bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of artery dissection during systemic exposure to vascular endothelial growth factor pathway inhibitors
Authors: Okui Jun , Waki Takashi , Kajiyama Kazuhiro , Sawada Sono , Watanabe Shinya , Namba Yukari , Kobayashi Ayano , Kawarasaki Shuichi , Amakasu Kohei , Iguchi Toyotaka , Horiuchi Naoya , Uyama Yoshiaki 
Published: December 2024

AbstractWhether or not vascular endothelial growth factor pathway inhibitors (VPIs) increase the risk of artery dissection is still unknown. This study aimed to quantitatively evaluate the possibility of artery dissection as a class effect of VPIs using nationwide real‐world data. This cohort study was conducted based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB), which spans nearly the entire Japanese population of over 100 million individuals. We included the patients prescribed with 12 types of VPIs between 2012 and 2020. The incidence rate (IR) ratio of artery dissection for each VPI were estimated in comparison with bevacizumab, the only VPI in Japan with artery dissection listed in the package insert. Artery dissection as an outcome was targeted for acute artery dissection requiring hospitalization (including dissecting aneurysm). As a reference, a natural IR standardized by sex and age of bevacizumab‐prescribed patients was also estimated using the direct method for the general population of NDB. Of 503,342 patients, the IR of artery dissection for bevacizumab was 44.4 (/100,000 person‐years), and the adjusted IR ratios for each VPI compared with bevacizumab were consistently similar to or >1.0. The IRs for each VPI were also higher than the crude natural IR (1.66/100,000 person‐years; 95% CI: 1.59–1.73) and the standardized natural IR (2.18/100,000 person‐years; 95% CI: 1.86–2.50). Real‐world evidence suggests the risk of artery dissection as a class effect of VPIs. More attention on this risk will be necessary when using VPIs in clinical practice.
Feasibility of implementing the elective oocyte cryopreservation in China: A case study
Authors: Xie Yijing , Zhai Xiaomei 
Published: December 2024

AbstractIn China, a prominent case exists wherein a medically fit woman filed a lawsuit against a hospital for denying her request to undergo oocyte cryopreservation. She contended the hospital had infringed upon her rights. This paper focuses on medicalization and gender equality to discuss whether or not a hospital can infringe upon a woman's rights. We believe elective oocyte cryopreservation is not a medical treatment and it may lead to an overwhelming utilization of extensive medical resources. Reproductive medicine may face the risk of resource commercialization due to the practice of selective egg freezing. There are physiological disparities between males and females. The ability of men to cryopreserve sperm does not necessarily extend to a woman's capacity for oocyte cryopreservation. We contend that the application of this technology should continue to adhere to the principle of prudence.
Safety, pharmacokinetics and pharmacodynamics of multiple‐dose noiiglutide (SHR20004), a novel GLP‐1 receptor agonist, in Chinese obese subjects without diabetes mellitus
Authors: Zou Yang , Jiang Fan , Sun Chan , Zhao Chunyang , Qian Hongjie , Jia Jingying , Yu Chen , Chen Hong , Wang Mingli , Chen Qian 
Published: December 2024

AbstractAimsThis study aimed to assess the safety, pharmacokinetics and pharmacodynamics of noiiglutide (SHR20004), a novel glucagon‐like peptide‐1 receptor agonist, in Chinese obese participants without diabetes mellitus (DM).Materials and MethodsThis phase 1, randomised, double‐blind, placebo‐controlled study enrolled adult participants with body mass index (BMI) ≥28 kg/m2. The study used a titration method, each subject received daily noiiglutide injection for 3–6 weeks, until reaching the final dose of 0.18, 0.24, 0.30 or 0.36 mg per day. Each dose group consisted of 10 participants, with eight receiving noiiglutide and two receiving placebos. Safety assessments were conducted throughout the study, and pharmacokinetics and pharmacodynamics were evaluated.ResultsMost treatment‐emergent adverse events were of mild to moderate in severity, with no serious adverse event or adverse event led to withdraw. Blood concentration of noiiglutide reached a steady state after daily administration for 4 days, with no significant accumulation. Mean elimination half‐life (t1/2) was between 9.90 and 11.8 h at steady state. At the end of treatment, the mean weight loss compared to baseline for the placebo group and each treatment group was −1.89, −3.26, −5.45, −4.35 and −7.46 kg respectively. The weight and BMI reductions observed in each noiiglutide treatment group were greater than those in the placebo group and exhibited an increasing trend with extended administration duration.ConclusionsDaily administration of noiiglutide using a titration method was well tolerated by Chinese obese participants without DM and showed potential therapeutic effect for weight loss.
The role of the glucagon‐FGF21 axis in improving beta cell function during glucose intolerance and SGLT2 inhibition
Authors: Moreno‐Lopez Maria , Louvet Isaline , Delalleau Nathalie , Acosta‐Montalvo Ana , Thevenet Julien , Pasquetti Gianni , Gmyr Valery , Kerr‐Conte Julie , Pattou Francois , Bonner Caroline , Saponaro Chiara 
Published: December 2024

