bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Canadian Prospective Cohort Study to understand progression in multiple sclerosis: baseline characteristics
Authors: Oh Jiwon , Arbour Nathalie , Giuliani Fabrizio , Guenette Melanie , Kolind Shannon , Lynd Larry , Marrie Ruth Ann , Metz Luanne M. , Prat Alexandre , Schabas Alice , Smyth Penelope , Tam Roger , Traboulsee Anthony , Yong Voon Wee , Patten Scott B. 
Published: September 2024

Background: Disease progression is observed across the spectrum of people with multiple sclerosis (MS) and identification of effective treatment strategies to halt progression remains one of the greatest unmet clinical needs. Objectives: The Canadian Prospective Cohort Study to Understand Progression in MS (CanProCo) was designed to evaluate a wide range of factors associated with the onset and rate of clinical disease progression in MS and to describe the interplay between these factors. Design: A prospective cohort study. Methods: CanProCo is a national, prospective, observational cohort study that has recruited 944 individuals from 5 large academic MS centers in Canada. Participants include people with radiologically isolated syndrome (RIS), early relapsing-remitting and primary progressive MS (RRMS, PPMS), and healthy controls (HCs). Annually, participants complete self-reported questionnaires, undergo clinical evaluation and, if clinically indicated, magnetic resonance images (MRIs) of the brain and cervical spinal cord; in a subset of participants ( n = 399), blood, and research MRIs of the brain and cervical spinal cord are collected. Linkages to health administrative databases are available at three sites. Results: Overall, 944 participants were recruited (53 HCs, 63 RIS, 751 RRMS, 77 PPMS). RIS and MS participants had a mean age of 39.0 years and 70.5% female. The mean time since diagnosis was 2.7 years. There were differences observed in the Expanded Disability Status Scale score and components of the MS performance test (walking speed test, manual dexterity test, processing speed test, and low-contrast visual acuity) between RIS and MS subtypes. Questionnaires revealed more symptoms of depression and anxiety and impaired physical and mental quality of life in people with RIS/MS versus HCs and differences across RIS/MS subtypes. Conclusion: Physical and mental neurological disability is prevalent even in the earliest stages of MS. Transdisciplinary approaches such as those used in CanProCo are needed to better characterize clinical progression in MS. Additional CanProCo results, including MRI, biological, and pharmaco-economic data will be forthcoming. Going forward, CanProCo’s data sharing and collaborative vision will facilitate numerous global collaborations, which will inform the development and implementation of effective interventions for people with MS around the world.
NingXueShengBan Decoction Regulates Immune Homeostasis by PI3 K/Akt/mTOR and TLR4/NF-κB Signaling Pathways in Immune Thrombocytopenia Patients
Authors: Wang Haijin , Wang Mengxiao , Yang Wuxia , Ni Runfeng , Ma Lin , Wang Dan , Yan Chao , Wu Yuhong , Liu Baoshan , Wang Aidi 
Published: September 2024

