bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of RICAS (Remote Ischemic Preconditioning on Collaterals of Atherosclerosis Stroke): Rationale and Design
Authors: Zhao Zi‐Ai , Lv Yan , Chen Hui‐Sheng 
Published: February 2025

Background
As a noninvasive, low‐cost, nonpharmacological procedure with excellent properties of safety, remote ischemic conditioning (RIC) has been demonstrated to prevent recurrence of stroke among patients with ischemic stroke of large artery atherosclerosis origin. We hypothesized that the benefit is attributed to the improvement of collaterals by chronic RIC in this population, and we aimed to explore the influence of chronic RIC on collateral status evaluated by digital subtraction angiography in this population.

Methods

The RICAS (Remote Ischemic Preconditioning on Collaterals of Atherosclerosis Stroke) study is a prospective, randomized, blind end point, multicenter study. Eligible patients with ischemic stroke of anterior circulation caused by large artery atherosclerosis, poor collateral compensation, and more than 1 month of symptom onset, are randomly assigned into experimental and control groups with a ratio of 1:1. The patients in the experiment group will receive treatment with RIC (bilateral upper limbs, for a total procedure time of 50 minutes, twice daily) for 1 year as an adjunct to guideline‐based treatment, while patients in the control group only receive guideline‐based treatment. A maximum of 300 patients (150 participants per group) are required to test the superiority hypothesis with 80% power (using a 2‐sided
α
=0.05) to detect a 15% difference. Subgroup analyses for the primary end point will be performed on 8 prespecified subgroups by age, sex, ischemic event (acute ischemic stroke ore transient ischemic stroke), tandem lesion, history of hypertension, hypercholesterolemia, diabetes, and myocardial infarction. The primary outcome is the proportion of collateral status improvement, which is defined as an increase of ≥1 point on the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology score, as assessed by digital subtraction angiography at 12 months after randomization. The safety outcomes include RIC‐related adverse events.

Conclusions
This study may provide the direct evidence for the potential effect of chronic RIC treatment on the improvement of collateral status.

Registration

URL:
https://clinicaltrials.gov
. Unique identifier: NCT06170944.
Investigating Multiple Mediators to Mitigate Socioeconomic Differences in Patient‐Reported Outcomes After Stroke: A Nationwide Register‐Based Study
Authors: Lindmark Anita , Darehed David 
Published: February 2025

Background
Substantial socioeconomic differences in patient‐reported outcome measures (PROMs) 3 months after stroke have recently been shown. We aimed to understand the underlying mechanisms and investigate potential interventional targets to equalize differences.

Methods
All patients aged 18 to 64 years, independent in activities of daily living, registered with a first‐time stroke in Riksstroke (the Swedish Stroke Register) from 2015 to 2017 were included. PROMs 3 months after stroke included activities of daily living status, mood, fatigue, pain, and general health. Socioeconomic status (SES) was measured on the basis of income and education. Using causal mediation analysis, we simulated the effect of interventions on the distributions of smoking, metabolic health (diabetes, antihypertensive treatment, statin treatment), atrial fibrillation, and stroke characteristics (stroke type, severity) on the absolute SES‐related risk difference in PROMs.

Results
Of 6910 patients, 8% had become dependent in activities of daily living, 13% reported low mood, 42% fatigue, 23% pain, and 17% poor general health 3 months after stroke. Adjusted for sex and age, low SES was associated with increased absolute risks of poor PROMs with between 6% and 18% compared with higher SES with the largest increase for general health (18.2% [95% CI, 13.5%–22.9%]). Intervening to shift the distribution of all mediators among patients with low SES to those of patients with higher SES potentially reduces SES disparities by a proportion of 14% to 45%. For most PROMs the most important intervention was reducing smoking and improving metabolic health.

