringement.MethodsUnidentifiable data from 63,640 hemodialysis sessions (26,746 of 79 patients for internal validation, 36,894 of 255 patients for external validation) from two Korean hospital hemodialysis databases were finally analyzed, using three IDH definitions: (1) systolic blood pressure (SBP) nadir &lt;90 mmHg (Nadir90); (2) SBP decrease ≥20 mmHg from baseline (Fall20); and (3) SBP decrease ≥20 mmHg and/or mean arterial pressure decrease ≥10 mmHg (Fall20/MAP10). The developed models use 30 min information to predict an IDH event in the following 10 min window. Area under the receiver operating characteristic curves (AUROCs) and precision-recall curves were used to compare machine learning and deep learning models by logistic regression, XGBoost, and convolutional neural networks.ResultsAmong 344,714 segments, 9,154 (2.7%), 134,988 (39.2%), and 149,674 (43.4%) IDH events occurred according to three different IDH definitions (Nadir90, Fall20, and Fall20/MAP10, respectively). Compared with models including logistic regression, random forest, and XGBoost, the deep learning model achieved the best performance in predicting IDH (AUROCs: Nadir90, 0.905; Fall20, 0.864; Fall20/MAP10, 0.863) only using measurements from hemodialysis machine during dialysis session.ConclusionsThe deep learning model performed well only using monitoring measurement of hemodialysis machine in predicting IDH without any personal information that could risk privacy infringement.
Self-Expandable Metal Stent in the Management of Malignant Airway Disorders
Authors: Bai Yang , Zhan Ke , Chi Jing , Jiang JinYue , Li Shuang , Yin Yuting , Li Yishi , Guo Shuliang 
Published: July 2022

BackgroundSelf-expanding metallic stent (SEMS) is a palliative therapy for patients with malignant central airway obstruction (CAO) or tracheoesophageal fistula (TEF). Despite this, many patients experience death shortly after SEMS placement.AimsWe aimed to investigate the effect of SEMS on the palliative treatment between malignant CAO and malignant TEF patients and investigate the associated prognostic factors of the 3-month survival.MethodsWe performed a single-center, retrospective study of malignant CAO or TEF patients receiving SEMS placement. Clinical data were collected using the standardized data abstraction forms. Data were analyzed using SPSS 22.0. A two-sided P-value &lt;0.05 was statistically significant.Results106 malignant patients (82 CAO and 24 TEF) receiving SEMS placement were included. The body mass index (BMI), hemoglobin levels, and albumin levels in the malignant TEF group were lower than in the malignant CAO group (all P &lt; 0.05). The procalcitonin levels, C-reactive protein levels, and the proportion of inflammatory lesions were higher in the malignant TEF group than in the malignant CAO group (all P &lt; 0.05). The proportion of symptomatic improvement after the SEMS placement was 97.6% in the malignant CAO group, whereas 50.0% in the malignant TEF group, with a significant difference (P = 0.000). Three months after SEMS placement, the survival rate at was 67.0%, significantly lower in the malignant TEF group than in the malignant CAO group (45.8% vs. 73.2%, P = 0.013). Multivariate analysis revealed that BMI [odds ratio (OR) = 1.841, 95% certificated interval (CI) (1.155-2.935), P = 0.010] and neutrophil percentage [OR = 0.936, 95% CI (0.883–0.993), P = 0.027] were the independent risk factors for patients who survived three months after SEMS placement.ConclusionsWe observed symptom improvement in malignant CAO and TEF patients after SEMS placement. The survival rate in malignant TEF patients after SEMS placement was low, probably due to aspiration pneumonitis and malnutrition. Therefore, we recommend more aggressive treatment modalities in patients with malignant TEF, such as strong antibiotics, nutrition support, and strategic ventilation. More studies are needed to investigate the prognostic factors in patients with malignant airway disorders receiving SEMS placement.
A Survey on Current Practices of Umbilical Cord Clamping in Malaysia
Authors: Pong Kwai Meng , Puasa Norezliani , Mahdy Zaleha Abdullah 
Published: July 2022

BackgroundDelayed cord clamping (DCC) has been demonstrated to have significant benefits in reducing the incidence of intraventricular hemorrhage, blood transfusion and neonatal mortality in preterm neonates and improving hemodynamic and long-term neurodevelopment among term infants. There is no clear guideline on umbilical cord clamping (UCC) practices in Malaysia.ObjectiveThe aim of this survey was to assess the knowledge and practice of DCC among obstetric doctors and midwives in Malaysia, and pediatric colleagues who witness the delivery.MethodThis is a cross-sectional survey conducted in childbirth facilities in Malaysia from October 2020 to January 2021. A convenient snowball sampling was adopted. A validated questionnaire was disseminated to practicing obstetric and pediatric doctors and midwives electronically via email and WhatsApp using Google Form. The data were analyzed using descriptive and analytical statistics.ResultsA total of 327 respondents completed the questionnaires, comprising 206 obstetric doctors, 72 pediatric doctors and 49 midwives. The majority of respondents were specialists or higher in rank (53.2%). Only 29% reported the existence of guidelines on UCC in their place of work. Midwives (P = 0.003) and staff of lower ranks and level of education (P &lt; 0.001) appeared to be more aware of the existence of a UCC guideline. Most respondents had positive knowledge of DCC for both term and preterm neonates. A large proportion (82%) of respondents agreed that DCC helped increase neonatal iron stores, and was good for both preterm (70.7%) and term (76.2%) neonates not requiring positive pressure ventilation. Doctors, specialists, those who are 40 years old and above, and those who have been in service for at least 10 years were found to have better knowledge regarding DCC (P &lt; 0.05).ConclusionThe awareness and practice of obstetric, pediatric and midwifery staff of guidelines on UCC were less than satisfactory. Even though most respondents have good knowledge and positive perception regarding benefits of DCC, these were not translated into their routine practice. Hence, a national guideline emphasizing the benefits of DCC should be made available in all childbirth facilities.
Development and Validation of a Website to Guide Decision-Making for Disorders of Consciousness
Authors: Kang Junwei , Zhong Yuan , Chen Gengfa , Huang Lianghua , Tang Yunliang , Ye Wen , Feng Zhen 
Published: July 2022

BackgroundThis study aimed to develop and validate a nomogram and present it on a website to be used to predict the overall survival at 16, 32, and 48 months in patients with prolonged disorder of consciousness (pDOC).MethodsWe retrospectively analyzed the data of 381 patients with pDOC at two centers. The data were randomly divided into training and validation sets using a ratio of 6:4. On the training set, Cox proportional hazard analyses were used to identify the predictive variables. In the training set, two models were screened by COX regression analysis, and based on clinical evidence, model 2 was eventually selected in the nomogram after comparing the receiver operating characteristic (ROC) of the two models. In the training and validation sets, ROC curves, calibration curves, and decision curve analysis (DCA) curves were utilized to measure discrimination, calibration, and clinical efficacy, respectively.ResultsThe final model included age, Glasgow coma scale (GCS) score, serum albumin level, and computed tomography (CT) midline shift, all of which had a significant effect on survival after DOCs. For the 16-, 32-, and 48-month survival on the training set, the model had good discriminative power, with areas under the curve (AUCs) of 0.791, 0.760, and 0.886, respectively. For the validation set, the AUCs for the 16-, 32-, and 48-month survival predictions were 0.806, 0.789, and 0.867, respectively. Model performance was good for both the training and validation sets according to calibration plots and DCA.ConclusionWe developed an accurate, efficient nomogram, and a corresponding website based on four correlated factors to help clinicians improve their assessment of patient outcomes and help personalize the treatment process and clinical decisions.
Functional MRI Correlates of Carbon Dioxide Chemosensing in Persons With Epilepsy
Authors: Hampson Johnson P. , Lacuey Nuria , Rani MR Sandhya , Hampson Jaison S. , Simeone Kristina A. , Simeone Timothy A. , Narayana Ponnada A. , Lemieux Louis , Lhatoo Samden D. 
Published: July 2022

ObjectivesSudden unexpected death in epilepsy (SUDEP) is a catastrophic epilepsy outcome for which there are no reliable premortem imaging biomarkers of risk. Percival respiratory depression is seen in monitored SUDEP and near SUDEP cases, and abnormal chemosensing of raised blood carbon dioxide (CO2) is thought to contribute. Damage to brainstem respiratory control and chemosensing structures has been demonstrated in structural imaging and neuropathological studies of SUDEP. We hypothesized that functional MRI (fMRI) correlates of abnormal chemosensing are detectable in brainstems of persons with epilepsy (PWE) and are different from healthy controls (HC).MethodsWe analyzed fMRI BOLD activation and brain connectivity in 10 PWE and 10 age- and sex-matched HCs during precisely metered iso-oxic, hypercapnic breathing challenges. Segmented brainstem responses were of particular interest, along with characterization of functional connectivity metrics between these structures. Regional BOLD activations during hypercapnic challenges were convolved with hemodynamic responses, and the resulting activation maps were passed on to group-level analyses. For the functional connectivity analysis, significant clusters from BOLD results were used as seeds. Each individual seed time-series activation map was extracted for bivariate correlation coefficient analyses to study changes in brain connectivity between PWE and HCs.Results(1) Greater brainstem BOLD activations in PWE were observed compared to HC during hypercapnic challenges in several structures with respiratory/chemosensing properties. Group comparison between PWE vs. HC showed significantly greater activation in the dorsal raphe among PWE (p &lt; 0.05) compared to HCs. (2) PWE had significantly greater seed-seed connectivity and recruited more structures during hypercapnia compared to HC.SignificanceThe results of this study show that BOLD responses to hypercapnia in human brainstem are detectable and different in PWE compared to HC. Increased dorsal raphe BOLD activation in PWE and increased seed-seed connectivity between brainstem and adjacent subcortical areas may indicate abnormal chemosensing in these individuals. Imaging investigation of brainstem respiratory centers involved in respiratory regulation in PWE is an important step toward identifying suspected dysfunction of brainstem breathing control that culminates in SUDEP and deserve further study as potential imaging SUDEP biomarkers.
The Predictive Role of Hand Section of Fugl–Meyer Assessment and Motor Activity Log in Action Research Arm Test in People With Stroke
Authors: Chen Peiming , Liu Tai-Wa , Tse Mimi M. Y. , Lai Claudia K. Y. , Tsoh Joshua , Ng Shamay S. M. 
Published: July 2022

Background:Recent findings of clinical studies have demonstrated a significant positive relationship between Fugl–Meyer Assessment of upper extremity score and the action research arm test (ARAT) score in people with stroke. Although the motor activity log (MAL) can assess the self-perception of motor performance, which can affect the performance of the upper limb, the relationship between MAL score and ARAT score still remains unclear. The objective of this study is to quantify the independent contribution of MAL score and FMA-hand score on the ARAT score in people with stroke.MethodsThis is a cross-sectional study. There were a total of 87 subjects (50 males, 37 females; mean age = 61.12 ± 6.88 years, post-stroke duration=6.31 ± 2.84 years) included in this study. Self-perceived performance in using the paretic limb was measured by MAL, including subscale of the amount of usage (MAL-AOU) and quality of movement (MAL-QOM). Functional performance of the upper limb was measured by action research arm test (ARAT). Upper limb motor control of the hand was measured by hand section of Fugl–Meyer assessment (FMA-hand).ResultsThe result showed that MAL-QOM (r = 0.648, p &lt; 0.001), MAL-AOU (r = 0.606, p &lt; 0.001), FMA-hand scores (r = 0.663, p &lt; 0.001), and the use of a walking aid (r = −0.422, p &lt; 0.001) were significantly correlated with the ARAT scores. A total 66.9% of the variance in the ARAT scores was predicted by the final regression model including MAL-QOM, MAL-AOU, FMA-hand scores, and walking aid. The FMA-hand score was the best predictor of ARAT scores, which can predict a 36.4% variance of ARAT scores in people with stroke, which controlled the effect of using a walking aid. After controlling for use of a walking aid and FMA-hand scores, the multiple linear regression modeling showed that MAL-QOM and MAL-AOU scores could also independently predict an additional 10.4% of the variance in ARAT scores.ConclusionIn addition to the FMA-hand score, the MAL score was significantly correlated with the ARAT score. Improving self-perceived performance should be one goal of rehabilitation in people with stroke. Further work developing and testing techniques to do so is clearly warranted.
Quantitative Analysis of Diffusion-Restricted Lesions in a Differential Diagnosis of Status Epilepticus and Acute Ischemic Stroke
Authors: Machegger Lukas , Bosque Varela Pilar , Kuchukhidze Giorgi , Steinbacher Jürgen , Öllerer Andreas , Prüwasser Tanja , Zimmermann Georg , Pikija Slaven , Pfaff Johannes , Trinka Eugen , Mc Coy Mark 
Published: July 2022

Background and PurposeDistinction between acute ischemic stroke (AIS) and status epilepticus (SE) on MRI can be challenging as restricted diffusion may occur in both conditions. In this study, we aimed to test a tool, which could help in differentiating AIS from SE when restricted diffusion was present on MRI.Materials and MethodsIn diffusion weighted imaging (DWI) with a b-value of 1,000 and apparent diffusion coefficient (ADC) maps, we compared the ratios of intensities of gray values of diffusion-restricted lesions to the healthy mirror side in patients with AIS and SE. Patients were recruited prospectively between February 2019 and October 2021. All patients underwent MRI and EEG within the first 48 h of symptom onset.ResultsWe identified 26 patients with SE and 164 patients with AIS. All patients had diffusion-restricted lesions with a hyperintensity in DWI and ADC signal decrease. Diffusion restriction was significantly more intense in patients with AIS as compared to patients with SE. The median ratios of intensities of gray values of diffusion-restricted lesions to the healthy mirror side for DWI were 1.42 (interquartile range [IQR] 1.32–1.47) in SE and 1.67 (IQR 1.49–1.90) in AIS (p &lt; 0.001). ADC decrease was more significant in AIS as compared to SE with median ratios of 0.80 (IQR 0.72–0.89) vs. 0.61 (IQR 0.50–0.71), respectively (p &lt; 0.001). A cutoff value for ratios of DWI signal was 1.495 with a sensitivity of 75% and a specificity of 85%. Values lower than 1.495 were more likely to be associated with SE and higher values were with AIS. A cutoff value for ADC ratios was 0.735 with a sensitivity of 73% and a specificity of 84%. Values lower than 0.735 were more likely to be associated with AIS and higher values were with SE.ConclusionDiffusion restriction and ADC decrease were significantly more intense in patients with AIS as compared to SE. Therefore, quantitative analysis of diffusion restriction may be a helpful tool for differentiating between AIS and SE when restricted diffusion is present on MRI.
Concentration of Serum Biomarkers of Brain Injury in Neonates With a Low Cord pH With or Without Mild Hypoxic-Ischemic Encephalopathy
Authors: Gaulee Pratima , Yang Zhihui , Sura Livia , Xu Haiyan , Rossignol Candace , Weiss Michael D. , Bliznyuk Nikolay 
Published: July 2022

ObjectiveTo determine the concentrations of four neuroprotein biomarkers and 68 miRNAs in neonates with low cord pH and/or mild hypoxic-ischemic encephalopathy (HIE).Study DesignA prospective cohort study enrolled neonates with low cord pH (n = 18), moderate-severe HIE (n = 40), and healthy controls (n = 38). Groups provided serum samples at 0–6 h of life. The concentrations of biomarkers and miRNAs were compared between cohorts.ResultThe low cord pH and moderate-severe HIE groups had increased concentrations of GFAP, NFL and Tau compared to controls (P &lt; 0.05, P &lt; 0.001, respectively). NFL concentrations in mild HIE was higher than controls (P &lt; 0.05) but less than moderate-severe HIE (P &lt; 0.001). Of 68 miRNAs, 36 in low cord pH group and 40 in moderate-severe HIE were upregulated compared to controls (P &lt; 0.05). Five miRNAs in low cord pH group (P &lt; 0.05) and 3 in moderate-severe HIE were downregulated compared to controls (P &lt; 0.05).ConclusionA biomarker panel in neonates with low cord pH may help clinicians make real-time decisions.
Identification of Candidate Genes Associated With Prognosis in Glioblastoma
Authors: Li Rongjie , Jiang Qiulan , Tang Chunhai , Chen Liechun , Kong Deyan , Zou Chun , Lin Yan , Luo Jiefeng , Zou Donghua 
Published: July 2022

BackgroundGlioblastoma (GBM) is the most common malignant primary brain tumor, which associated with extremely poor prognosis.MethodsData from datasets GSE16011, GSE7696, GSE50161, GSE90598 and The Cancer Genome Atlas (TCGA) were analyzed to identify differentially expressed genes (DEGs) between patients and controls. DEGs common to all five datasets were analyzed for functional enrichment and for association with overall survival using Cox regression. Candidate genes were further screened using least absolute shrinkage and selection operator (LASSO) and random forest algorithms, and the effects of candidate genes on prognosis were explored using a Gaussian mixed model, a risk model, and concordance cluster analysis. We also characterized the GBM landscape of immune cell infiltration, methylation, and somatic mutations.ResultsWe identified 3,139 common DEGs, which were associated mainly with PI3K-Akt signaling, focal adhesion, and Hippo signaling. Cox regression identified 106 common DEGs that were significantly associated with overall survival. LASSO and random forest algorithms identified six candidate genes (AEBP1, ANXA2R, MAP1LC3A, TMEM60, PRRG3 and RPS4X) that predicted overall survival and GBM recurrence. AEBP1 showed the best prognostic performance. We found that GBM tissues were heavily infiltrated by T helper cells and macrophages, which correlated with higher AEBP1 expression. Stratifying patients based on the six candidate genes led to two groups with significantly different overall survival. Somatic mutations in AEBP1 and modified methylation of MAP1LC3A were associated with GBM.ConclusionWe have identified candidate genes, particularly AEBP1, strongly associated with GBM prognosis, which may help in efforts to understand and treat the disease.