Objective Immune thrombocytopenia (ITP) is an autoimmune hemorrhagic disease. The immune imbalance of T cells is an essential pathological mechanism of ITP, more specific, the balance of Effector T cells (Teff)/Regulatory T cell (Treg) maintains T cell immune homeostasis. Dendritic cells (DC), the largest antigen-presenting cell, interfere with T cell differentiation pathways and exert immune regulatory functions. Our team created and applied the “ NingXueShengBan” (NXSB) decoction. According to our prior studies, we found that NXSB decoction could restore Th17/Treg balance in ITP mice by regulating protein expression in Notch pathway. Therefore, we further research the mechanism of NXSB decoction that regulates ITP immune homeostasis through affecting the interaction between DC and T cells. Methods In this study, we collected peripheral blood from health donors and ITP patients and extracted DC and CD4 + T cells then grouped in control group, model group and NXSB group. Moreover, we established a co-culture model simulating the immune environment in ITP patient to further investigate whether NXSB had therapeutic effects by the interaction between DC and CD4 + T cells. Results In the current study, we found that NXSB decoction potently regulated interaction between DC and T cells by inhibiting DC development and function, specifically, the differentiation of CD4+ T cells was inhibited after NXSB decoction intervened. Our data showed that NXSB decoction inhibited Toll-like receptor 4 (TLR-4), reduced the expression of Nuclear factor kappa-B (NF-κB) and led to the reduction of downstream inflammatory factors, thereby inhibiting the inflammatory response. More importantly, NXSB decoction reduced the DC surface expression of activation and maturation markers. Moreover, we detected that the decreased expression of the phosphorylated Phosphatidylinositol 3-kinase (PI3 K), Protein kinase B (Akt), Mammalian target of rapamycin (mTOR), and their downstream effectors indicated, we found that NXSB decoction could inhibit PI3 K/Akt/mTOR signaling pathways significantly. Conclusions Collectively, our data suggested that NXSB decoction ameliorates ITP-induced immune imbalance via its anti-inflammation and immunosuppressive by regulating TLR-4/ NF-κB and PI3 K/Akt/mTOR signaling pathways.
Exploring the Effects of Different Processing Techniques on the Antitussive Expectorant of Platycodon grandiflorus by Metabonomics and Pharmacologic Methods
Authors: Zhao Shuting , Xv Jingying , Tang Miaomiao , Hou Wei 
Published: September 2024

Background and Purpose Platycodon grandiflorum is a traditional Chinese herbal medicine, which can disperse lung, promote pharynx, dispel phlegm and expel pus. Its processing history was first seen in the “Zhou Hou Bei Ji Fang” of the Jin Dynasty in China. Through processing, effective substances in plants can be enriched and negative substances can be reduced. Therefore, this study explored the effects of different processing methods on the antitussive and expectorant effects of Platycodon grandiflorum through metabolomics and pharmacology, aiming to provide a theoretical basis for clinical application. Experimental Approach The changes of metabolites before and after processing of Platycodon grandiflorum were analyzed by Nexera UHPLC LC-30A-HILIC-Orbitrap-Q Exactive HF-X platform. The antitussive and expectorant effects of processed Platycodon grandiflorum were verified by mouse concentrated ammonia induced cough method and tracheal phenol red drainage method. Key Results After processing, some metabolites of Platycodon grandiflorum changed, among which 24 kinds of terpenoid metabolites changed significantly. Through the experiment of ammonia-induced cough in mice and phenol red expectorant experiment, it was found that fresh JZI 40%, fresh CZ 80%, dry JZZ 40% and dry JZI 80% had obvious antitussive effect, and dry JZZ 40% had obvious expectorant effect. Conclusions and Implications Some processing methods can indeed further improve the antitussive and expectorant effects of Platycodon grandiflorum, which may be due to the effect of increasing the content of triterpenoids after processing, but the mechanism of processing to improve the effect of relieving cough and expectorant needs further study.
Antimicrobial Prescription Patterns for Acute Sinusitis 2015–2022: A Comparison to Published Guidelines
Authors: Dhar Sarit , Kothari Dhruv S. , Tomescu Ana L. , D’Anza Brian , Rodriguez Kenneth , Sheyn Anthony , Rangarajan Sanjeet V. 
Published: September 2024