Conclusions
Working‐age patients with low SES report more severe outcomes 3 months after stroke than patients with higher SES. Targeted interventions reducing the prevalence of smoking, diabetes, hypertension, and high cholesterol in patients with low SES could mitigate these disparities.
Effects of tropical cyclone size on its energy cycle and steady-state intensity in idealized numerical simulations
Authors: Li Yuanlong , Tan Zhe-Min , Wang Yuqing 
Published: February 2025

Abstract
Previous modeling studies have found that tropical cyclones (TCs) with a larger initial overall (both inner-core and outer-core) size tend to have a higher steady-state intensity. Since TC size before and in steady state keeps a strong memory of its initial size, the dependence of steady-state intensity on initial size is often studied by examining the effect of steady-state size on steady-state intensity. Recent studies have ascribed the effect to an increasing contribution from the supergradient wind to intensity as size increases from the boundary layer dynamics perspective. In the present study, the effect has been revisited from the energetic perspective based on the isentropic energy diagnostic analysis using axisymmetric numerical simulations. Results show that as the overall TC size increases, the overall surface enthalpy fluxes increase and thus the inflow leg in the energy cycle absorbs more entropy in larger TCs, resulting in higher generations of kinetic energy and thus higher intensities. It is also found that a higher sea surface temperature tends to reduce the effect of TC size on the entropy absorption in the TC energy cycle, but results in a higher Carnot efficiency. As a result, the increasing tendency of generation of kinetic energy or TC intensity with size is similar under different sea surface temperatures.
Documented Cannabis Use Is a Risk Factor for Nonunion After Nonoperative Management of Scaphoid Fractures: A Retrospective Review of 159 998 Patients
Authors: Pathak Neil , Ratnasamy Phillip P. , Oghenesume Oghenewoma P. , Luo Xuan , Grauer Jonathan N. , Halim Andrea 
Published: February 2025

Background: The purpose of the present study was to assess whether an association exists between cannabis use and nonunion among patients with acute scaphoid fractures initially treated nonoperatively. Methods: Using the PearlDiver national data set (2010-2020), adult patients with a scaphoid fracture were identified. Patients initially treated with nonoperative management were selected, and 3 subgroups were defined: non-cannabis/non-tobacco (non-users), tobacco-only, cannabis-only. Matched cohorts for each subgroup controlled for age, sex, and comorbidities. Nonunion rates at 6 months, 12 months, and 2 years after fracture diagnosis were determined for each subgroup’s matched cohort. Rates of subsequent nonunion surgery were also determined. Multivariable analysis was then done to determine potential associations. Results: A total of 159 998 scaphoid fracture patients were identified. The non-users’ group exhibited a nonunion rate of 7.7%. The nonunion rates for the tobacco-only and cannabis-only groups (11.8% and 10.1% respectively) were significantly greater than that of the non-users group. Based on multivariable analysis, cannabis use and tobacco use were individually associated with a greater risk of scaphoid nonunion as well as subsequent nonunion surgery at 6 months, 12 months, and 2 years after index fracture. Conclusion: Documented cannabis use in the electronic medical record is associated with an increased risk of scaphoid nonunion and subsequent nonunion surgery. Further studies are necessary to clarify if this association can be contributed solely to cannabis use, to mixing cannabis or tobacco, or to other variables. In the meantime, physicians can counsel their patients on this potential association and increased risk.
RTN3 regulates collagen biosynthesis and profibrotic macrophage differentiation to promote pulmonary fibrosis via interacting with CRTH2
Authors: Wang Chen-Yu , Chen Ya-Qin , Huang Hao , Yuan Zhuang-Zhuang , Dong Yi , Jin Jie-Yuan , Long Jie-Yi , Liu Lv , Fan Liang-Liang , Xiang Rong 
Published: February 2025

Abstract

Background
As an endoplasmic reticulum (ER) protein, Reticulum 3 (RTN3) has been reported to play a crucial role in neurodegenerative diseases, lipid metabolism, and chronic kidney disease. The involvement of RTN3 in idiopathic pulmonary fibrosis (IPF), a progressive and fatal interstitial lung disease, remains unexplored.