AbstractObjectiveAlthough primarily secreted by the liver, Fibroblast Growth Factor 21 (FGF21) is also expressed in the pancreas, where its function remains unclear. This study aims to elucidate the role of the glucagon‐FGF21 interaction in the metabolic benefits of SGLT2 inhibition (SGLT2i) and hypothesizes it is key to enhancing glucose and lipid metabolism in individuals with glucose intolerance or type 2 diabetes (T2D).MethodsFGF21, FGF1R, and β‐klotho expression in human pancreas was analysed by RNAscope, qPCR and immunofluorescent techniques. Glucose‐stimulated insulin secretion (GSIS) assay was used to investigate the effects of recombinant FGF21 (rFGF21) on islets from donors with glucose intolerance or T2D. To explore the role of the glucagon‐FGF21 axis in the benefits of SGLT2i, we used WT and Sglt2 knockout (KO) mice fed a chow diet (CD) or a high‐fat diet (HFD) and chronically treated with vehicle or dapagliflozin.ResultsChronic rFGF21 treatment enhanced GSIS in islets from donors with glucose intolerance, with increased FGFR1 expression, suggesting FGF21's greater efficacy in the early stages of disease. In diet‐induced insulin‐resistant mice, dapagliflozin reduced postprandial glycaemia and elevated plasma glucagon and FGF21 levels. Sglt2 KO mice on a CD showed increased fasting plasma glucagon without changes in FGF21. In diet‐induced insulin‐resistant Sglt2 KO mice, elevated glucagon and FGF21 levels paralleled chronic dapagliflozin treatment, indicating similar metabolic adaptations in both models.ConclusionOur findings indicate FGF21 as a crucial mediator in liver‐pancreas crosstalk, improving lipid and glucose metabolism, enhancing pancreatic function, and potentiating the therapeutic efficacy of SGLT2i, thereby representing a target for prediabetes treatment.
Intestinal mucosal immunity and type 1 diabetes: Non‐negligible communication between gut and pancreas
Authors: Liu Ruonan , Zhang Jing , Chen Si , Xiao Yang , Hu Jingyi , Zhou Zhiguang , Xie Lingxiang 
Published: December 2024

AbstractType 1 diabetes (T1D) is a chronic autoimmune disease characterized by T cell‐mediated pancreatic β cell loss, resulting in lifelong absolute insulin deficiency and hyperglycaemia. Environmental factors are recognized as a key contributor to the development of T1D, with the gut serving as a primary interface for environmental stimuli. Recent studies have revealed that the alterations in the intestinal microenvironment profoundly affect host immune responses, contributing to the aetiology and pathogenesis of T1D. However, the dominant intestinal immune cells and the underlying mechanisms remain incompletely elucidated. In this review, we provide an overview of the possible mechanisms of the intestinal mucosal system that underpin the pathogenesis of T1D, shedding light on the roles of both non‐classical and classical immune cells in T1D. Our goal is to gain insights into how modulating these immune components may hold potential implications for T1D prevention and provide novel perspectives for immune‐mediated therapy.
Predictors for choosing doravirine‐based versus INSTI‐based regimen in ART‐naïve and ART‐experienced people with HIV in real‐world setting: Data from the Icona cohort
Authors: d'Arminio Monforte Antonella , Tavelli Alessandro , Quiros‐Roldan Eugenia , Fabbiani Massimiliano , Ferrara Micol , Lo Caputo Sergio , Squillace Nicola , Rusconi Stefano , Ponzano Marta , Bovis Francesca , Antinori Andrea , Saracino Annalisa , Cozzi‐Lepri Alessandro 
Published: December 2024