Background Acute rhinosinusitis (ARS) is one of the most encountered conditions in primary care and otolaryngology clinics. However, little is known about how antibiotic prescription practices following a diagnosis of ARS compare to guidelines set forth by the American Academy of Otolaryngology in 2015. Objective To investigate the epidemiology of ARS and the corresponding antibiotic prescribing practices by physicians and compare to published guidelines. Methods Using the TriNetX Live database, we identified all patients diagnosed with ARS using the ICD10 code J01 between April 2015 and December 2022 across the state of Tennessee. After investigating the demographics of this cohort, we compared the first prescribed antibiotic within one day of ARS diagnosis to published guidelines. Antibiotics were grouped into their respective classes. Results Of 81 310 patients diagnosed with ARS identified in the specified time frame, 66% were Female, 49% were African American, 44% were White, and the mean age was 47 ± 20 years. The six most common initial antibiotics prescribed for ARS were erythromycins/macrolides [14 609 (25.8%)], amoxicillin/clavulanate [14 322 (25.3%)], amoxicillin [9300 (16.4%)], third generation cephalosporins [7733 (13.6%)], quinolones [3648 (6.4%)] and tetracyclines [2235 (3.9%)]. Of this cohort, 56 719 patients (69.8%) of patients were prescribed an antibiotic within one day of diagnosis. Conclusion Despite published guidelines recommending amoxicillin with or without clavulanic acid as first-line treatment for ARS, only 42.2% of prescribed antibiotics followed this guideline in our cohort. While accounting for patients with penicillin allergy, the second-most represented antibiotics were erythromycins/macrolides, which are specifically recommended against due to high rates of S. Pneumoniae resistance. Our results suggest that further investigation into the causes of erythromycin/macrolide prescriptions as first line treatment for ARS and practices at other institutions should be conducted. In addition, building awareness around published ARS guidelines for physicians may be useful in improving antibiotic stewardship in treatment of ARS.
Large subserous uterine leiomyoma presenting as intraabdominal tumor: A case report
Authors: Ashindoitiang John A , Canice Nwagbara Victor I , Edet Ekpo E , Ugbem Theophilus Ipeh , Ukam Joseph S , Asuquo Maurice E 
Published: September 2024

Uterine leiomyomas are common benign gynecological tumors due to the overgrowth of uterine smooth muscle. Pedunculated uterine leiomyoma occurs when the mass is in continuity with the uterus with a stalk and may grow either within the uterine cavity or outside of the uterus and may mimic ovarian neoplasms or intraabdominal tumors. Presented is a 28-year-old woman with a progressive abdominal swelling in the past 9 months seen at the surgical outpatient of our facility. Preoperative CT suggested a diagnosis of an intrabdominal cystic. She had laparotomy and was offered myomectomies on account of a large subserous uterine mass arising from the right side of the uterine fundus, small subserous fundal mass, intramural mass in the left side of the fundus and a cervical mass. Histology confirmed multiple uterine leiomyomas with extensive cystic degenerative changes of the large subserous uterine myoma and adenomyosis of the left fundal mass. Detecting the continuity of an abdominal mass even with extensive degenerative changes mimicking a cyst in continuity with the uterus by a pedicle sign on imaging in the absence of ascites should arouse the diagnosis of pedunculated subserosal leiomyoma. This should be further heightened when it is found in association with cervical myoma. Subserous uterine leiomyoma should be considered in a patient of childbearing age with a grossly distended abdomen without obvious evidence of pregnancy or malignancy. Large subserous uterine leiomyoma in an intraabdominal location may present with diagnostic and surgical challenges that require interdisciplinary cooperation.
Comparative analysis of blast prediction software for far-field shock wave effects behind a blast wall
Authors: Chester Alastair , Hazael Rachael , Critchley Richard 
Published: September 2024

This paper investigates a selection of current and emerging software used in the prediction of overpressure generated through the detonation of a high explosive in the far field behind a blast wall. In particular, this paper compares the software Autodyn, blastFoam, ProSAir, Viper::Blast and WALAIR++. These packages are compared by simulating a 100 kg TNT explosive charge at a stand-off distance of 25 m from a complex structure, then reviewing the performance in terms of the overpressure results, speed of each modelling package, the degree of effect from mesh, and domain sizes and ease of use. A live experimental trial representing the simulation was also performed, although it used a similar but different explosive, for a high-level comparison. The live-trial instrumentation design details are reviewed and compared with best practice. The choice of software is found to lead to variations in peak pressure predictions of 28%, specific impulse by 10% and the simulation speed can vary by a factor of up to 1600 for this type of study. This shows that the choice of blast software package can have a significant impact on the accuracy and attainability of blast predictions.
Fetal exposure to isotretinoin in Saudi Arabia: a multicenter real-world data analysis from 2015 to 2020
Authors: Albogami Yasser , Almadani Ohoud , Almohareb Sumaya N. , Alshehri Sultan , Alkhaibari Abdullah , Anzan Mona , Alsharif Alaa , Alhossan Abdulaziz , Alrwisan Adel 
Published: September 2024