Methods
In this study, we explored the role of RTN3 in pulmonary fibrosis using public datasets, IPF patient samples, and animal models. We investigated its pathogenic mechanisms in lung fibroblasts and alveolar macrophages.

Results
We found decreased levels of RTN3 in IPF patients, bleomycin-induced mice, and TGFβ-treated cell lines. RTN3-null mice exhibited more severe pulmonary fibrosis phenotypes in old age or after bleomycin treatment. Collagen synthesis was significantly increased in RTN3-null mice lung tissues and lung fibroblasts. Mechanistic studies revealed that RTN3 deficiency reduced the ER-anchored CRTH2 in lung fibroblasts, which serves as an antifibrotic molecule via antagonizing collagen biosynthesis. Simultaneously, RTN3 deficiency reduced the autophagy degradation of CRTH2 which acts as an activator of profibrotic macrophage differentiation. Both effects of RTN3 and CRTH2 in lung fibroblasts and alveolar macrophages aggravated age-or bleomycin-induced pulmonary fibrosis. Additionally, we also identified a mutation of RTN3 in patients with ILD.

Conclusions
Our research demonstrated that RTN3 plays a significant role in the lung, and reduction of RTN3 levels may be a risk factor for IPF and related diseases.
DNA methylation biomarkers of intellectual/developmental disability across the lifespan
Authors: LaSalle Janine M. 
Published: February 2025

Abstract
Epigenetic mechanisms, including DNA methylation, act at the interface of genes and environment by allowing a static genome to respond and adapt to a dynamic environment during the lifespan of an individual. Genome-wide DNA methylation analyses on a wide range of human biospecimens are beginning to identify epigenetic biomarkers that can predict risk of intellectual/developmental disabilities (IDD). DNA methylation-based epigenetic signatures are becoming clinically useful in categorizing benign from pathogenic genetic variants following exome sequencing. While DNA methylation marks differ by tissue source, recent studies have shown that accessible perinatal tissues, such as placenta, cord blood, newborn blood spots, and cell free DNA may serve as accessible surrogate tissues for testing epigenetic biomarkers relevant to understanding genetic, environmental, and gene by environment interactions on the developing brain. These DNA methylation signatures may also provide important information about the biological pathways that become dysregulated prior to disease progression that could be used to develop early pharmacological interventions. Future applications could involve preventative screenings using DNA methylation biomarkers during pregnancy or the newborn period for IDDs and other neurodevelopmental disorders. DNA methylation biomarkers in adolescence and adulthood are also likely to be clinically useful for tracking biological aging or co-occurring health conditions that develop across the lifespan. In conclusion, DNA methylation biomarkers are expected to become more common in clinical diagnoses of IDD, to improve understanding of complex IDD etiologies, to improve endpoints for clinical trials, and to monitor potential health concerns for individuals with IDD as they age.
Harmonising artistic designs with private and collective notions of home: a focus group study of older persons’ experiences of art in residential care specialised in dementia care
Authors: Dahlin-Ivanoff Synneve , Wikström Ewa , Gunn Maja , Lood Qarin 
Published: February 2025

Abstract

Background
Integrating art in residential care settings aims to create meaningful experiences and enhance the facility’s aesthetic as a home. However, the literature shows a gap, as the voices of older persons are largely absent. This study aimed to explore the views of older persons in residential care facilities specialised in dementia care regarding art and expressions of home. Older persons with cognitive impairments are frequently depicted as lacking meaningful contributions, limiting their opportunities to voice their opinions and influence their environment.

Methods
This study used a qualitative explorative design with focus group method, allowing older persons with dementia to discuss their views of art in relation to expressions of home. Eleven older persons participated in four focus groups. This method encourages interaction between participants, shedding light on a collective understanding.

Results
The study found that the residential care facility was perceived as a home by the participants, based on their descriptions of how both private and shared collective spaces in the facility fostered a dynamic sense of belonging. Art owned by the older persons often held personal value and they valued art for its intrinsic qualities, such as beauty, meaning, and expression. The perception of art differed between the private and collective spaces, and the discussions centered on aligning the artistic design with the participants’ notions of home to foster a socially engaging environment.

Conclusion
Clearly defined private and collective spaces seem to be crucial for fostering self-determination and a sense of belonging for older persons living in residential care facilities specialised in dementia care. A balance between private and collective spaces boosted social engagement, with art playing a key role in reflecting older persons’ previous lives, shared interests and experiences, with co-creation of artistic design ensuring a dynamic environment.
Students’ descriptions about experiences beneficial to mental health - a thematic analysis
Authors: Skoglund Anne , Hotham Sarah , Schröder Agneta , Moen Øyfrid Larsen 
Published: February 2025

Abstract
University years are an important transitional time for young adults. Recently, an increasing number of students have reported mental health problems. The increasing numbers are an international phenomenon. Qualitative research on mental health promotion for students is, however, scarce. The aim of this study is to explore students’ descriptions of experiences in their student life that are beneficial to mental health. A Norwegian project named “In my experience” collected descriptions, through the web-based tool Sensemaker, from students about experiences that have had an impact on their student life. This study explores the descriptions of experiences beneficial to students’ mental health that the students categorized as having had a positive or very positive impact on their student life. A total of 171 descriptions from students aged 18–29 were analyzed using thematic analysis. Two main themes were identified: becoming a student, which consisted of descriptions about the feeling of a new life as a student, and being a student, which described experiences with managing student life that were beneficial for mental health. Experiences such as being welcomed, being included, belonging to a social group, finding one’s own identity, maturing, and developing were all highlighted in the descriptions. Student societies and other forms of civic engagement and being accepted and included in an academic community were fundamental. A limitation of the study was the relatively low number of male participants, and further research on male students’ descriptions about beneficial experiences is needed.
Exploring a process-oriented way of working – a case study involving primary and specialised care
Authors: Poulsen Hanna Odén , Ros Axel , Braithwaite Jeffrey , Elg Mattias , Kilander Helena 
Published: February 2025

Abstract

Background
Health care organisations have a long history of dividing work and tasks into decentralised functions and units by forming divisions and departments with delegated power. New ways of working, such as process-oriented approaches, have been called for to address challenges such as staffing shortages and resource constraints. There is limited understanding of the interplays that will occur in health care organisations during a shift from a traditional decentralised structure to a process-oriented approach. This study aims to explore the perceptions of health care staff and leaders when introducing a process-oriented routine.

Method
We conducted interviews and focus groups with 29 participants in specialised and primary care in order to explore their experiences of a newly introduced routine regarding on-demand consultation, aimed at enhancing communication and patient coordination in a Swedish health care region. The participants included operating managers, schedulers and physicians. Data were analysed using reflexive thematic analysis in accordance with Braun & Clark’s guidance.

Results
The findings encompass three main themes when introducing a process-oriented routine: Creates a readiness to act, The critical role of trust for adopting on-demand consultation in everyday practice and Challenges associated with transformation. The results show that health care staff and leaders are positive about the new way of working, but the readiness to act is challenged by issues of trust, as well as cultural components and structural factors such as experienced resource constraints.

Conclusion
Our results underscore the need to consider not only organisational aspects but also social and individual relational factors when introducing a process-oriented way of work into a decentralised and complex health care system.
Exploring the link between parvovirus B19 and encephalitis: a systematic review and comprehensive meta-analysis of molecular and serological evidence
Authors: Sharma Kashmi , Khandia Rekha , Shrivastava Rohan , Nema Ram K. , Mishra Somesh , Kanwar Rupinder K. , Raut Ashwin A. , Agrawal Amit , Gupta Vandana , Pandey Megha K. 
Published: February 2025

Abstract
Encephalitis, a severe brain inflammation, can arise due to various infectious agents, including viruses like Parvovirus B19 (B19V). Previously linked to mild neonatal and young one’s illnesses and some haematological diseases, recent evidence associates B19V with encephalitis, with no clear prevalence and mechanisms in place. This systematic review and meta-analysis aim to determine the prevalence of B19V in cases of encephalitis, exploring variations associated with diagnostic approaches, and identifying gaps in existing research to enhance clinical comprehension and diagnostic methods. An extensive search (1994–2024) was performed through PubMed, Scopus, ScienceDirect, and Cochrane databases for research and epidemiological investigations related to B19V in cases of encephalitis. Inclusion criteria focused on studies that verified B19V using molecular (PCR, NGS) or serological (IgM/IgG) techniques in cerebrospinal fluid or serum. Data analysis was done to pool the prevalence data of included studies using a random-effects model. Heterogeneity was evaluated using I2 statistics. Sensitivity and meta-regression analyses were conducted to evaluate variability and the effects of moderators. A total of fourteen studies involving 3,135 encephalitis patients resulted in a combined prevalence of 3% (95% CI: 2–4%). Studies using PCR indicated a greater prevalence (3%) in comparison to ELISA (1%) and NGS (2%). A moderate level of heterogeneity (I2 = 57.4%) was attributed to the variability in diagnostic methods and geographic distribution. Sensitivity analyses validated strong estimates, while meta-regression revealed country as a key moderator accounting for heterogeneity. Publication bias was modest. The research indicates that B19V may be involved in certain encephalitis instances, with an overall prevalence of 3%. The differences observed in the studies emphasize the need for standardized diagnostic procedures and more extensive multicentric epidemiological research.
Huqi formula suppresses hepatocellular carcinoma growth by modulating the PI3K/AKT/mTOR pathway and promoting T cell infiltration
Authors: Yin Donghao , Li Xiang , Yang Xuemeng , Shang Xiaofei , Li Zhen , Geng Jiahao , Xu Yanyu , Xu Zijing , Wang Zixuan , Shang Zimeng , Yang Zhiyun , Hu Linlan , Li Quanwei , Wang Jiabo , Song Xinhua , Li Xiuhui , Wang Xiaojun 
Published: February 2025

Abstract

Background
Hepatocellular carcinoma (HCC) poses ongoing difficulties for public health systems due to its high incidence and poor prognosis. Huqi formula (HQF), a well-known prescription in traditional Chinese medicine, has demonstrated notable clinical effectiveness in the treatment of HCC. However, the mechanisms underlying its therapeutic effects have yet to be completely elucidated.

Purpose
This study aimed to investigate the anti-HCC effects of HQF and its underlying mechanisms.

Methods
Chemical profiling and quantification of HQF were conducted by LC–MS and HPLC. Orthotopic and subcutaneous tumor models were established through hydrodynamic injection of Akt/Nras plasmids and subcutaneous injection of c-Met/sgPten cells, respectively, to evaluate the therapeutic effects of HQF on HCC. Network pharmacology, RNA-Seq, molecular docking, Western blot, and flow cytometry were employed to assess the anti-HCC mechanisms.

Results
LC–MS analysis identified 41 components, with HPLC quantification showing salvianolic acid B as the most abundant compound (0.303%). In Akt/Nras and c-Met/sgPten-induced HCC models, HQF significantly reduced tissue damage, improved liver function, and inhibited HCC progression. Mechanistic studies revealed that HQF induced apoptosis in HCC cells by downregulating p-PI3K, p-AKT, and p-mTOR expression, with molecular docking indicating the strongest binding affinity between salvianolic acid B and PI3K. HQF further enhanced CD4+ and CD8+ T cell infiltration within the tumor microenvironment. When combined with PD-1 therapy, HQF improved therapeutic efficacy against HCC. Finally, toxicity assays confirmed the safety profile of HQF.

Conclusion
HQF demonstrated significant anti-HCC effects and a synergistic effect with PD-1, could be used as an alternative therapeutic agent for HCC.

Graphical Abstract