bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of knowledge and awareness of stroke among Arabic speaking adults: unveiling the current landscape in seven countries through the first international representative study
Authors: Malaeb Diana , Mansour Sara , Barakat Muna , Cherri Sarah , Kharaba Zelal J. , Jirjees Feras , Al Zayer Reem , Eltayib Eyman M. , Khidhair Zeinab , AlObaidi Hala , El Khatib Sami , Alex Ruth , Menon Vineetha , Hosseini Basile , Noureldine Jinane , Alfoteih Yassen , Hallit Souheil , Hosseini Hassan 
Published: November 2024

IntroductionWhile several studies have examined stroke public knowledge and awareness in individual countries within the Middle East and North Africa (MENA) region, none have provided a comprehensive cross-country assessment.PurposeTo assess public stroke knowledge and awareness among Arabic-speaking adults in seven MENA countries and identify associated factors.Materials and methodsAn online cross-sectional survey was self-administered by the public population in Iraq, Lebanon, Sudan, Jordan, United Arab Emirates, Syria, and Saudi Arabia (April 2021–2023). Associations of stroke risk factors, early symptoms, and consequences with socio-demographics and medical history were analyzed using logistic regression models.ResultsOf 4,090 participants (58.3% females), 42.9% identified four out of five correct answers related to general stroke knowledge. Only 25.2% identified all stroke risk factors, 24.7% recognized all symptoms, and 37.5% knew all possible consequences. Results show consistent pattern of high identification for at least one risk factor and consequences across all countries (96.3 to 99.8% and 86.2 to 100%, respectively), with varying levels of early symptom identification (56.8 to 97.9%). Females were more likely to identify a stroke risk factor, symptom, and consequence compared to males (OR = 2.525, 2.474, and 2.302, respectively, p &lt; 0.001). Employed, urban residents, and those with higher education demonstrated better stroke awareness.ConclusionThe sample showed variable levels of stroke knowledge among the public, underscoring the pressing need for targeted community initiatives, media campaigns, and educational interventions. These efforts are paramount for improving awareness, early detection, and timely response, especially in countries with lower levels of community stroke awareness.
Predictive value of low serum interleukin-33 levels in acute ischemic stroke outcomes
Authors: Liu Wei , Luo Dongliang , Liu Xingyu , Zhang Yuqing , Wang Zhong 
Published: November 2024

BackgroundHuman interleukin-33 (IL-33), a member of the IL-1 family, has been identified as a therapeutic target due to its role as a proinflammatory mediator in various diseases. This study aims to evaluate the prognostic value of serum IL-33 levels in patients admitted with their first-ever acute ischemic stroke.MethodsThis single-center, prospective, observational study included 216 patients with acute ischemic stroke. Serum IL-33 levels were measured at hospital admission to assess their predictive value for functional outcomes and mortality within 3 months. IL-33 levels were dichotomized at the median into two groups: the reduced group (IL-33 ≤ median) and the normal group (IL-33 &gt; median).ResultsThe median age of the 216 patients was 66 years (interquartile range [IQR], 56–75), with 132 (61.6%) being women. IL-33 serum levels were inversely correlated with stroke severity, as measured by the National Institutes of Health Stroke Scale (NIHSS) score and lesion size. Patients in the reduced IL-33 group had a higher rate of unfavorable outcomes (55.6% vs. 18.5%; absolute difference, 29.2% [95% confidence interval (CI), 24.5% to 34.4%]; odds ratio (OR), 3.19 [95% CI, 1.72 to 5.91]) and mortality (24.1% vs. 3.7%; absolute difference, 15.8% [95% CI, 13.1% to 18.3%]; OR, 4.12 [95% CI, 1.38 to 12.31]) compared to the normal group. Furthermore, IL-33 levels enhanced the prognostic accuracy of the NIHSS for predicting functional outcomes (combined area under the curve [AUC], 0.84; 95% CI, 0.79–0.84; P &lt; 0.001) and mortality (combined AUC, 0.88; 95% CI, 0.83–0.94; P &lt; 0.001).ConclusionThis study demonstrates that lower IL-33 levels are associated with increased stroke severity and poorer prognosis. These findings suggest that IL-33 may serve as a valuable biomarker for predicting poor outcomes following acute ischemic stroke.
Comparative analysis of the nutritional composition, digestibility, metabolomics profiles and growth influence of cow, goat and sheep milk powder diets in rat models
Authors: Yang Chun , Pan Jiancun , Pang Shaojie , Hu Shuang , Liu Miao , Zhang Xinyan , Song Liping , Ren Xiangnan , Wang Zhongli 
Published: November 2024