AbstractRationaleDoravirine (DOR) is an attractive new option both for ART‐naïve people with HIV (PWH) and those with suppressed HIV‐RNA who seek treatment simplification. We used real‐world data to examine the pattern of use of DOR‐containing regimens in these settings.MethodsAll PWH enrolled in the Icona cohort after January 2020 who initiated a three‐drug regimen (3‐DR) with DOR or an integrase inhibitor (INSTI)‐based regimen as first antiretroviral therapy (ART) or when switching ART, with HIV‐RNA ≤50 copies/mL, were included. We used univariate and multivariable logistic regression models to identify demographic factors, immuno‐virological and laboratory markers associated with the prescription of 3‐DR DOR instead of INSTI‐based regimens.ResultsA total of 5803 PWH were included; 1958 were in the first regimen (80 DOR, 1,878 INSTI) and 3854 (387 DOR, 3,458 INSTI) were ART‐experienced virologically suppressed. In the first line, 3‐DR DOR was more frequently started in people who inject drugs, and its use was also associated with higher body mass index, higher low‐density lipoprotein levels, and less advanced HIV disease compared with PWH initiating an INSTI‐based regimen. In the switch setting, older age, Italian origin, higher estimated glomerular filtration rate and aspartate aminotransferase levels were all strongly associated with 3‐DR DOR use, as well as higher a CD4/CD8 ratio (only vs. 3‐DR INSTI), while the association with lipid abnormalities was attenuated.ConclusionsOur analysis shows that among PWH in care in Italy, those with less advanced HIV disease but with other fragilities and potential risk factors for comorbidities are more likely to use DOR‐ than INSTI‐based regimens, regardless of prior treatment history.
Antifungal stewardship in Australian hospitals: defining the scope and future targets
Authors: Urbancic Karen F. , Kong David C. M. , Johnson Paul D. R. , Yong Michelle K. , Slavin Monica A. , Thursky Karin 
Published: December 2024

AbstractBackgroundAntimicrobial stewardship (AMS) guidelines now recommend antifungal stewardship (AFS) interventions to improve the management of invasive fungal diseases (IFDs). AFS programmes have not been reported in Australia.AimsTo determine the monitoring of antifungal use, AFS strategies and targets, and barriers to AFS implementation in Australian hospitals.MethodsAn electronic quantitative cross‐sectional survey was developed and distributed to public and private hospitals in Australia in February 2018. Descriptive statistics were used to summarise the findings.ResultsEighty‐three Australian hospitals completed the survey with an overall response rate of 58% (83/143). Most hospitals monitored antifungal use (62/83, 75%). Frequently used AFS metrics included costs (48/60, 80%) and yearly point prevalence surveys (45/60, 75%). Core AFS strategies were commonly in place, including preauthorisation requirements (71/80, 89%) and expert antifungal post‐prescription review and feedback (PPRF) (63/80, 79%). Both these strategies were more strictly applied to high‐cost, intravenous agents. Formal education (44/79, 56%) and hospital‐endorsed guidelines (35/79, 44%) were modestly used. Fungal diagnostics and antifungal therapeutic drug monitoring (TDM) were utilised, largely off site. IFD surveillance was infrequently performed (9/77, 12%). Barriers to AFS identified included lack of staff time, prioritisation of AFS, and access to rapid diagnostics and TDM.ConclusionsAFS strategies utilised in Australian hospitals have focused on high‐cost, intravenous agents. Although expert oversight of antifungals is evident, many sites omit potentially important targets for AFS, including fluconazole and oral posaconazole. Identifying these gaps and barriers to AFS will guide the development of an AFS model for hospitals.
Emerging concepts of CMV in transplantation
Authors: Westall Glen P. , Gottlieb David , Hughes Peter , Marinelli Tina , Rawlinson William D. , Ritchie David , Sasadeusz Joe , Yong Michelle K. 
Published: December 2024

AbstractCytomegalovirus (CMV) infections continue to be associated with significant morbidity and mortality following solid organ transplantation and haemopoietic stem cell transplantation. Advances in understanding the biology of CMV in the immunosuppressed host will translate into improved management approaches and better clinical outcomes. Updated definitions of resistant and refractory CMV infections will lead to more consistent reporting of CMV outcomes, better inform appropriate antiviral strategies and influence clinical trial design. Improved knowledge of the immunological control of CMV in the immunosuppressed host has led to novel diagnostics, emerging therapeutic cellular therapies and the development of an informed rationale for prophylactic and pre‐emptive strategies. As the boundaries of transplantation are extended, new patterns of CMV infection are being recognised. Finally, recent studies support the use of novel antiviral therapies in transplant recipients in the appropriate clinical setting. In this review, we provide an update on important new and emerging concepts in the management of CMV in immunosuppressed transplant recipients.
Mechanical characteristics of dual‐phase medium‐entropy boride/carbide ceramics synthesized through SPS
Authors: Bayrak Kübra Gürcan , Umutlu Özge Nur , Koroglu Levent , Demir Burak 
Published: December 2024

AbstractMaterial scientists constantly look for new compounds with exceptional properties to meet the ever‐changing technology and industry needs. Hereby, the dual‐phase medium‐entropy ceramics have fabricated by employing high‐energy ball milling (HEBM) and spark plasma sintering (SPS) techniques on commercial boride and carbide powders of IVB group metals. The boride and carbide powders have undergone 3‐hour milling in a planetary ball mill, followed by SPS processing at 1800°C and 2000°C under 30 MPa uniaxial pressure for 10 min. The milled powders and SPS'ed ceramics have been characterized, focusing on composition, density, and microstructure using X‐ray diffractometry (XRD) and scanning electron microscopy (SEM)/energy dispersive spectroscopy (EDS). Microhardness and sliding wear tests have also been performed on the SPS'ed ceramics. The systematic analysis of the characterization results has revealed that the microstructural evolution and mechanical properties of the dual‐phase ceramics have developed to a comparable level with the single‐phase ceramics, regardless of the sintering temperature. In fact, the dual‐phase ceramics sintered at 1800°C come to the forefront due to the superior hardness and fracture toughness values (∼ 16 GPa and ∼ 5.4 MPa.m1/2).
An Evolutionary Concept Analysis of Spiritual Competence in Nursing
Authors: Alshakhshir Nadeen Sami , Ersig Anne L. , Ward Earlise , Hendricks‐Ferguson Verna L. , Montgomery Kathleen E. 
Published: December 2024

ABSTRACTAimsClarify the concept of spiritual competence in the context of nursing through evidence‐based extraction of attributes, antecedents and consequences.DesignConcept analysis.MethodsRodgers' evolutionary method of concept analysis guided this analysis, and we followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews.ResultsAn analysis of 45 studies clarified the concept of spiritual competence in the context of nursing. Spiritual competence in nursing is a dynamic process that, once initiated by nurses' spiritual awareness, promotes their spiritual well‐being, their spiritual knowledge and skills and their sense of spiritual‐care self‐efficacy.ConclusionA comprehensive understanding and clear conceptual definition of the concept of spiritual competence in nursing will enable researchers to overcome barriers and foster nurses' development of spiritual competence to provide spiritual care in nursing.Implications for the Profession and Patient CareThe clarified concept of spiritual competence in nursing can help to shape education and clinical‐training programs for nurses in a way that supports their ability to provide spiritual care and promote patient well‐being and positive health outcomes.Patient or Public ContributionNo patient or public contribution was essential to the conduct of this research.
Exploration of the biological mechanisms of CENPA as an oncogene in glioma: Screening based on cancer functional status
Authors: Ling Yuanguo , Teng Wei , Long Niya , Qiu Wenjin , Wei Ruting , Hou Yunan , Jiang Lishi , Liu Jian , Zhou Xingwang , Chu Liangzhao 
Published: December 2024

