bluuebunny/crossref_metadata_2025_split huggingface dataset:
The consequences of COVID-19 lockdown for formal and informal resource utilization among home-dwelling people with dementia: results from the prospective PAN.DEM study
Authors: Vislapuu Maarja , Angeles Renira C. , Berge Line I. , Kjerstad Egil , Gedde Marie H. , Husebo Bettina S. 
Published: September 2021

Abstract
Background
COVID-19 isolated home-dwelling people with dementia (PwD) from home care services, respite care, and daytime activities. We aimed to investigate the consequences of these restrictions on informal (family, friends) and formal (homecare staff) resource utilization among co-residing (e.g., spouses) and visiting caregivers (e.g., children).

Methods
105 PwD (≥65 years old) and their caregivers were included in the prospective PANdemic in DEMentia (PAN.DEM) study, which was initiated when the ongoing stepped-wedge, cluster randomized LIVE@Home.Path trial (N = 438) was temporarily halted due to the pandemic. Primary outcome was change in resource utilization assessed by the Resource Utilization in Dementia Care (RUD) instrument in pre- (12 Dec. 2019 to 11 Mar. 2020) and during the lockdown periods (20 April 2020 to 15 May 2020). Degree of cognitive impairment was assessed by Mini-Mental Status Examination (MMSE), and physical functioning and independent living skills by Physical Self-Maintenance Scale and Lawton Instrumental Activities of Daily Living Scale. Associations between informal and formal care utilization, socio-demographics, and clinical variables were assessed by descriptive statistics and Ordinary Least Squares models (OLS).

Results
Mean age for PwD was 81.8 years; 61% were female; 45.6% lived alone, and the mean MMSE score was 20.8 (SD ± 3.7). PwD with co-residents (44%) were younger (78.4 years) than those who were living alone (84.5 years; P < 0.001). During the first 2 months of lockdown, PwD missed on average 20.5 h of formal care in a month (P < 0.001) leading to an approximately 100% increase in informal care, which was particularly pronounced in personal hygiene (6.9 vs. 11.4 days in a month, P < 0.001) and supervision (9.2 vs. 17.6 days in a month; P < 0.001). Visiting caregivers increased by 1.9 days (SD ± 11.5), but co-residing caregivers increased their number of days providing ADL by approximately 7 days per month (β = 6.9; CI, 0.39–13.1, P < 0.05) after adjusting for PwD and caregiver demographics and clinical variables. Decrease in home nursing care was particularly visible for PwD living alone (− 6.1 vs. -1.3 h per month, P = 0.005). Higher cognitive function (β = − 0.64, CI, − 1.26 – 0.02, P = 0.044) was associated with reduction in home nursing service during the lockdown.

Conclusion
The care situation for PwD changed dramatically in the early phase of the COVID-19 pandemic, especially for those living alone who received less support from homecare services and visiting caregivers. For future crises and the forthcoming post-pandemic period, health authorities must plan better and identify and prioritize those in greatest need.

Trial registration
ClinicalTrials.gov; NCT04043364.
Time series decomposition into dyslipidemia prevalence among urban Chinese population: secular and seasonal trends
Authors: Lao Jiahui , Liu Yafei , Yang Yang , Peng Peng , Ma Feifei , Ji Shuang , Chen Yujiao , Tang Fang 
Published: September 2021

Abstract
Background
Previous epidemiological studies have indicated the seasonal variability of serum lipid levels. However, little research has explicitly examined the separate secular and seasonal trends of dyslipidemia. The present study aimed to identify secular and seasonal trends for the prevalence of dyslipidemia and the 4 clinical classifications among the urban Chinese population by time series decomposition.

Methods
A total of 306,335 participants with metabolic-related indicators from January 2011 to December 2017 were recruited based on routine health check-up systems. Multivariate direct standardization was used to eliminate uneven distributions of the age, sex, and BMI of participants over time. Seasonal and trend decomposition using LOESS (STL decomposition) was performed to break dyslipidemia prevalence down into trend component, seasonal component and remainder component.

Results
A total of 21.52 % of participants were diagnosed with dyslipidemia, and significant differences in dyslipidemia and the 4 clinical classifications were observed by sex (P <0.001). The secular trends of dyslipidemia prevalence fluctuated in 2011–2017 with the lowest point in September 2016. The dyslipidemia prevalence from January to March and May to July was higher than the annual average (λ = 1.00, 1.16, 1.06, 1.01, 1.02, 1.03), with the highest point in February. Different seasonal trends were observed among the 4 clinical classifications. Compared to females, a higher point was observed among males in February, which was similar to participants aged < 55 years (vs. ≥ 55 years) and participants with a BMI ≤ 23.9 (vs. BMI > 23.9).

Conclusions
There were significant secular and seasonal features for dyslipidemia prevalence among the urban Chinese population. Different seasonal trends were found in the 4 clinical classifications of dyslipidemia. Precautionary measures should be implemented to control elevated dyslipidemia prevalence in specific seasons, especially in the winter and during traditional holidays.
Image-guided selection of Gd@C-dots as sensitizers to improve radiotherapy of non-small cell lung cancer
Authors: Ma Xiaofen , Lee Chaebin , Zhang Tao , Cai Jinghua , Wang Hui , Jiang Fangchao , Wu Zhanhong , Xie Jin , Jiang Guihua , Li Zibo 
Published: September 2021

Abstract
Background
Recently, gadolinium-intercalated carbon dots (Gd@C-dots) have demonstrated potential advantages over traditional high-Z nanoparticles (HZNPs) as radiosensitizers due to their high stability, minimal metal leakage, and remarkable efficacy.

Results
In this work, two Gd@C-dots formulations were fabricated which bore carboxylic acid (CA-Gd@C-dots) or amino group (pPD-Gd@C-dots), respectively, on the carbon shell. While it is critical to develop innovative nanomateirals for cancer therapy, determining their tumor accumulation and retention is equally important. Therefore, in vivo positron emission tomography (PET) was performed, which found that 64Cu-labeled pPD-Gd@C-dots demonstrated significantly improved tumor retention (up to 48 h post injection) compared with CA-Gd@C-dots. Indeed, cell uptake of 64Cu-pPD-Gd@C-dots reached close to 60% of total dose compared with ~ 5% of 64Cu-CA-Gd@C-dots. pPD-Gd@C-dots was therefore further evaluated as a new radiosensitizer for non-small cell lung cancer treatment. While single dose radiation plus intratumorally injected pPD-Gd@C-dots did lead to improved tumor suppression, the inhibition effect was further improved with two doses of radiation. The persistent retention of pPD-Gd@C-dots in tumor region eliminates the need of reinjecting radiosensitizer for the second radiation.

Conclusions
PET offers a simple and straightforward way to study nanoparticle retention in vivo, and the selected pPD-Gd@C-dots hold great potential as an effective radiosensitizer.

Graphic abstract
Long non-coding RNA NORAD promotes pancreatic cancer stem cell proliferation and self-renewal by blocking microRNA-202-5p-mediated ANP32E inhibition
Authors: Ma Yu-Shui , Yang Xiao-Li , Liu Yu-Shan , Ding Hua , Wu Jian-Jun , Shi Yi , Jia Cheng-You , Lu Gai-Xia , Zhang Dan-Dan , Wang Hui-Min , Wang Pei-Yao , Yu Fei , Lv Zhong-Wei , Wang Gao-Ren , Liu Ji-Bin , Fu Da 
Published: September 2021

Abstract
Background
Cancer stem cells (CSCs) are key regulators in the processes of tumor initiation, progression, and recurrence. The mechanism that maintains their stemness remains enigmatic, although the role of several long noncoding RNAs (lncRNAs) has been highlighted in the pancreatic cancer stem cells (PCSCs). In this study, we first established that PCSCs overexpressing lncRNA NORAD, and then investigated the effects of NORAD on the maintenance of PCSC stemness.

Methods
Expression of lncRNA NORAD, miR-202-5p and ANP32E in PC tissues and cell lines was quantified after RNA isolation. Dual-luciferase reporter assay, RNA pull-down and RIP assays were performed to verify the interactions among NORAD, miR-202-5p and ANP32E. We then carried out gain- and loss-of function of miR-202-5p, ANP32E and NORAD in PANC-1 cell line, followed by measurement of the aldehyde dehydrogenase activity, cell viability, apoptosis, cell cycle distribution, colony formation, self-renewal ability and tumorigenicity of PC cells.

Results
LncRNA NORAD and ANP32E were upregulated in PC tissues and cells, whereas the miR-202-5p level was down-regulated. LncRNA NORAD competitively bound to miR-202-5p, and promoted the expression of the miR-202-5p target gene ANP32E thereby promoting PC cell viability, proliferation, and self-renewal ability in vitro, as well as facilitating tumorigenesis of PCSCs in vivo.

Conclusion
Overall, lncRNA NORAD upregulates ANP32E expression by competitively binding to miR-202-5, which accelerates the proliferation and self-renewal of PCSCs.
Digitally connected work and its consequences for strain – a systematic review
Authors: Zolg Sabrina , Heiden Barbara , Herbig Britta 
Published: September 2021

AbstractBackgroundEvolving digitization has an impact not only on the organization of work, but also on the health of employees. Dealing with new technologies, integrating new processes and requirements into work, and restructuring tasks among others are demands that can be stressful and impair health.ObjectivesOur aim was to identify (clusters of) working conditions associated with digitally connected work and to analyze their relations with strain, that is, health and well-being outcomes.MethodsBetween May and October 2019, a search string was used to systematically search six databases (EMBASE, Medline, PSYNDEX, PsycInfo, SocIndex, WISO) for German and English texts according to the PEO scheme. The methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Design.Results14 studies were identified. Despite the search string containing latest technologies, we identified mostly studies from the 1980s/90s. To aggregate findings, a categorization of work factors (cognitive demands, social factors, organizational factors, environmental factors) and health factors (motivation/satisfaction, reduced well-being/affective symptoms, physiological parameters/somatic complaints) is introduced. The most frequently identified work factors belong to the category of cognitive demands. For health factors, motivation/satisfaction was identified most often. 475 associations were found in total.ConclusionsThis systematic review provides an overview of work and health factors that have been studied between 1981 and 2019. Recent texts frequently study individualized health factors (e.g., life satisfaction) whereas objective physiological measurement data and objective survey methods such as workplace analysis are not used. This latter approach was predominantly found in the older studies. In order to obtain a comprehensive picture, however, it is worthwhile to use a combination of these subjective and objective approaches for future studies in this field.
Effectiveness of diluted povidone-iodine lavage for preventing periprosthetic joint infection: an updated systematic review and meta-analysis
Authors: Kobayashi Naomi , Kamono Emi , Maeda Kento , Misumi Toshihiro , Yukizawa Yohei , Inaba Yutaka 
Published: September 2021

Abstract
Background
Of the several methods used to prevent surgical site infection (SSI), diluted povidone-iodine (PI) lavage is used widely. However, the clinical utility of PI for preventing periprosthetic joint infection (PJI) remains controversial. The aim of this study was to perform a systematic review and meta-analysis of the utility of dilute PI lavage for preventing PJI in primary and revision surgery.

Methods
This study was conducted in accordance with the PRISMA checklist for systematic reviews and meta-analyses. A comprehensive literature search of PubMed, CINAHL, ClinicalTrials.gov, and Cochrane Library databases was performed. The results are summarized qualitatively and as a meta-analysis of pooled odds ratios with 95% confidence intervals (95% CIs). Heterogeneity of treatment effects among studies was classified as low, moderate, or high, corresponding to I2 values of < 25%, 25–50%, and > 50%. A random effects model was applied in cases of high heterogeneity; otherwise, the fixed effects model was applied. Subgroup analyses were conducted to identify potential sources of heterogeneity.

Results
After the screening and eligibility assessment process, eight studies were finally extracted for analysis. Overall, the results showed that PI had no significant effect on PJI with ununified control group. However, subgroup analysis of studies with a saline control group revealed an odds ratio of 0.33 (95% CI, 0.16–0.71) for the PI group, suggesting a significant effect for preventing PJI.

Conclusion
The systematic review and meta-analysis of the current literature demonstrates that diluted PI lavage is significantly better than saline solution lavage for preventing PJI.

Level of evidence
Level I, Systematic review and meta-analysis.
Modified Nuss operation using introducer-bar complex for pectus excavatum in adults: a retrospective study
Authors: Wang Lei , Liu Juan , Li Yao , Feng Tienan , Cao Beibei , Xiao Haibo , Hu Fengqing , Li Guoqing 
Published: September 2021

Abstract
Background
Shortcoming of traditional Nuss operation on adults is gradually found in the clinical practice. A new kind of introducer-bar complex was introduced. However, there is limited evidence regarding its safety and efficacy. Therefore, a single center, retrospective study was conducted to address this issue.

Methods
Patients with pectus excavatum who underwent surgery between January 2015 and June 2017 were consecutively enrolled in this study. In all, 52 patients underwent the modified procedure using the introducer-bar complex (new procedure group), whereas 48 underwent the traditional anti-Nuss procedure (traditional procedure group). Outcomes analysis of balanced baseline was performed to compare the intraoperative and postoperative short-term outcomes.

Results
All patients in the new procedure group had shorter operation duration (51.54 ± 20.32 vs. 79.45 ± 13.88 min, p = 0.017), postoperative hospitalizations (4.77 ± 1.62 vs. 6.86 ± 2.18 days, p = 0.028), plate removal surgery durations (39.30 ± 8.97 vs. 60.30 ± 10.49 min, p < 0.001), and less blood loss during operation (6.25 ± 4.88 vs. 10.90 ± 5.75 ml, p = 0.003) than patients in the traditional procedure group. There was no significant difference in the length of incision, postoperative Haller index, cost, number of steel bars, postoperative surgical outcome and incidence of complications between the two groups.

Conclusion
Through the main clinical outcome were similar, our results shown that modified procedure may have the shorter operation time, postoperative hospital stay, and operation time for plate removal and less blood loss, which may bring potential clinical benefits to patients.
Comparative evaluation of BMI-1 proto-oncogene expression in normal tissue, adenoma and papillary carcinoma of human thyroid in pathology samples
Authors: Hajian Mohadeseh , Esmaeili Abolghasem , Talebi Ardeshir 
Published: September 2021

AbstractObjectivePapillary Thyroid carcinoma accounts for more than 60% of adult thyroid carcinomas. Finding a helpful marker is vital to determine the correct treatment approach. The present study was aimed to evaluate the expression of the B cell-specific Moloney murine leukemia virus integration site 1 (BMI-1) gene in papillary carcinoma, adenoma, and adjacent healthy thyroid tissues. Pathology blocks of thyroid tissues at the pathology department of patients who have undergone thyroid surgery between 2015 and 2019 were examined; papillary carcinoma, adenoma, and healthy tissues were selected and sectioned. Total RNA was extracted, and the relative expression level of theBMI-1gene was examined using the Real-Time qPCR method.ResultsIn the papillary and adenoma tissues,BMI-1was overexpressed (1.047-fold and 1.042-fold) in comparison to healthy tissues (p < 0.05 for both comparisons). However, no statistically significant differences were observed between adenoma and papillary carcinoma tissues regardingBMI-1gene expression. This study demonstrated a new biomarker for thyroid malignancies and found that the mRNA levels of the BMI-1 gene were higher in tumor tissues compared with healthy tissues. Further studies are needed to evaluate theBMI1gene expression in other thyroid cancers.
Cardiovascular comorbidities of atopic dermatitis: using National Health Insurance data in Korea
Authors: Jung Hye Jung , Lee Dong Heon , Park Mi Youn , Ahn Jiyoung 
Published: September 2021

AbstractBackgroundIt is well known that atopic dermatitis (AD) is associated with other allergic diseases. Recentely, links to diseases other than allergic disease have also been actively studied. Among them, the results of studies regarding AD comorbidities, especially cardiovascular disease (CVD), have varied from country to country.ObjectiveTo analyze whether the risk of CVD is different between AD patients and healthy controls using Korean National Health Insurance Data.MethodsWe obtained data from 2005 to 2016 from the Korean National Health Insurance Research Database. Patients with one AD code and two AD-related tests codes were selected as AD patients, and age-and sex-matched controls to the AD patients were selected from among those without AD (1:5). Each group was investigated for accompanying metabolic syndrome (which contains hypertension, type 2 diabetes, and hyperlipidemia) and CVD (angina, myocardial infarction, peripheral vascular disease, and stroke) using ICD 10 codes.ResultsThe incidence of metabolic diseases and CVD were significantly different between the AD and control groups. Using multivariable Cox regression, differences were adjusted for sex, age, and other CVD and metabolic diseases. As a result, not only metabolic disease, but also the CVD risk of AD patients was significantly higher than that of the control group. Patients with AD had as significantly higher risk of hyperlipidemia (hazard ratio [HR] = 33.02, p < 0.001), hypertension (HR = 4.86, p < 0.001), and type 2 diabetes (HR = 2.96, p < 0.001). AD patients also had a higher risk of stroke (HR = 10.61, p < 0.001), myocardial infarction (HR = 9.43, p < 0.001), angina (HR = 5.99, p < 0.001), and peripheral vascular disease (HR = 2.46, p < 0.001). Besides hyperlipidemia, there was no difference in risk according to AD severity.ConclusionPatients with AD have a greater risk of CVD than those without AD.
Vulvar cancer staging: guidelines of the European Society of Urogenital Radiology (ESUR)
Authors: Nikolić Olivera , Sousa Filipa Alves e , Cunha Teresa Margarida , Nikolić Marijana Basta , Otero-García M. Milagros , Gui Benedetta , Nougaret Stephanie , Leonhardt Henrik ,   On behalf of the ESUR Female Pelvic Imaging Working Group, Nougaret Stephanie , Fournier Laure , Bourgioti Charis , Tsili Athina C. , Otero-Garcia Milagros , Manganaro Lucia , Cunha Teresa Margarida , Kido Aki , Alt Celine , Lucas Rita , Leonhardt Henrik , Gui Benedetta , Forstner Rosemarie , Maciel Cristina , Sala Evis , Bharwani Nishat , Buñesch Laura , Lakhman Yulia , Lopez Carolina , Nikolic Olivera , Nikolić Marijana Basta 
Published: September 2021

Abstract
Objective
The aim of the Female Pelvic Imaging Working Group of the European Society of Urogenital Radiology (ESUR) was to develop imaging staging guidelines for vulvar cancer and to propose standardised MRI protocols and reporting.

Methods
The guidelines recommended from the ESUR in this article resulted from a questionnaire analysis regarding imaging staging of vulvar cancer that was answered by all members of the Female Pelvic Imaging Working Group. Only the answers with an agreement equal to or more than 80% were considered. Additionally, the literature was reviewed to complement and further support our conclusions.

Results
The critical review of the literature and consensus obtained among experts allows for recommendations regarding imaging staging guidelines, patient preparation, MRI protocol, and a structured MRI report.

Conclusions
Standardising image acquisition techniques and MRI interpretation reduces ambiguity and ultimately improves the contribution of radiology to the staging and management of patients with vulvar cancer. Moreover, structured reporting assists with the communication of clinically relevant information to the referring physician.
First case of childhood Takayasu arteritis from Syria: a case report
Authors: Alwattar Wafa , Al khudari Rawan , Naameh Judy , Batha Jia , Almajzoub Raghad , Khalil Basheer 
Published: September 2021

Abstract
Background
Takayasu arteritis is a systemic granulomatous inflammation affecting the large- and medium-sized vessels such as aorta, its main branches, and pulmonary and renal arteries. Childhood Takayasu arteritis is a subtype of Takayasu arteritis that affects the age group ranging from young infants to late adolescents.

Case presentation
We report the first childhood Takayasu arteritis case from Syria, a 12-year-old Syrian girl presenting with nonspecific symptoms and signs plus ischemic clinical features in her left arm. She relapsed twice with different additional symptoms each time.

Conclusions
There is scarcity of reviews and studies on childhood Takayasu arteritis in Arabs. We aim to share our experience to keep childhood Takayasu arteritis in mind as a differential diagnosis in any child presenting with hypertension, absent or reduced peripheral arterial pulse, or blood pressure differences between extremities.
The key role of conjugate fault system in importing earthquakes into the eastern flank of the Red Sea
Authors: Abdelfattah Ali K. , Jallouli Chokri , Fnais Mohamed , Qaysi Saleh , Alzahrani Hassan , Mogren Saad 
Published: September 2021

AbstractThis study aims to synthesize seismic observations with gravity and magnetic data and to suggest a new scenario on the development of the Harrat Lunayyir (HL) tectonic system on the eastern Red Sea coastline, Saudi Arabia. Gravity and aeromagnetic anomalies distinctly mapped the NE and NW trends, while the InSAR data depict a small NW–SE graben and an NW–SE dyke. High-resolution relocations, which are well-consistent with the focal mechanism solutions for events with magnitudes greater than 3.0, admit two distinctly fault styles of different orientations. Thus, leading to the NE and NW fault planes’ reactivation related to the Precambrian basement faults and the Red Sea rift system, respectively. The spatiotemporal distributions of epicenters and focal mechanism solutions suggest a new seismic deformation scenario of the 2009 earthquake seismic activity. The low static frictions of 0.2–0.35 obtained from the stress inversion indicates reactivation of preexisting faults in the respective seismogenic zones. The obtained results give rise to a swarm-like sequence of tectonic implications, two activated fault styles differently oriented, and an NE conjugate fault system inherited in the region, which plays a vital role in transferring the ambient stress regime into the Red Sea’s eastern flank.