bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bilateral Sacroiliitis in a Patient with Rheumatoid Arthritis: Unraveling the Rope: A Case Report
Authors: Madubashini Liyana Arachchige Dona Thulini , De Silva Monika , Premarathne Bathiya , Dissanayake Melina 
Published: November 2024

Rheumatoid arthritis (RA) and spondyloarthritis(SpA) are chronic inflammatory disorders with unique symptoms and pathologies. Misclassification of these two entities is prevalent due to overlapping clinical features and the presence of typical symptoms for both disorders. Rheumatoid nodules are one of the most common extra articular manifestations in rheumatoid arthritis, usually associated with severe disease activity. Herein, we describe a case of rheumatoid arthritis with bilateral sacroiliitis, an uncommon joint involvement of rheumatoid arthritis, and accelerated subcutaneous nodulosis after treatment with adalimumab. Introduction RA is a chronic, autoimmune disorder that primarily affects peripheral synovial joints [1]. The axial skeleton is usually spared other than the cervical spine, particularly C1 to C2 [1]. Though sacroiliitis is a paramount sign of SpA, it can be rarely observed in RA [2]. The commonest extra-articular manifestation of RA is subcutaneous nodules, which can be accelerated with RA treatments [3]. Herein, we describe a patient presented with bilateral sacroiliitis, along with the diagnostic and therapeutic challenges we surmounted. Case presentation A-45-years-old female presented with a one-year history of inflammatory arthritis of bilateral metacarpophalangeal, wrist, and ankle joints. She also had inflammatory-type back pain with buttock pain and plantar fasciitis. The Left-sided Faber test was positive. The laboratory investigations revealed elevated inflammatory markers, negative RF and HLA-B27. MRI-SI joints revealed bilateral active sacroiliitis. She was treated as SpA with NSAIDS at first, followed by subcutaneous adalimumab due to inadequate response. Though arthritis improved following adalimumab, multiple firm subcutaneous nodules occurred in the extensor surface of the elbow and hands after six-doses of adalimumab. Biopsy was compatible with rheumatoid nodule and anti-cyclic citrullinated peptide was positive. Based on the presence of rheumatoid nodules and positive anti-CCP antibodies, the patient was diagnosed with seropositive RA and bilateral sacroiliitis, an unusual joint involvement in RA. Discussion Sacroiliitis is the paramount clinical sign in SpA [2]. However, it can be seen in a wide range of disease conditions [4]. Misclassification between SpA and RA can occur due to overlapping clinical manifestations [4].  The Rheumatoid nodule is the most common cutaneous manifestation of RA and often seen in seropositive RA and more severe disease [3]. There have been case reports of accelerated subcutaneous nodulosis in patient with RA, treated with MTX, leflunomide, azathioprine, TNF alfa inhibitors and tocilizumab [3].  Though Inflammatory back pain, active sacroiliitis, and plantar fasciitis mislead the diagnosis, rheumatoid nodules and positive anti-CCP antibodies aid the classification of RA.
Risk of New-Onset Inflammatory Central Nervous System Diseases After Tumor Necrosis Factor Inhibitors Treatment for Autoimmune Diseases: A Systematic Review and Meta-Analysis
Authors: Xie Wenhui 
Published: November 2024

Background: Tumor necrosis factor (TNF) inhibitors have been extensively utilized to treat various autoimmune diseases. However, there are ongoing debates about the risk of inflammatory central nervous system (CNS) diseases events following TNF inhibitors therapy, as well as uncertainty about how this risk varies across different autoimmune diseases or TNF blocking agents. We aimed to evaluate the risk of inflammatory CNS diseases after anti-TNF initiation and assess the difference in risk among different types of underlying autoimmune diseases, or TNF inhibitors. Method: Separate searches were conducted across PubMed, EMBASE, and the Cochrane Library from inception until March 1, 2024. Observational studies assessing the association between anti-TNF therapy and inflammatory CNS diseases relative to a comparator group. Study eligibility assessment and data extraction were independently conducted by two investigators following PRISMA guidelines. The risk ratio (RR) was used as the effect measure of the pooled analysis. The primary outcome was the risk of incident inflammatory CNS events after anti-TNF therapy for autoimmune diseases. Secondary analyses were performed based on different types of underlying autoimmune diseases and TNF inhibitors. Results: Eighteen studies involving 1,118,428 patients with autoimmune diseases contributing over 5,698,532 person-years of follow-up were analyzed. The incidence rates of new-onset inflammatory CNS events after initiating TNF inhibitors ranged from 2.0 to 13.4 per 10,000 person-years. Overall, exposure to TNF inhibitors was associated with a 33% increased risk of any inflammatory CNS diseases compared to conventional therapies (RR = 1.36, 95%CI 1.01-1.84; I2 = 49%), mainly attributed to demyelinating diseases (RR = 1.38, 95% CI 1.04-1.81; I2 = 31%). Secondary analyses revealed a similar risk of inflammatory CNS diseases across different types of underlying autoimmune diseases (rheumatic diseases: RR 1.36, 95%CI 0.84-2.21; inflammatory bowel disease 1.49, 95%CI 0.93-2.40; P for subgroup = 0.74) and TNF inhibitors (anti-TNF monoclonal antibodies versus etanercept: RR 1.04, 95%CI 0.93-1.15, I2 = 0%). Conclusions: Compared to conventional therapies, exposure to TNF inhibitors exposure was associated with a 36% increased risk of inflammatory CNS diseases, irrespective of background autoimmune diseases or TNF inhibitor types.
When Diplomats Become Leaders
Authors: Willimek Flora Marlene 
Published: November 2024

Abstract
Challenging assumptions about diplomacy as a self-effacing practice of collective governance, this article searches for leadership in a system that conventionally leaves no room for it.
Drawing on interviews and a Leadership Trait Analysis (lta), it advances an original conceptual framework for identifying and analysing diplomatic leadership in crisis. The cases of Ukraine’s current Ambassador to Germany and his predecessor illustrate the empirical application. The study finds that, under conditions of disrupted routine and increasing public visibility, not only political figures, but also diplomats posted abroad are able to practice a type of leadership. It concludes that eventually personality traits decide whether or not leadership is exercised. Expanding the sparse knowledge about psychological variables in diplomacy, my work finally calls for a more thorough exploration of the synthesis between research on leadership and diplomacy.
When France Advised Syria: Cooperation as a Principle of Recognition, and its Limits
Authors: Tannous Manon-Nour 
Published: November 2024

Abstract
This article is a re-examination of cooperation in international relations through the example of Franco-Syrian relations between 2001 and 2004. I explore how cooperation fulfils – or not – a function of recognition, especially in the case of countries under unequal terms. Based on archival research and interviews, the article analyses three concrete moments of cooperation between Syria and France during this time. While traditional Franco-Syrian cooperation, prior to 2000, was based on a mutual recognition of partners, in the aftermath of presidential change in Syria in 2000 and within the shifting regional context, the Franco-Syrian relationship seemed to be marked by an inequality. Therefore, the article aims to capture the symbols of this recognition between France and Syria, and to study the role of cooperation not only in deepening a bilateral relationship, but – in a new perspective in international relations – in undermining it.
Freedom of Association under the Treaties of the United Nations: A Right of Intrinsic or Instrumental Value?
Authors: McIntyre Ruairi , Cahill Maria 
Published: November 2024

Abstract
Although enshrined within various international instruments of the United Nations, the right to freedom of association is principally developed under the rubric of Article 22 of the International Covenant on Civil and Political Rights. This article seeks to trace the contours of this right with regard to the jurisprudence and commentary of the institutions of the UN. Part ii examines the protections afforded, restrictions permitted, and positive obligations imposed by article 22. Part ii analyses the interaction between article 22 and other rights guaranteed by the iccpr. Part iii seeks to assess the rationale underpinning the protection of the right to freedom of association as protected by the UN treaties. The research finds that the Human Rights Committee has disproportionately framed Article 22 in terms of its political and systemic significance, and have neglected to develop a philosophical basis for the right deriving from its inherent value to the human person.
Freedom of Association in Nigeria: A Cacophony of Contestations
Authors: Amao Femi 
Published: November 2024

Abstract
This article examines the protection and exercise of the right to freedom of association in Nigeria. It discusses the freedom in the context of its historical and political background. The article delineates the ambit of the freedom under the constitution and other relevant legal frameworks in Nigeria. It further examines the nexus between the right and customary norms. It looks at the approach of the Nigerian courts to the interpretation and application of the legal framework. It also examines the influence of the African Charter on Human and Peoples’ Rights in the protection of the right in the country. In addition, the article examines how the legal framework for the right impacts trade unions and civil society organisations, especially in the light of attempts to restrict the freedom.
Freedom of Association in Mexico
Authors: Anzures Gurría José Juan 
Published: November 2024

Abstract
Freedom of association has been constitutionally recognized in Mexico since the mid-19th century. But it has been in recent years that academic scholarship and case law have constructed its content and scope. It is a freedom right that requires the performance of a negative conduct on the part of the State. Its constitutionally protected scope comprises a positive, a negative, as well as a collective dimension. Additionally, it is an instrumental right through which other fundamental rights can be exercised and the constitutional and democratic Rule of Law is consolidated. The greatest academic scholarship and case law development in Mexico refers to two specific types of associations: political parties and labor unions.
A Resource History of US-China Rapprochement
Authors: Vassallo Christopher 
Published: November 2024

Abstract
Facing the prospect of dual crises in domestic production and international supply of oil in the 1970s, Washington looked to an unlikely new source: The People’s Republic of China. Reputable American analysts at the time assessed that China’s near offshore contained reserves on par with the Persian Gulf region. Three consecutive administrations in Washington seriously considered China one geoeconomic “fix” to pressing concerns about concentrated resource dependency, first for oil then later for metals and minerals. During the Nixon Administration, fears of overdependency on producer nations encouraged this turn. By Carter’s time, officials maintained a more expansive view of China’s mineral potential and were committed to transcending oil dependencies partly via a program of investment in Chinese minerals. Though China now represents Washington’s gravest point of dependency, rather than its soundest escape, the fulcrum of the US-China economic relationship today remains the same as in the 1970s: foreign resource dependency.
Sitting less and moving more: the impact of physical activity on mortality in the population of Spain
Authors: de la Cámara Miguel Á , Ortiz Cristina , Granero-Melcon Beatriz , Martínez-Portillo Alejandro , Neira-León Montserrat , Galán Iñaki 
Published: November 2024

Abstract
Background
Sitting time (ST) constitutes a significant aspect of sedentary behavior, and its worldwide escalation raises concerns regarding public health. International guidelines recommend limiting sedentary time and replacing it with physical activity (PA) to reduce the risk of diseases and mortality. This study examines the impact of replacing ST with PA on all-cause, cardiovascular disease (CVD), and cancer mortality in a representative cohort of the population of Spain.

Methods
We included 30 955 participants aged 15–69 years from two National Health Surveys performed in 2011 and 2017. Data were linked to mortality records as of December 2022. Data on ST, light PA (LPA), and moderate-vigorous PA (MVPA) were collected as part of the International Physical Activity Questionnaire at baseline. Isotemporal substitution analysis from Poisson regression models was used to estimate the relative risk ratio (RR) of replacing ST with LPA or MVPA.

Results
During a median follow-up of 5.7 years, 957 deaths were reported. The replacement of 1 h per week of ST with 1 h per week of MVPA was significantly associated with a lower risk of all-cause (3.3%), CVD (6.7%), and cancer mortality (3.1%). Similarly, replacing 1 h per week of ST with 1 h per week of LPA was significantly associated with a lower risk of all-cause (1.6%) and cancer mortality (2.1%). Finally, substituting 1 h per week of LPA with 1 h per week of MVPA was significantly associated with a 7.6% lower risk of CVD mortality.

Conclusions
Substituting one hour per week of ST with an equivalent amount of PA was associated with a lower risk of all-cause, CVD, and cancer mortality.
Effects of different types of intermittent fasting on metabolic outcomes: an umbrella review and network meta-analysis
Authors: Chen Yu-En , Tsai Hui-Li , Tu Yu-Kang , Chen Ling-Wei 
Published: November 2024

Abstract

Background
Intermittent fasting (IF) holds promise for enhancing metabolic health. However, the optimum IF forms and their superiority over continuous energy restriction (CER) remain unclear due to disconnected findings.

Methods
We systematically searched PubMed, Embase, and the Cochrane databases for meta-analyses of randomized controlled trials (RCTs) investigating the association between IF and metabolic health outcomes. Subsequently, we performed an umbrella review and network meta-analysis (NMA) to evaluate the efficacy of different forms of IF (time-restricted eating (TRE), alternate-day fasting (ADF), and 5:2 diet (regular eating for 5 days and energy restriction for 2 days per week)) compared to CER and usual diets on metabolic health outcomes. To assess the certainty of both direct and indirect estimates, we employed the Confidence in Network Meta-Analysis (CINeMA) approach. Additionally, we calculated the surface under the cumulative ranking curve (SUCRA) for each dietary strategy to determine their ranking in terms of metabolic health benefits.

Results
Ten of the best and non-redundant meta-analysis studies, involving 153 original studies and 9846 participants, were included. When considering direct evidence only, all IF forms significantly reduced body weight compared to usual diets. In NMA incorporating indirect evidence, all IF regimens also significantly reduced body weight compared to usual diets. In the SUCRA of NMA, IF ranked higher than usual diets or CER in 85.4% and 56.1% of the outcomes, respectively. ADF had the highest overall ranking for improving metabolic health (ranked first: 64.3%, ranked second: 14.3%).

Conclusions
Overall, all IF forms demonstrate potentials to improve metabolic health, with ADF appearing to produce better outcomes across investigated outcomes. Further high-quality trials are warranted to confirm the (relative) efficacy of IF on metabolic health.

Trial registration
PROSPERO (record no: CRD42022302690).
Comparative meta-analysis of transcriptomic studies in spinal muscular atrophy: comparison between tissues and mouse models
Authors: Kumar Shamini Hemandhar , Brandt Katharina , Claus Peter , Jung Klaus 
Published: November 2024

Abstract
Background
Spinal Muscular Atrophy (SMA), a neuromuscular disorder that leads to weakness in the muscles due to degeneration of motor neurons. Mutations in the survival motor neuron 1 (SMN1) gene leads to the deficiency of SMN protein that causes SMA. The molecular alterations associated with SMA extends across the transcriptome and proteome. Although several studies have examined the transcriptomic profile of SMA, the difference in experimental settings across these studies highlight the need for a comparative meta-analysis to better understand these differences.

Methods and data
We conducted a systematic comparative meta-analysis of publicly available gene expression data from six selected studies to elucidate variations in the transcriptomic landscape across different experimental conditions, including tissue types and mouse models. We used both microarray and RNA-seq datasets, retrieved from Gene Expression Omnibus (GEO) and ArrayExpress (AE). Methods included normalization, differential expression analysis, gene-set enrichment analysis (GSEA), network reconstruction and co-expression analysis.

Results
Differential expression analysis revealed varying numbers of differentially expressed genes ranging between zero and 1,655 across the selected studies. Notably, the Metallothionein gene Mt2 was common in several of the eight comparisons. This highlights its role in oxidative stress and detoxification. Additionally, genes such as Hspb1, St14 and Sult1a1 were among the top ten differentially expressed genes in more than one comparison. The Snrpa1 gene, involved in pre-mRNA splicing, was upregulated in the spinal cord and has a strong correlation with other differentially expressed genes from other comparisons in our network reconstruction analysis. Gene-set enrichment analysis identified significant GO terms such as contractile fibers and myosin complexes in more than one comparison which highlights its significant role in SMA.

Conclusions
Our comparative meta-analysis identified only few genes and pathways that were consistently dysregulated in SMA across different tissues and experimental settings. Conversely, many genes and pathways appeared to play a tissue-specific role in SMA. In comparison with the original studies, reproducibility was rather weak.
Two-phase heat conduction problems with Sturm-type boundary conditions
Authors: Koilyshov Umbetkul , Sadybekov Makhmud 
Published: November 2024

AbstractIn this work, the solution is justified using the method of separation of variables for initial-boundary value problems of the heat conduction equation with piecewise constant thermal conductivity coefficient under Sturm-type boundary conditions (separated boundary conditions). Various cases are considered. A system of eigenfunctions of the corresponding spectral problem is constructed and it is proved that this system of eigenfunctions forms a Riesz basis. The theorem of the existence of a unique classical solution to the problem is proved.
An assessment of quality of life in ESRD patients undergoing hemodialysis
Authors: Abbas Emad Mir , R. Harshavardhan , Mohammed Hafeez , Loona Vikram , K. M. Faseeh 
Published: November 2024

Abstract
Background and aim
Assessment of quality of life in ESRD patients. The quality of life of the patients may be greatly reduced because it necessitates lifelong treatment in the form of renal replacement therapy or hemodialysis. Therefore, the main goal of the study is to evaluate the QOL (quality of life) of patients receiving hemodialysis using WHO QOL criteria.

Methods
At the Dr. B. R. AMCH dialysis unit, a cross-sectional descriptive study involving (n = 134) patients (of whom n = 34 gave negative consent) was carried out over the course of 3 years, from September 10, 2018, to September 10, 2021.

Conclusion
WHO QOL is a trustworthy tool for assessing QOL in ESRD patients. The research indicates that the progression of the illness has a negative impact on both mental and physical health, as well as causing financial strain and strained relationships with others.
Remote Patient Monitoring Using Mobile Health Technology in Cancer Care and Research: Patients' Views and Preferences
Authors: Stuijt Dominique G. , van Doeveren Eva E.M. , Kos Milan , Eversdijk Marijn , Bosch Jacobus J. , Bins Adriaan D. , Bak Marieke A.R. , van Oijen Martijn G.H. 
Published: November 2024

PURPOSE
There is an increasing interest in studying the potential of mobile health (mHealth) technologies, such as smartphone apps and wearables, as monitoring tools for patients with cancer during or after their treatment. However, little research is dedicated to exploring the opinions and concerns of patients regarding the adoption of these technologies. This study aimed to gain insight into patients' perspectives and preferences for participating in mHealth-based monitoring in cancer care.

METHODS
A qualitative study comprising semistructured interviews was conducted in the Netherlands between April and June 2023. Participants were eligible if they were 18 years or older with a current or past diagnosis of cancer. The interview guide was developed on the basis of the technology acceptance model, with main themes being use, communication, trust, privacy, and expectations.

RESULTS
Thirteen participants with urologic primary cancer were interviewed. Most patients had already some familiarity with the use of digital monitoring devices or wearables. Main barriers included persistent reminders of the illness, receiving notifications deemed unnecessary or unwanted, and the acknowledgment that mHealth technology does not serve as a substitute for human doctors. Conversely, patients recognized the potential for time-savings through the utilization of mHealth, viewed active monitoring as nonburdensome, considered mHealth a tool for reducing the communication threshold with their doctor, and expressed willingness to adopt such a platform if they perceived personal or societal relevance.

CONCLUSION
This study has elucidated which factors are important for successful development of mHealth for patients with cancer. While both barriers and facilitators play a role, patients' attitudes were positive toward the implementation of remote digital monitoring, showing promising prospects for future research of mHealth in oncology.