AbstractGlioma is the most common primary tumour in central nervous system, characterized by high invasiveness, a high recurrence rate and extremely poor prognosis. Machine learning based on cancer functional state helps to combine multi‐omics methods to screen for key gene, such as CENPA, that influences the phenotype of glioma and patients' prognosis. Based on 14 CFS, glioma was divided into three subtypes. Bioinformatics and machine learning methods were utilized to develop an enhanced prognostic prediction signature based on three subtypes. We selected CENPA as a hub biomarker and conducted in vitro experiments such as IHC, western blot, Coip, transwell, cck8, flow cytometry, scratch assay, qPCR, AlphaFold, MOE and in vivo experiments. We identified three subtypes of glioma based on the 14 CFS. The C subtype exhibits poor clinical outcomes, increased carbohydrate and nucleotide metabolism, high infiltration of immune cells, high CNV and tumour mutation burden (p < 0.05). The differential expression of gene between three subtypes were used to construct a novel signature with improved performance in prognostic prediction via machine learning. CENPA was selected as the hub gene, in vitro experiments such as ihc, western blot and qPCR showed that CENPA had high expression in tissues and cell lines (p < 0.05). The scratch assay, edu, cck8, flow cytometry and transwell after CENPA knockdown or overexpression had significant effects on the functions of glioma. Meanwhile, CENPA was regulated by EZH2 and influenced downstream wnt pathway, affecting phosphorylation of two sites, Ser675 and Ser552, on β‐catenin. The effect of CENPA knockdown was reversed by drug CHIR‐99021. Animal experiments indicated that the tumour volume of control and overexpression group increased faster, especially the overexpression group, which was significantly faster (p < 0.001). Machine learning based on CFS is beneficial for the selection of key genes and disease assessment. In glioma, CENPA is positively correlated with WHO grading at both the gene and protein levels, and high CENPA affects patients' poor prognosis. Regulating CENPA can affect functions of glioma, and these phenomena may act through the EZH2/CENPA/β‐catenin signalling axis. CENPA knockdown can be reversed by the drug CHIR‐99021. CENPA may become one of the therapeutic targets in glioma.
Daily fluctuations in adolescents' sleep predict next‐day attention, sleepiness, and fatigue: an ecological momentary assessment study over 28 days
Authors: Shen Lin , Nicolazzo Jessica , Sletten Tracey L. , Anderson Clare , Yap Yang , Wiley Joshua F. , Bei Bei 
Published: December 2024

BackgroundCurrent understanding of the associations between adolescents' daily sleep and daytime alertness and fatigue under naturalistically occurring restricted (school) and unrestricted (vacation) sleep opportunities is limited.MethodsA convenience sample of adolescents (n = 205; 54.1% females, Mage ± SD = 16.9 ± 0.87 years) completed daily measures of sleep, alertness, and fatigue over 28 days (2 weeks during school, and the subsequent 2‐week vacation). Actigraphy and sleep diary total sleep time (TST) and sleep efficiency (SE) were measured. Participants self‐reported sleepiness and fatigue every morning and afternoon, and completed a tablet‐based, 3.2‐min psychomotor vigilance task (PVT) every afternoon. Cross‐lagged multilevel models tested daily TST and SE as predictors of next‐day subjective sleepiness/fatigue and PVT performance. Between‐ (i.e., differences between individuals) and within‐person associations (i.e., whether nights with higher‐than‐individual's‐average TST/SE, predict next‐day outcomes) were tested simultaneously. Covariates included previous‐day outcome, day of the week, study day (1–28), school/vacation, chronotype, and sociodemographic variables.ResultsWithin‐persons, higher‐than‐average TST and SE (both actigraphy and diary) predicted better next‐day PVT performance (all p ≤ .006), and lower subjective sleepiness and fatigue the following morning and afternoon (all p ≤ .032). Between‐persons, adolescents with higher overall diary SE had lower morning subjective sleepiness (p < .001) and fewer PVT false starts in the afternoon (p = 0.02).ConclusionsNights with longer‐ and higher‐than‐average sleep efficiency (both actigraphy and diary) predicted better daytime alertness and fatigue, both when examined objectively via sustained attention and via self‐report. These findings are relevant for understanding the significance of sleep for adolescents' day‐to‐day alertness levels and fatigue, particularly in the context of classroom learning and road safety.