IntroductionThe diversity of dairy products and the increasing consumption levels have led to a growing interest in goat and sheep milk, which are rich in essential nutrients and functional components. The study aims to explore the nutritional composition, growth performance, digestibility, and serum metabolic differences of milk powders from cow, goat, and sheep using LC–MS/MS-based metabolomics in rat models.MethodsSixty male Sprague-Dawley rats were fed with whole cow, goat, and sheep milk powder samples , and their feces and urine were analyzed for fat and protein content. LC/MS analysis was conducted using a Dionex UltiMate 3000 UHPLC system coupled with a Thermo Q EXACTIVE mass spectrometer, with data processed using Wekemo Bioincloud for quality control, normalization, comparisons with the KEGG database, statistical analyses, and selection of differential metabolites.ResultsThe sheep milk powder showed highest protein and fat content level, while cow and goat milk powders separately demonstrated higher lactose and carbohydrate levels. Each milk powder had a unique mineral profile, with sheep milk powder containing the highest calcium content. All groups exhibited consistent growth in body weight and high rates of protein and fat digestibility. Metabolomics analysis revealed distinct metabolic profiles, with goat milk powder linked to steroid hormone biosynthesis and sheep milk powder associated with hormone regulation and bile acid pathways.ConclusionThis study offers valuable insights into the metabolic implications of different milk powder sources, informing dietary choices and facilitating the development of targeted public health strategies to optimize nutritional intake and promote overall well-being.
The dietary inflammatory index and asthma prevalence: a cross-sectional analysis from NHANES
Authors: Lu Chuansen , Zhu Yike 
Published: November 2024

BackgroundInflammation is a key factor in the development of asthma, and diet significantly influences inflammatory responses. This study examines the relationship between the Dietary Inflammatory Index (DII) and asthma prevalence.MethodsWe conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018. Demographic details, anthropometric measurements, dietary habits, lifestyle factors, and asthma status were recorded for all participants. Multivariable logistic regression was utilized to assess the relationship between DII and asthma prevalence. Additionally, restricted cubic spline (RCS) analysis was employed to explore the nonlinearity and dose–response relationship between DII and asthma risk. Subgroup analyses were stratified by gender, age, race, body mass index (BMI), poverty income ratio (PIR), education, smoking status, alcohol use, and family medical history to dissect the association between DII and asthma across diverse populations.ResultsThe analysis included 37,283 adults from NHANES. After adjusting for potential confounders in the multivariable logistic regression model, a significant positive association was identified between DII and asthma (OR, 95% CI: 1.05, 1.02–1.09, per 1 SD increase). The RCS analysis revealed a nonlinear association (p for nonlinearity = 0.0026), with an inflection point at 1.366, beyond which an increase in DII was significantly associated with asthma risk. Furthermore, the stratified analyses indicated a positive association between DII and asthma in the majority of subgroups.ConclusionThe findings underscore a significant and nonlinear association between DII and asthma. To enhance asthma prevention and management, greater emphasis should be placed on modulating dietary-induced inflammation.
One-piece resection for the treatment of ventral intradural extramedullary spinal meningioma: a retrospective study
Authors: Cao Guangqing , Li Xinao , Wang Dachuan , Zhao Yachao 
Published: November 2024

ObjectiveThis study aimed to evaluate the feasibility and efficacy of one-piece resection for the treatment of ventral intradural extramedullary spinal meningiomas (VIESMs).MethodsBetween January 2017 and December 2023, all patients who underwent one-piece resection for VIESMs were retrospectively reviewed with their demographic, intraoperative and postoperative data being recorded. In addition, postoperative neurological status based on the modified McCormick functional schema (mMFS), along with radiological manifestations on the magnetic resonance imaging (MRI) were assessed and compared with that before the operation.ResultsA total of 27 cases (7 men and 20 women) with an average age of 63.37 ± 10.48 years old were included in the present study with the operation time, blood loss, length of hospital stay, and follow-up periods being 292.41 ± 42.64 min, 286.85 ± 47.03 ml, 10.37 ± 1.69 days, and 16.81 ± 10.79 months, respectively. Postoperatively, one case experienced cerebrospinal fluid leakage without neurological deterioration. At the final follow-up, the mMFS scores were unchanged in seven (25.93%) cases while they improved in the remaining 20 (74.07%) cases. Finally, the MRI examinations showed that one-piece resection was successfully performed for each VIESM without a recurrence.ConclusionOne-piece resection was a feasible, safe and effective procedure for treating VIESMs. Partial removal of the ipsilateral pedicle, facet joint, and even posterior vertebral wall to establish a wide surgical corridor and vision, resection of the dentate ligaments to minimize spinal cord traction, and meticulous coagulation of the dural attachment to reduce recurrence were the key technical points.
Effects of two-stage preterm formulas on growth, nutritional biomarkers, and neurodevelopment in preterm infants
Authors: Kwinta Przemko , Lazarova Svilena , Demová Klaudia , Chen Yipu , Hartweg Mickaël , Krattinger Laura-Florina , Fumero Cecilia , Buczyńska Aleksandra , Durlak Wojciech , Uhrikova Zuzana , Kozar Marek , Samuel Tinu Mary , Zibolen Mirko 
Published: November 2024

BackgroundFormula-fed preterm infants require nutrient-enriched formulas with optimized protein levels to support growth and neurodevelopment. The purpose of this study was to evaluate the safety, tolerability, and effectiveness of a new liquid two-staged formula system designed to provide tailored nutrition during hospital stay and after discharge.MethodsMale and female very-low-birth-weight preterm infants (birth weight ≤1,500 g; gestational age ≤32 weeks) were recruited from three neonatal units in Poland and Slovakia in a prospective, open-label, interventional study. Stage 1 formula providing 3.6 g intact protein/100 kcal was consumed from enrollment until reaching 1,800 g, followed by a post-discharge (PD) Stage 2 formula with 2.8 g/100 kcal protein, which was consumed for 30 days. Weight gain velocity (WGV in g/kg/day) between the first day of achieving full enteral feeding (FEF D1 rate of 150 ml/kg/day and cessation of parenteral feeding) and day reaching 1,800 g was compared to the minimally required WGV (15 g/kg/day) for non-inferiority (primary endpoint), and to the Fenton median growth rate for superiority (17.3 g/kg/day), adjusting for sex, gestational age, site, visit, and WGV. Changes in z-scores, feeding tolerance, nutritional biomarker status, and safety were also assessed from FEF D1 to 30 days PD. In an observational follow-up at 2 years of age, neurodevelopment was evaluated using the Bayley Scales of Infant and Toddler Development (BSID-III).ResultsAdjusted weight gain velocity (95% CI) between the first day of full enteral feeding and day reaching 1,800 g in per protocol (PP, N = 18) was 23.0 (20.1–25.9) g/kg/day; lower limit of the 95% CIs exceeded the non-inferiority margin (15 g/kg/day, p &lt; 0.001) and the superiority margin (17.3 g/kg/day, p &lt; 0.001). Mean stool frequency ranged from 2.5 to 3.3 stools per day. The two-stage formula supported adequate growth patterns throughout the study and nutritional biomarkers of protein and mineral status were within normal ranges. At 24 months corrected age, the mean ± SD of the BSID cognitive scale was 97.3 ± 13.9 in PP, with all infants achieving a score &gt;70. None of the adverse events reported were related to the study formulas.ConclusionThe two-stage preterm formulas supported postnatal weight gain, adequate growth, cognitive development within normal ranges, and a safe profile of protein and bone biomarkers.
Clinical Trial RegistrationClinicaltrials.gov registration, NCT03728764, NCT04962035.
Adverse event profile of lorazepam: a real-world pharmacovigilance study using the FDA adverse event reporting system database
Authors: Su Zhengkang , Huang Zhengwei , Chen Xiaoyu , Li Xi 
Published: November 2024

IntroductionAnxiety diagnoses have surged recently during and after the COVID-19 pandemic. Lorazepam is widely recognized for its efficacy in treatment of anxiety, as well as insomnia, etc. However, the long-term safety profile of lorazepam in extensive patient populations has not been thoroughly established.MethodsThis study aims to evaluate the potential lorazepam-associated adverse events (AEs) using data mining of the Food and Drug Administration Adverse Event Reporting System (FAERS) of the United States, seeking to provide a guidance for the future therapeutic practices.ResultsOur study revealed drug abuse, suicide attempt, sopor, delirium, and psychotic disorder were among the most prevalent AEs linked to lorazepam. In addition to common AEs, we also found that patients using lorazepam may have the risk of abnormal fat metabolism, cardiac impairment, and immunosuppression-related disorders.DiscussionIn general, our research has unveiled novel AE signals and expanded our understanding of the safety profile of lorazepam in clinical practices, providing guidance for its rational use.
Rare cancer with primary pleural epithelioid hemangioendothelioma diagnosed by thoracoscopic biopsy achieving disease control after 16 months: case report and literature review
Authors: Pateras Ioannis S. , Kostopanagiotou Konstantinos , Samaras Menelaos G. , Koumarianou Anna , Koutrouli Mina , Korodimos Nikolaos , Kampoli Katerina , Apollonatou Vasiliki , Manali Effrosyni , Loukides Stylianos , Tomos Periklis , Tsiodras Sotirios , Panayiotides Ioannis G. 
Published: November 2024

Epithelioid hemangioendothelioma (EHE) is a rare malignant vascular tumor whose pleural EHE (pEHE) type is even more uncommon, with significant heterogeneity in the clinical behavior as well as challenging diagnosis and treatment decisions. Herein, we present a 74-year-old woman admitted to the hospital with dyspnea, pleural effusion, and refractory euvolemic hyponatremia. Chest computed tomography revealed a large right-side pleural effusion with irregular thickening of the parietal pleura and localized nodularity. Histologic evaluation of the thoracoscopic pleural biopsy tissue was used to confirm the diagnosis of pEHE. Assessment of the volume status suggested that the hyponatremia was attributable to a paraneoplastic endocrine syndrome. Administration of the multitarget tyrosine kinase inhibitor pazopanib helped achieve disease control, with the patient remaining free of symptoms after 16 months of follow-up. This case report adds to the knowledge base of this exceptionally rare condition, highlighting the need for a multidisciplinary approach.
Research for association and correlation between stress at workplace and individual mental health
Authors: Lee Mi-Jeong , Lee Wanhyung 
Published: November 2024

BackgroundOccupational stress negatively affects mental health and productivity. Managing worker mental health has been equated to assessing workplace stressors, although there are challenges in screening and managing the mental health of vulnerable workers. This study aimed to determine the correlation between workplace stress characteristics and two depression assessment questionnaires to guide workplaces on assessing job stress more effectively.MethodsA cross-sectional survey study was conducted with 812 workers from manufacturing sector in Korea. Depression was measured using the CES-D and PHQ-9 questionnaires, and the KOSS-SF was used to assess job stress.ResultsThe results showed that 26.2% of participants had high job stress levels, with job control and demands being the highest subfactors. The CES-D and PHQ-9 were positively correlated with job stress factors, with the PHQ-9 showing stronger correlations than the CES-D.ConclusionThe CES-D and PHQ-9 were associated with workplace stress; however, the CES-D was not associated with job control, whereas the PHQ-9 was not associated with job demands or relationship conflicts. Additionally, the PHQ-9 showed a higher correlation with workplace stress than the CES-D. The correlation between depression screening tests differed according to workplace stress characteristics, but the PHQ-9 was helpful in screening workers for depression.
Determinants of the low use of Thailand’s Universal Coverage Scheme: a national cross-sectional study
Authors: Paek Seung Chun , Zhang Ning Jackie 
Published: November 2024

IntroductionThailand’s Universal Coverage Scheme (UCS) has increased overall healthcare use by offering free healthcare for about 76% of the entire population since it was introduced in 2002. However, a considerable number of beneficiaries have continued to depend on private healthcare, and the low use of the UCS has been cited as a challenge to accomplishing the policy’s goal of universal access to healthcare. Thus, this study divided healthcare use into three patterns (self-medication, private providers, and UCS) and investigated the socio-demographic characteristics of non-users of the UCS and their reasons for non-use.MethodsA cross-sectional quantitative analysis was performed using data from the 2019 Health and Welfare Survey. UCS beneficiaries aged 15 years or older who had used healthcare during the past month were included in the sample. Descriptive analysis and multinomial logistic regression were performed to analyze associations between patterns of healthcare use and socio-demographic factors chosen based on Aday and Andersen’s access to medical care model.ResultsOf the study sample (n = 5,636), about 46.1% used healthcare services outside the UCS delivery system, of whom 33.8 and 12.3% used self-medication and private healthcare providers, respectively. Non-users generally had a higher socio-demographic status than UCS users. Specifically, they were young, had a high income, were employed, lived in urban areas, or did not have a chronic disease. The most common reason for non-use of the UCS was accessibility barriers (59.6%; e.g., long queues in public providers), followed by availability (25.4%; e.g., limited operating hours of public providers) and quality barriers (14%; e.g., unsureness of the quality of medicine offered by public providers). Moreover, self-medication users tended to be concerned about availability barriers, while private-provider users tended to be concerned about quality barriers for using the UCS.ConclusionUnder the UCS policy, there is a gap between the demands for healthcare and the resources assigned to increase the capability of public healthcare providers. That is, the UCS has increased financial accessibility for the use of the UCS (i.e., free healthcare from public providers). However, it probably has not yet increased healthcare resources and infrastructure facilitating the use of the UCS. This may have prevented the UCS from meeting the demands of its intended beneficiaries, especially those in high socio-economic groups, and ultimately forced them to use private healthcare.
Depression among keratoconus patients: a systematic review and meta-analysis
Authors: Moshfeghinia Reza , Arman Ali , Sobhi Navid , Mahmoudinezhad Golnoush , Molavi Vardanjani Hossein 
Published: November 2024

BackgroundKeratoconus (KC) is a chronic corneal disease that typically presents in early adulthood, and may potentially result in poor mental health in affected individuals. The evidence regarding the association of depression with KC is controversial. Hence, we investigated the association between depression and KC via a systematic review and meta-analysis.MethodsFive electronic medical databases (PubMed, Scopus, PsycINFO, Web of Science, and CINAHL Complete) were systematically queried for English-language records from their inception to January 8, 2024. We include observational studies that measured the risk of depression or compared depression scores in KC patients in comparison to healthy ones. The Newcastle–Ottawa Quality Assessment Scale was utilized to assess bias risk in the included studies. Random-effect modeling was applied for meta-analysis (STATA-17).ResultsOut of the 159 documents retrieved, seven articles were deemed relevant after screening. An analysis involving 83 KC patients and 3,186 controls indicated that KC participants had significantly higher depression scores [SMD: 0.71 [0.31, 1.11]; p &lt; 0.01, I2: 52.7%]. However, a meta-analysis of four studies comparing depression rates in KC patients (n = 23,838) to control groups (n = 73,482) found no increased risk of depression among KC patients compared to controls [OR: 1.13 [0.66, 1.94]; p = 0.65, I2: 95.35%].ConclusionWhile KC patients exhibit significantly higher depression scores compared to controls, a meta-analysis indicates no increased overall risk of depression among KC patients. These findings highlight the complexity of the relationship between keratoconus and mental health, warranting further investigation.Systematic review registrationPROSPERO, identifier, CRD42024502247, available at: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024502247.