bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex differences and clinical outcomes, including ventricular tachyarrhythmias, of patients with heart failure with reduced ejection fraction treated with sacubitril/valsartan
Authors: Abumayyaleh Mohammad , Krack Carina , Demmer Jonathan , Pilsinger Christina , Schupp Tobias , Behnes Michael , Sattler Katherine , El-Battrawy Ibrahim , Hamdani Nazha , Akin Ibrahim 
Published: December 2024

BackgroundWomen with heart failure with reduced ejection fraction (HFrEF) often experience worse clinical outcomes compared to men, including higher rates of mortality, hospitalization, and congestion. However, the effects of sacubitril/valsartan on these outcomes, as well as on ventricular tachyarrhythmias, have not been well studied in women with HFrEF.MethodsThis study included consecutive series of patients treated with sacubitril/valsartan at University Hospital Mannheim from 2016 to 2020. Baseline and follow-up data were compared between women and men. The endpoints included all-cause mortality, ventricular tachyarrhythmias, all-cause hospitalization, and congestion.ResultsA total of 246 patients were analyzed, comprising 50 (20.3%) women and 196 (79.7%) men. The study population consisted of 34.3% ambulatory patients and 65.7% hospitalized patients admitted for acute decompensated or symptomatic HF. The sex distribution was as follows: among women, 48.6% were ambulatory and 51.4% were hospitalized, while among men, 30.6% were ambulatory and 69.4% were hospitalized. Ischemic cardiomyopathy (ICM) was less common as a cause of heart failure (HF) in women than in men (32% vs. 57.7%, p = 0.001). During the 12-month follow-up, left ventricular ejection fraction (LVEF) improved more significantly in women than in men, increasing from 29.0% (10.0–45.0) to 40.0% (15.0–59.0) in women (p = 0.009) compared to an increase from 28.0% (3.0–65.0) to 33.0% (13.0–60.0) in men. There were no significant differences in all-cause mortality at 12-month between women and men (4% vs. 6.7%; p = 0.742). The results indicated no significant differences between the sexes in the incidence of ventricular tachyarrhythmias [ventricular fibrillation [VF] and sustained ventricular tachycardia [VT]] (4.5% vs. 0.6%; p = 0.121) (2.3% vs. 3.9%; p = 1.00), hospitalizations (70.2% vs. 67.8%; p = 0.769), congestion at 12-month follow-up (11.4% vs. 10.1%; p = 0.762). Female sex was not identified as a predictor for the occurrence of ventricular tachyarrhythmias or mortality rate at 12 months [hazard ratio (HR), 0.586; 95%-confidence interval (CI) 0.17–2.016; p = 0.397] (HR, 1.898; 95%-CI 0.381–9.464; p = 0.434).ConclusionWomen with HFrEF treated with sacubitril/valsartan showed a greater improvement in LVEF compared to men, though clinical outcomes were similar across sexes. Female sex was not a predictor of ventricular tachyarrhythmias or mortality at 12 months.
How critical is SME financial literacy and digital financial access for financial and economic development in the expanded BRICS block?
Authors: M. Manoj Kumar , Almuraqab Nasser , Moonesar Immanuel Azaad , Braendle Udo Christian , Rao Ananth 
Published: December 2024

IntroductionThe expanded BRICS block presents significant opportunities for SMEs (Small and Medium Enterprises), but challenges related to financial literacy and digital access hinder their potential. While global efforts emphasize financial literacy and digitization as key drivers of economic growth, especially in developing regions, their specific impact on SMEs in the BRICS block remains underexplored. This paper contributes to the literature by contextualizing how financial literacy and digital financial access influence SME sustainability and economic progress, particularly in light of ongoing efforts to bridge the digital divide.MethodsUsing Principal Component Analysis to reduce dimensionality, the study uses advanced Random Forest Tree modeling, to evaluate current practices in SME finance, credit access, and digitization.ResultsResults indicate that both financial literacy and digitalization play pivotal roles in driving sustainable economic development, with significant implications for policy interventions aimed at supporting SME growth in emerging economies.DiscussionThis study addresses the crucial intersection of SME financial literacy and digital financial access, focusing on their role in fostering economic development within the expanded BRICS block-a group now comprising major emerging economies that collectively face substantial disparities in financial inclusion. The study results are relevant not only for understanding the BRICS context but also for shaping global strategies toward inclusive financial systems and SME resilience in the digital era.
Language development in Slovenian toddlers: the role of electronic media, parental knowledge of language development, and parental input
Authors: Fekonja Urška , Marjanovič-Umek Ljubica , Pogorelc-Jesih Nika , Ferjan Ramírez Naja 
Published: December 2024

IntroductionThis study examines the relationships between toddlers' language production, parental language input, media exposure, and parental knowledge of early language development.MethodsWe used a unique collection of daylong recordings of Slovenian toddlers (age: 16–30 months, N = 40, 18 girls) to measure the language environment, toddlers' language production and media exposure. In addition, parental reports of toddlers' media exposure and language ability (using the Slovenian adaptation of the CDI) were collected.ResultsThe results indicate that toddlers' average exposure to electronic media was rather low, with exposure varying widely across the sample. Parental language input was related to various measures of toddlers' language. Parents with a greater knowledge of early language development used more parentese, while their toddlers had less exposure to electronic media. In addition, toddlers' media exposure was related to their age, with older toddlers having more exposure to electronic media, and was marginally related to the number of words spoken by adults and parents' education. No significant relationship was found between toddlers' language ability and media exposure when controlling for toddlers' age.DiscussionThe findings underline the importance of parental knowledge about language development and the characteristics of the language environment for toddlers' language ability.
Comparative immunogenicity assessment of biosimilar natalizumab to its reference medicine: a matching immunogenicity profile
Authors: Chamberlain Paul , Hemmer Bernhard , Höfler Josef , Wessels Hendrik , von Richter Oliver , Hornuss Cyrill , Poetzl Johann , Roth Karsten 
Published: December 2024

BackgroundBiosimilar natalizumab (biosim-NTZ) is the first biosimilar monoclonal antibody of reference natalizumab (ref-NTZ) for treatment of relapsing forms of multiple sclerosis (MS). Within the totality of evidence for demonstration of biosimilarity, immunogenicity assessments were performed in healthy subjects and patients with relapsing-remitting MS (RRMS) to confirm a matching immunogenicity profile between biosim-NTZ and ref-NTZ.MethodsImmunogenicity of biosim-NTZ versus ref-NTZ was evaluated in two pivotal clinical studies. In a comparative efficacy and safety study, patients with RRMS (n=264) received monthly infusions of biosim-NTZ/EU-ref-NTZ over 48 weeks. The primary endpoint period was Week 0 to Week 24. In a separate, comparative pharmacokinetic/pharmacodynamic (PK/PD) study, healthy subjects (n=450) received a single dose of biosim-NTZ, US-ref-NTZ or EU-ref-NTZ prior to an 85-day follow-up. In both studies, state-of-the-art, highly sensitive and drug tolerant bioanalytical assays were used to identify the proportion of participants with anti-drug antibodies (ADA) and neutralizing antibodies (NAb) against natalizumab over time.ResultsIn the comparative efficacy and safety study, biosim-NTZ and EU-ref-NTZ demonstrated similar incidences of overall ADA (79.4% vs 73.7%, respectively) and NAb (68.7% vs 66.2%, respectively) at Week 24. ADA titers over time were also concordant throughout the study period. Switching treatment from EU-ref-NTZ to biosim-NTZ had no impact on treatment-related ADA/NAb or clinical responses. Likewise, the single-dose PK/PD study reported matching overall incidence of ADA between treatment groups and matching ADA titer profiles over time.ConclusionThe immunogenicity profile of biosim-NTZ was confirmed to match that of ref-NTZ in healthy subjects and patients with RRMS by applying highly sensitive methods.
The development of murine bone marrow-derived mast cells expressing functional human MRGPRX2 for ex vivo and in vivo studies
Authors: Bawazir Maram , Roy Saptarshi , Ali Hydar 
Published: December 2024

IntroductionA subtype of human mast cells (MCs) found in the skin and to a lesser extent in the lung and gut express a novel G protein-coupled receptor (GPCR) known as Mas-related GPCR-X2 (MRGPRX2, mouse counterpart MrgprB2). In addition to drug-induced pseudoallergy and cutaneous disorders, MrgprB2 contributes to ulcerative colitis, IgE-mediated lung inflammation and systemic anaphylaxis. Interestingly, most agonists activate MRGPRX2 with higher potency than MrgprB2. In this study, we sought to replace mouse MrgprB2 with human MRGPRX2 and to study receptor function ex vivo and in vivo.MethodsMrgprB2−/− bone marrow (BM) cells were transduced with retrovirus encoding MRGPRX2 and differentiated into BMMCs (MRGRPX2-BMMCs) ex vivo. Cell surface MRGPRX2 expression was determined by flow cytometry. Effects of substance P (SP) and LL-37 on Ca2+ mobilization, degranulation and TNF-α generation were determined. MRGPRX2-BMMCs were engrafted intraperitoneally into MC-deficient Wsh/Wsh mice. After 6–8 weeks, immunofluorescence staining was performed on peritoneal lavage cells (PLCs), and sections of small intestine and colon with anti c-Kit and anti-MRGPRX2 antibodies. SP-induced degranulation in PLCs obtained from engrafted mice was determined.ResultsMRGPRX2-BMMCs expressed cell surface MRGPRX2 and responded to both SP and LL-37 for Ca2+ mobilization, degranulation and TNF-α generation. Furthermore, Wsh/Wsh mice engrafted with MRGPRX2-BMMCs expressed the receptor in peritoneal, intestinal and colonic MCs. In addition, PLCs from engrafted mice responded to SP for degranulation.ConclusionReplacing mouse MrgprB2 with functional human MRGPRX2 in primary BMMCs and their engraftment in MC-deficient mice demonstrated the expression of this receptor in different tissues, which provides unique opportunities to study receptor signaling ex vivo and disease phenotype in vivo.
High-frequency laser therapy: a new alternative to physiotherapy in the treatment of cervical disk hernia
Authors: Kuculmez Ozlem , Dündar Ahi Emine , Cosar Sacide Nur , Guzel Sukran 
Published: December 2024

IntroductionHigh-frequency laser therapy has been increasingly used in several musculoskeletal disorders, but there is still a lack of evidence for the usage of the device in neck pain. This study aimed to compare the effectiveness of physiotherapy, high-frequency laser, and exercise therapy methods in the treatment of pain in cervical disk herniation.MethodsIt was a multicenter, randomized, controlled clinical trial. Patients aged between 18 and 65 with neck pain and a diagnosis of cervical disk hernia were included in the study. Patients with a history of cervical surgery, rheumatism, cancer, or pacemaker were excluded from the study. The patients were randomized into 15 sessions of physiotherapy, high-frequency laser, or exercise therapy groups and evaluated with a range of motion, visual analog score, Neck Disability Index, and Short Form Health Survey-36 before treatment, after treatment, and in 1st and 3rd months. p &lt; 0.05 was considered statistically significant.ResultsIn total, 150 patients were analyzed. There was a significant improvement in range of motion, visual analog score, Neck Disability Index, and Short Form Health Survey-36 scores in three groups after 3-month follow-up (p &lt; 0.05). The improvement was statistically greater in the physiotherapy and high-frequency laser therapy groups (p &lt; 0.05), but there was no significant difference between these two groups (p &gt; 0.05).DiscussionThe results in the physiotherapy and high-frequency laser therapy groups were better than the exercise group. They may be alternatives to each other in cervical disk hernia treatment.
Evaluating the effect of chronic and continuous use of methadone on the glomerular filtration rate of patients receiving oral methadone (syrup)
Authors: Chegini Valiollah Goudarzvand , Kazemifar Amir Mohammad , Tavakolian Amir Ershad , Karimi Arian Ghannadi , Sofi Arsalan Jamali Pour , Ipchian Darya , Kamali Sahand , Varkiani Mehran Ebrahimi , Yazdi Zohreh 
Published: December 2024

IntroductionThis study systematically examines the effects of chronic oral methadone use on the glomerular filtration rate (GFR) in patients participating in methadone maintenance therapy (MMT) in Qazvin City, Iran. Methadone, a synthetic μ-opioid receptor agonist, is predominantly utilized for the management of opioid dependence and pain relief; however, there is growing concern regarding its potential nephrotoxic effects.MethodsAn observational cross-sectional study was executed involving 150 participants who had been on methadone syrup for a minimum duration of 2 years. Comprehensive data pertaining to demographic variables, methadone dosage, and serum creatinine levels were meticulously gathered at baseline, as well as at 3 and 6 months. GFR was calculated utilizing the Cockcroft-Gault formula.ResultsThe results demonstrate that, while the mean GFR values remained within the normal range, a significant correlation was observed between methadone dosage and a reduction in GFR; specifically, higher dosages were associated with lower GFR values. In contrast, the duration of methadone use did not significantly affect GFR.ConclusionThese findings indicate that, although methadone dosage may influence renal function, long-term methadone therapy does not inherently exacerbate the risk of chronic kidney disease (CKD) in this population. This underscores the critical need for diligent monitoring of methadone dosages to mitigate the risk of potential renal impairment and highlights the importance of further research into the long-term implications of methadone on renal health.
Microbial characteristics of bile in gallstone patients: a comprehensive analysis of 9,939 cases
Authors: Zheng Xin , Yan Yunjun , Li Xin , Liu Mimin , Zhao Xiaoyue , He Jing , Zhuang Xuewei 
Published: December 2024

IntroductionThe exact triggers of gallstone formation remain incompletely understood, but research indicates that microbial infection is a significant factor and can interfere with treatment. There is no consensus on the bile microbial culture profiles in previous studies, and determining the microbial profile could aid in targeted prevention and treatment. The primary aim of this study is to investigate the differences in microbial communities cultured from bile specimens of patients with gallstones.MethodsWe collected the clinical characteristics and bile microbial status of 9,939 gallstone patients. Statistical analysis was employed to assess the relationship between microbes and clinical features, and a random forest model was utilized to predict recurrence.ResultsResults showed a higher proportion of females among patients, with the age group of 60-74 years being the most prevalent. The most common type of gallstone was solitary gallbladder stones. A total of 76 microbes were cultured from 5,153 patients, with Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis being the most frequently identified. Significant differences in microbial diversity and positive detection rates were observed across different age groups, types of gallstones, and recurrence status. Positive frequencies of E. coli, Enterococcus faecium, and K. pneumoniae varied significantly by age group and gallstone type. The microbial diversity in the recurrence group was significantly lower compared to the non-recurrence group. The recurrence rate was significantly higher in the group with single microbial species compared to those with no microbes or multiple microbes. For the recurrence group, there were significant differences in the frequencies of seven microbes (Aeromonas hydrophila, Enterococcus casseliflavus, Enterococcus faecium, E. coli, K. pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa) before and after recurrence, with these microbes appearing in a higher number of patients after recurrence. Regression analysis identified patient age, stone size, diabetes, venous thrombosis, liver cirrhosis, malignancy, coronary heart disease, and the number of microbial species as important predictors of recurrence. A random forest model constructed using these variables demonstrated good performance and high predictive ability (ROC-AUC = 0.862).DiscussionThese findings highlight the significant role of microbial communities in gallstone formation and recurrence. Furthermore, the identified predictors of recurrence, including clinical factors and microbial diversity, may help develop personalized prevention and recurrence strategies for gallstone patients.
How does young adults’ dietary and health-related quality of life vary by food security and household income?
Authors: Kim Eun-kyung , Kwon Yong-Seok , Kim Sena , Lee Jin-Young , Park Young Hee 
Published: December 2024

ObjectivesThe objective of this study was to compare the dietary and health-related quality of life of young adults according to their household income and food security status.MethodsTo conduct this study, 10,224 young adults aged 19–34 years who participated in the 2008–2018 Korea National Health and Nutrition Examination Survey (KNHANES) were selected. Subjects were categorized into four groups based on household income and food security: ‘food secure and high income,’ ‘food insecure and high income,’ ‘food secure and low income,’ and ‘food insecure and low income’. General characteristics, daily diet, and dietary quality were compared among the four groups.ResultsThe proportion of participants consuming a daily diet below the estimated average requirements for protein, vitamins A, B1, and B2, niacin, vitamin C, calcium, phosphorus, and iron increased in the ‘food insecure and low income’ group. Among the most commonly consumed foods, instant noodles and Sprite ranked relatively high in the ‘food insecure and low income’ group, while apples and beef ranked relatively high in the ‘food secure and high income’ group. The food insecure and low income group exhibited significantly increased rates of mobility problems [OR = 1.55(95% CI = 1.05–2.29)] and anxiety/depression [OR = 1.33(95% CI = 1.07–1.64)] in comparison with the food secure and high income group.ConclusionFood insecurity was positively associated with poor diet quality and was associated with health-related quality of life, mobility, and anxiety/depression, especially among young adults.
Intrathecal methotrexate injection combined treatment of gastric cancer with leptomeningeal metastasis: case report
Authors: Xie Wenting , Kang Xun , Huang Sijie , Li Wenbin 
Published: December 2024

BackgroundLeptomeningeal metastasis of gastric adenocarcinoma (LM-GC) is a rare and severe complication with a poor prognosis, its prognosis is significantly poorer than liver, lung, and peritoneal metastases. Studies on LM-GC have been limited to clinical case reports. Despite advances in systemic therapies, there is a lack of standardized treatment protocols for LM-GC due to its rarity and the challenges it presents.MethodsThis case series reports on six patients diagnosed with LM-GC who received intrathecal methotrexate (MTX) injection from June 2018 to November 2023. Treatment efficacy, safety, and prognostic factors were analyzed by comparing symptoms and laboratory test results before and after treatment.ResultsThe average OS for the cohort was 7.5 months, exceeding previous reports for LM-GC patients, which has a median survival time of 4-6 weeks. No significant changes were observed in cerebrospinal fluid glucose and chloride levels post-MTX treatment. However, a statistically significant decrease in cerebrospinal fluid protein levels was noted after treatment (P &lt; 0.05). Adverse reactions were mild, with the most common being bone marrow suppression and oral mucosal ulcers.ConclusionIntrathecal MTX injection combined treatment offers a potential therapeutic strategy for LM-GC, improving clinical symptoms and extending survival. Further research is warranted to validate these findings and explore the molecular mechanisms of LM-GC for targeted therapies.
Spinal accessory nerve transfer for shoulder abduction has no benefit over supraclavicular exploration and nerve grafting in brachial plexus birth injury: a systematic review
Authors: Mendiratta Dhruv , Singh Rohan , Abdelmalek George , Pant Krittika , Chu Alice , McGrath Aleksandra 
Published: December 2024

IntroductionBrachial plexus birth injury (BPBI) has an incidence of 0.9 per 1,000 live births in the population. Techniques for repair classically include supraclavicular exploration and nerve grafting (SENG) and more recently nerve transfer, namely of the spinal accessory nerve (SAN) to the suprascapular nerve (SSN) to improve functional outcomes such as glenohumeral abduction and external rotation. This systematic review was conducted to evaluate whether spinal accessory nerve transfer produced significantly better outcomes for shoulder abduction in BPBI.MethodsA search was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis Individual Patient Data guidelines. Standardized comparisons were made using the Mallet Score for shoulder abduction.Results10 full-text articles with itemized patient outcome measures were selected. 110 patients were identified with 51 patients in the SENG group and 59 patients in the SAN transfer group. The mean shoulder abduction Mallet score in the SENG group was 3.50 ± 0.84, while the mean Mallet score in the SAN transfer group was 3.58 ± 0.77, which displayed no significant differences (p = 0.9012). There was no significant relationship between the age at time of surgery and post-operative Mallet scores for shoulder abduction after SENG (p = 0.3720).DiscussionOur systematic review found that there was no difference observed in post-operative outcomes of shoulder abduction when comparing SAN transfer and nerve grafting. Continued support for nerve grafting lies in the argument that it incorporates the patient's native neuroanatomy and allows for sensory reinnervation.