Background: Despite its high efficacy in treating severe acne, isotretinoin is associated with serious side effects, including teratogenicity. However, the extent of isotretinoin exposure during pregnancy in Saudi Arabia remains unknown. Objectives: This study aims to quantify the extent of fetal exposure to isotretinoin in Saudi Arabia and to evaluate adherence to risk minimization measures approved by the Saudi Food and Drug Authority. Design: Retrospective cohort study. Methods: This multicenter retrospective study included a cohort of 6233 women of childbearing ages (WCBAs) who had received isotretinoin therapy between 2015 and 2020. Exposure to isotretinoin use was ascertained from patients’ electronic health records and was defined as any positive pregnancy test (urine or serum) or any diagnosis or procedure related to pregnancy occurring during the risk period. We defined the risk period starting from isotretinoin initiation until up to 30 days after the last prescription. We quantified the overall incidence proportion of fetal exposure to isotretinoin by dividing the number of pregnancy cases during the risk period by the total study sample of WCBAs. Results: The cohort predominantly included young females (20–29 years), with a mean age of 24 years. Only 5% of the WCBAs used contraceptives, and 10% have a record of pregnancy testing. During the risk period, 34 pregnancies were identified, yielding a cumulative pregnancy incidence of 5.6 per 1000 WCBAs. Pregnancy outcomes for exposed women were about 5% of births had defects, while abortions accounted for 14.3% of pregnancies. Conclusion: Our investigation shows an alarming incidence of fetal exposure to isotretinoin in Saudi Arabia, substantially surpassing global estimates. These results underscore a critical need for enhanced interventions and robust risk minimization strategies tailored to the distinct challenges faced by the Saudi Arabian population.
Clinical and diagnostic features of central nervous system tuberculosis in Indian children – a descriptive study
Authors: Daniel Bella Devaleenal , Selladurai Elilarasi , Balaji Sarath , Venkatesan Arunagirinathan , Venkatesan Mythily , Giridharan Prathiksha , Shanmugam Sivakumar , Natrajan Saravanan , Karunaianantham Ramesh , Kandasamy Devika , Subramani Rajakumar , Muthuramalingam Kannan , Pramila Snegha K. , Hissar Syed , Dooley Kelly E. , Thakur Kiran T. 
Published: September 2024

Background: Children with tuberculous meningitis (TBM) present with diagnostic challenges as they often have atypical clinical features. Objective: To describe the baseline characteristic features of children diagnosed with central nervous system (CNS) TB (TBM and tuberculoma). Design: Retrospective descriptive study. Methods: Children less than 12 years presenting with neurological signs and symptoms were assessed for a therapeutic TBM trial eligibility. The results of their clinical, laboratory, neuroimaging, cerebrospinal fluid evaluations were analysed for TBM diagnosis. Results: Of 600 children evaluated, 61(10%) had CNS tuberculosis; TBM 47, tuberculoma 14. 20(33%) had definite TBM. Mean age of children with TBM was 5 ± 3.4 years. Of 47, 13(28%), 21(45%) and 13(28%) had grade I, II, and III disease respectively. Abnormalities suggestive of TBM in MRI and computed tomography brain were observed in 76% (26/34) and 77% (24/31) respectively. Abnormal cerebrospinal fluid white blood cell count, protein and glucose were observed in 56% (24/43), 49% (22/45), 47% (21/45) respectively. Among 41 patients with TBM followed up until discharge, five died. