bluuebunny/crossref_metadata_2025_split huggingface dataset:
Visceral adiposity as a predictor of new-onset diabetes in patients with primary aldosteronism: a cohort study
Authors: Chu Wen-Kai , Er Leay Kiaw , Chang Chin-Chen , Lu Jin-Ying , Wu Wan-Chen , Tsai Yao-Chou , Lin Yen-Hung , Wu Vin-Cent 
Published: November 2024

Background: Patients with primary aldosteronism (PA) exhibit a high prevalence of diabetes mellitus (DM). However, the relationship between visceral adipose tissue (VAT) and new-onset diabetes mellitus (NODM) in PA patients remains unclear. Objectives: To explore the association between VAT and the risk of NODM in PA patients. Design: This is a prospective cohort study spanning 10 years (2010–2020). Methods: A total of 342 PA patients were enrolled prospectively. Abdominal adiposity indexes, including VAT area, VAT ratio, subcutaneous adipose tissue (SAT) area, and SAT ratio, were measured using a computed tomography-based software at diagnosis. Results: Of 342 PA patients (46.2% male, mean age 50.8 ± 11.2 years), 35 (10.2%) developed NODM over a mean follow-up of 7.4 years. A positive nonlinear association between NODM risk and Log (VAT ratio) ⩾ −0.72 was observed (high-VAT group). High VAT (odds ratio (OR), 6.09; p = 0.005), older age (OR, 1.09; p < 0.001), higher body mass index (OR, 1.24; p < 0.001), higher waist-to-hip ratio (OR, 1.11, p < 0.001), lower baseline aldosterone (OR, 0.99, p = 0.011), higher diastolic blood pressure (OR, 1.05, p = 0.012), and lower systolic blood pressure (OR, 0.98, p = 0.045) as risk factors for high VAT. Adrenalectomy did not significantly associate with reduced NODM risk (OR, 0.49; p = 0.292). Conclusion: Our findings highlight that 10.2% of PA patients develop NODM over a mean follow-up of 7.4 years, with high VAT increasing the risk. Baseline VAT is a key determinant of NODM development in PA patients, regardless of targeted treatments.
Association between galectin-3 and hepatosteatosis in a community-based cross-sectional study
Authors: Lin Ming-Shyan , Tu Ya-Chi , Lin Yu-Sheng , Lin Meng-Hung , Lin Chun-Liang , Tsai Ming-Horng , Hsieh Yung-Yu , Chen Tien-Hsing , Chen Mei-Yen , Shi Chung-Sheng 
Published: November 2024

Background: Hepatosteatosis is a common condition that can lead to cirrhosis and liver cancer. Galectin-3 (GAL-3) has been implicated in liver fibrosis and inflammation. Objectives: The purpose of this study was to investigate the association between GAL-3 and hepatosteatosis. Design: This study is a retrospective secondary analysis of data from a community health screening program. Methods: A total of 766 participants were included in the final analysis. Hepatosteatosis was diagnosed using ultrasonography, and GAL-3 levels were measured using enzyme-linked immunosorbent assay. Logistic regression analysis was used to examine the association between GAL-3 levels and the presence of hepatosteatosis, adjusting for age, sex, and other potential confounding factors. Results: The prevalence of moderate-to-severe hepatosteatosis in the study population was 31.5%. The participants with hepatosteatosis had a significantly higher mean level of GAL-3 compared to those without hepatosteatosis (16.6 ± 7.3 vs 13.5 ± 7.3 ng/ml; p < 0.001). After adjusting for age, sex, body mass index, and other potential confounding factors, a higher level of GAL-3 was significantly associated with an increased risk of moderate-to-severe hepatosteatosis (adjusted odds ratio (aOR) 1.24, 95% confidence interval (CI) 1.05–1.46, p = 0.010). The coexistence of alanine transaminase/aspartate transaminase ratio >1 and GAL-3 >14.4 ng/ml was associated with a significantly increased risk (aOR 3.37, 95% CI: 1.90–5.99, p < 0.001). Conclusion: Our findings suggest that GAL-3 level is significantly associated with the presence of moderate-to-severe hepatosteatosis, independent of other known cardiometabolic risk factors.
HbA1c changes in the first year post-kidney transplant and associated risk factors in a Saudi cohort
Authors: Arabi Ziad , Alghamdi Hazim S. , Arabi Tarek , Shafqat Areez , Elwy Badr , Sabbah Belal 
Published: November 2024

Background: There is limited data about the risk factors of clinically significant glycosylated hemoglobin (HbA1c) change and post-transplant diabetes mellitus (PTDM) in the first year post-kidney transplantation (KT), especially in the Middle East. Objectives: To determine the trends of HbA1c levels, the risk factors associated with HbA1c increases, and predictors of clinically significant HbA1c change and PTDM in the first year post-KT. Design: Retrospective chart review. Methods: We included all KT recipients (KTRs) at our center from 2017 until 2020. The study focused on reviewing the patients’ demographic information, cardiovascular risk factors, and HbA1c values at baseline, 6 months, and 12 months. Results: A total of 203 KTRs were included. The mean age of the participants was 44.7 ± 15.5 years, 59.1% were men, and 80.3% received living donors. Eighty-two (40.4%) KTRs had pre-KT diabetes. At 12 months post-KT, the total HbA1c change was 0.87 ± 1.6. In total, 130 (64.04%) KTRs demonstrated clinically significant HbA1c change, and 19 (15.7%) nondiabetics developed PTDM. Pre-KT diabetics suffered greater increases than their nondiabetic counterparts (0.8 vs 0.6, p = 0.043). Increased age (adjusted odds ratio (aOR) = 1.053), weight change (aOR = 1.055), pre-KT hypertension (aOR = 3.015), and lower baseline HbA1c (aOR = 0.453) were independently associated with clinically significant HbA1c change. PTDM patients were older ( p = 0.007) and had higher HbA1c levels at baseline ( p = 0.033), 6 months ( p = 0.002), and 1-year post-KT ( p = 0.001). Gender, type of KT, dialysis, and cardiovascular risk factors were not different between PTDM and non-PTDM patients. Abnormal perfusion tests ( p < 0.001) and coronary artery disease on coronary angiogram ( p = 0.046) were more common in PTDM patients. Only age was independently associated with the presence of PTDM at 1-year post-KT (aOR = 1.044). Conclusion: The incidence rate of PTDM in Saudi KT patients is similar to that of other populations. Several risk factors, including low baseline HbA1c and pre-KT hypertension, predict a clinically significant change in HbA1c. Patients with these risk factors may require stricter monitoring and control of HbA1c.
Identifying Factors Associated With Variation in Telemental Health Delivery at Federally Qualified Health Centers
Authors: Lombardi Brianna , Sullivan Connor , Gaiser Maria , Zerden Lisa de Saxe , Galloway Evan , Wright Brad 
Published: November 2024

Background: COVID-19 accelerated federally qualified health centers’ use of telemental health. However, factors associated with telemental health service delivery remain unclear. We examined telemental health delivery by clinician type and mental health workforce composition across the U.S. to understand how staffing and other organizational characteristics are related to telemental health delivery at health centers. Methods: Using data from the 2021 Uniform Data System, we characterized the proportion of mental health care delivered via elemental (i.e., virtual visits) at health centers in the U.S. that received HRSA grant funding (n = 1,270) overall and by state and clinician type. Then, we conducted multivariate beta regression analyses to assess the proportion of mental health visits delivered via telemental health at health centers as a function of mental health workforce composition, while adjusting for health center size, patient mix, and state. Results: In 2021, health centers delivered 43% of their mental health visits via telemental health, with significant variation by state and clinician type. On average, the proportion of mental health visits delivered via telemental health was greater among psychiatrists (61%, P < .001) than psychologists (49%) and clinical social workers (45%). Factors significantly associated with the increased proportion of telemental health delivered by health centers included a higher supply of psychiatrists per patient, more grant dollars per patient, and a greater proportion of Asian patients served. Conclusions: Access to telemental health varies by state and across health centers based on mental health workforce composition. Future work is needed to examine funding and workforce strategies to increase telemental health service availability.
Costs during the first year after stroke by degree of functional disability: A societal perspective
Authors: Soler-Font Mercè , Ribera Aida , Aznar-Lou Ignacio , Sánchez-Viñas Alba , Slof John , Vela Emili , Salvat-Plana Mercè , Villa-García Lorena , Serrano-Blanco Antoni , Pérez de la Osa Natàlia , Ribó Marc , Abilleira Sònia 
Published: November 2024

Introduction: The aim of this study was to estimate societal costs during the first year after stroke by degree of functional disability. Patients and methods: Descriptive study of the cumulative costs incurred during 1-year follow-up of a cohort of patients with stroke in Catalonia (Spain) participating in a multicentre, population-based, cluster-randomised trial (RACECAT). Patients were recruited between September 2017 and January 2019. Costs were collected for each patient from stroke onset to 1-year follow-up through hospital accounting records, electronic healthcare records and structured telephone-based interviews at 6 and 12-months follow-up. Disability was assessed using the 90-day modified Rankin Scale (mRS). Healthcare, community care, and patient/family costs were included. We used complete data from 567 eligible participants. Cost data were analysed using generalised linear models (GLMs) with gamma distributions and log link functions. For variables with >10% zero values, two-part models were applied. We performed sensitivity analyses modifying unit costs for patient/family costs. Results: Of the 567 patients included, 53% had ischaemic large vessel oclusion (LVO) stroke, 24% intracranial haemorrhage and 23% ischaemic non-LVO stroke. Mean cost per patient during the first year after stroke was €29,673 ± 28,632, and increased with degree of disability (mRS 0–2: €18,568 ± 12,244; mRS 3: €38,214 ± 28,172; mRS 4–5: €52,859 ± 36,383). Healthcare costs represented the highest proportion of total costs (63%; €18,724/patient) across all disability levels, with index hospitalisation being the highest (€12,319 ± 17,675); however, community care and patient/family costs represented over 40% of total cost in patients with higher disability levels. Discussion and conclusion: Our results are in line with other studies; the costs during the first year after stroke are high and increase with disability. These results are valuable for calculating the cost of severe stroke cases.
Acute treatment and secondary prevention for patients with minor stroke or transient ischemic attack: A Bayesian network meta-analysis
Authors: Guo Sitong , Qin Shiran , Xu Dandan , Chen Chunxia , Chen Xiaoyu 
Published: November 2024

Introduction: The efficacy of different antiplatelet treatment in minor strokes (MSs) or transient ischemic attacks (TIAs) and that of antiplatelet and intravenous thrombolysis (IVT) in MSs remain controversial. Methods: We searched PubMed, Embase, Web of Science and the Cochrane Library to identify all eligible articles until April 12, 2024. Efficacy outcomes were all-cause mortality, excellent outcome, functional independence and recurrent stroke. Safety outcomes were any types of bleeding and intracerebral hemorrhage (ICH). The associations were calculated for the overall data by using odds ratios (ORs). Results: Twenty three high-quality studies with 10 RCTs and 13 non-RCTs were included, involving 47,135 patients with MSs or TIAs. In MSs or TIAs, dual antiplatelet therapies (DAPTs) significantly improved the modified Rankin Scale (mRS) scores for patients with recurrent stroke, major vascular events and ischemic stroke although it was associated with an increased risk of ICH and bleeding when compared to aspirin. In MSs, compared to IVT, DAPT had a significant advantage in improving the mRMS scores and SAPT and DAPT significantly reduced the risk of any bleeding or sICH. IVT significantly reduced all-cause mortality, although it also increased the risk of sICH and ICH compared to no IVT. Conclusions: In MSs or TIAs, compared to aspirin, DAPTs can effectively prevent the recurrence of post-stroke neurological dysfunction and ischemic events, but it may increase the risk of ICH together with moderate or severe bleeding. Dipyridamole + aspirin resulted in the lowest risk of bleeding. In MSs, compared to IVT, DAPT may be associated with better improvements in neurological function, and it may not increase the risk of bleeding.
Nitinol Compression Staples in Foot Orthopaedic Surgery: A Systematic Review
Authors: Reddy Akshay R. , Hampton Hailey , Dzieza Wojciech K. , Toussaint R. James 
Published: November 2024

Background: Nitinol compression staples have been increasingly used in foot and ankle orthopaedic surgery because of simple implantation, reproducibility, and favorable biomechanical features. Compared with traditional implants (i.e., plates and screws), nitinol staple use in foot and ankle orthopaedics has not been extensively described. This systematic review aims to describe the current clinical outcomes of nitinol staple use in forefoot and midfoot surgery. Methods: A search was conducted using PubMed, Web of Science, and Embase. All studies that included clinical outcomes of nitinol in foot surgery were evaluated for their demographics, outcome scores, or complication rates. Biomechanical studies and studies investigating nitinol nails in the hindfoot were excluded. Two reviewers screened titles, abstracts, and full texts. Results: Of the 198 total articles from the search, 9 articles met the inclusion criteria. Of the 9 articles, 4 articles investigated outcomes of nitinol in the forefoot, 3 articles in the midfoot, 1 article in the forefoot and midfoot, and 1 article in the midfoot and hindfoot. This systematic review included articles that were retrospective in nature and thus subject to selection bias. The mean follow-up ranged from 6 to 35.9 months. The included studies demonstrated significantly improved postoperative visual analog scale pain score ( P < .001), Ankle Osteoarthritis Scale scores ( P < .001), and Foot and Ankle Ability Measure activities of daily living scores ( P < .001). Of the 6 studies that report union for patients receiving purely nitinol staple constructs or nitinol staples in combination with another construct, the overall fusion rate was 94.6% and the overall complication rate was 11.25%. Conclusion: This systematic review demonstrates that nitinol staples in foot surgery, whether alone or in combination with another construct, can achieve an acceptable fusion rate. However, currently we found highly limited clinical study data directly comparing nitinol staples to traditional implants. The current literature is heterogenous in its discussion of nitinol staple configurations and designs. Level of Evidence: Level IV, Systematic Review.
Focusing on life rather than illness: the lived experience of children with life-threatening and life-limiting conditions—a qualitative study
Authors: Kittelsen Trine Brun , Castor Charlotte , Lee Anja , Kvarme Lisbeth Gravdal , Winger Anette 
Published: November 2024

Background: The perspectives of children with life-threatening or life-limiting (LT/LL) conditions have predominantly been conveyed through their parents rather than heard from the children themselves. Despite an increase in studies focusing on children’s perspectives in pediatric palliative care, this research remains limited, particularly in including children who are unable to express themselves orally. Objective: This study seeks to address gaps in existing knowledge, especially the limited inclusion of children’s perspectives and the exclusion of children with communicative and cognitive disabilities. The aim of this study was to explore the lived experiences of children living with LT/LL conditions. Design: The study has a qualitative, hermeneutic phenomenological design inspired by van Manen’s phenomenology of practice. Methods: Twelve children with cancer or genetic conditions participated. Due to the children’s varying cognitive and communicative abilities, multiple data collection methods were employed to capture the children’s perspectives, including interviews, interactions, descriptions of the children’s non-verbal expressions, and an adapted photo elicitation method. Data were analyzed using thematic analysis. Results: The findings showed that the children’s attention revolved around life rather than illness. The analysis revealed the presence of three themes: wanting to engage in life, being dependent on familiar relations, and the importance of cherished items. Conclusion: Professionals across various levels within pediatric palliative care should acknowledge children’s desire to engage in life despite serious illness and facilitate participation. Practices should be implemented to support children’s agencies and expressions of what is important to them. This recognition can guide care plans and interventions at all levels of pediatric palliative care when a child is living with an LT/LL condition. The study emphasizes that children with LT/LL conditions are children first and foremost, with a fundamental need to participate in meaningful activity, just like any other child.
Chemerin alleviates the placental oxidative stress and improves fetal overgrowth of gestational diabetes mellitus mice induced by high fat diet
Authors: Zhou Xuan , Jiang Yi , Wang Zizhuo , Wei Lijie , Zhang Huiting , Fang Chenyun , Zhu Shenglan , Du Yuanyuan , Su Rui , Li Weikun , He Zhenzhen , Zhang Liangnan , Tan Weidong , He Mengzhou , Yu Jun , Wang Shaoshuai , Ding Wencheng , Feng Ling 
Published: November 2024

Abstract
Background
Evidence has shown that oxidative stress induced by high glucose microenvironment in placenta of gestational diabetes mellitus (GDM) is indispensable to the progression of this condition. Adipokine chemerin was linked with GDM, yet the roles of chemerin in placental oxidative stress and its underlying effects on GDM in vivo remain elusive.

Methods
We firstly analyzed the disparities of oxidative stress levels in placenta between GDM and normoglycaemic pregnant women, and then added recombinant active chemerin to the high-glucose treated human trophoblastic cells to investigate effects of chemerin on reactive oxygen species (ROS), total antioxidant capacity (T-AOC) and intake of glucose. Finally, a GDM animal model induced by high-fat diet (HFD) was established and the impacts of chemerin on oxidative stress of placenta and fetal growth of GDM were explored.

Results
Analysis of human samples showed that the extent of lipid peroxidation in placenta was significantly elevated in GDM patients compared with their normoglycaemic counterparts. In the high glucose cell model, active chemerin lessened the content of ROS, heightened the index of T-AOC and stimulated glucose uptake in a concentration-dependent manner. Importantly, we successfully constructed a GDM mouse model through HFD. The treatment of chemerin was found to alleviate the high blood glucose levels in these HFD-fed pregnant mice and attenuate the excessive growth of their offspring. Our data also revealed that chemerin might counteract placental oxidative stress in HFD mice by improving the activity of superoxide dismutase.

Conclusions
The present study further elucidated the molecular biology of chemerin, which plays a pivotal role in ameliorating oxidative stress and hyperglycemia, resulting in improved fetal overgrowth in GDM.

Graphical abstract
From outsider to participant: a qualitative study about attaining and retaining work among persons with mental illness
Authors: Stangeland Fredrik , Sveinsdottir Vigdis , Ree Eline 
Published: November 2024

Abstract
Background
In Norway, the number of people on sick leave and health-related absence from work has increased over the last few years, and mental illness is one of the main contributing factors. Individual Placement and Support (IPS) and the Qualification Program (QP) are two work-oriented measures offered by Norwegian labor and welfare authorities, aimed at increasing labor market participation among people with health-related problems. The aim of this study was to explore which factors people with mental illnesses found helpful for attaining and retaining work, and their experiences with taking part in IPS and the QP.

Methods
The study had a qualitative explorative design. Eight semi-structured interviews with individuals who had attained and retained work after receiving IPS or taking part in the QP were conducted. The data were analyzed using systematic text condensation, a thematic and descriptive, cross-case analysis strategy.

Results
The analysis revealed three main themes, each related to the contexts of work and daily life: (1) inclusion and support, (2) structure and routines, and (3) motivation and self-confidence. The participants emphasized the importance of feeling included and supported both at work and by their family and friends. Furthermore, structures and routines at work and in the participants’ daily lives kept them engaged and made them feel better, which was important for retaining work. Having the motivation to attain and retain work was essential and seemed to increase over time together with improved self-confidence as a result of being able to stay at work.

Conclusion
Inclusion, support, structure, routines, and motivation are decisive for people with mental illnesses in changing their view of their health and increasing their independence and experiences of coping in work and everyday life. Taking part in work-oriented measures seemed to function as a “gateway” to changing behavior for the participants, both in work situations as well as more generally in life.
Initial clinical evaluation of a novel integrative bone matrix (IBM) in foot and ankle fusion procedures
Authors: Hofmann Kurt J. , Veale Nicholas J. , Veale Matt , Glass Evan , Beckles Matthew 
Published: November 2024

Abstract
Background
Foot and ankle arthrodesis procedures are frequently performed in concert with the utilization of bone grafts. However, the availability of autologous bone is often limited, inaccessible, or not suitable, thus there is a need for bone graft substitutes with equally effective clinical outcomes. A next generation integrative bone matrix (IBM) has been developed that has intrinsic osteogenic, osteoconductive, and osteoinductive characteristics, and is a promising solution to mitigate complications such as nonunion and reduce the need for autologous bone graft harvest.

Methods
The charts of twenty subjects undergoing foot and ankle fusion procedures with INFLUX™ SPARC, a novel IBM, were retrospectively reviewed to determine initial clinical safety and efficacy of this next generation bone graft. Endpoints included the presence of complications or surgical reintervention, fusion rates as determined by standardized radiographic films, and patient-reported outcome measures at various time points up to 24 weeks.

Results
No major complications or surgical reinterventions were observed in this study. Complete radiographic fusion was achieved in all subjects by 24 weeks, with a mean overall fusion time of 8.5 ± 4.8 weeks. Subjective pain, function, and quality of life outcomes showed consistent improvements throughout the follow-up period, and all subjects (100%) achieved the minimum clinically significant mean improvements for all measures by week 24.

Conclusions
This study supports the use of this new IBM as a promising alternative to autologous bone grafting, offering high fusion success rates, low complications, and clinically meaningful improvements in patient-reported outcomes, particularly in higher-risk patient populations. Future investigations are needed to confirm these findings in larger and longer-term studies, and to explore the broader applications of this innovative bone graft.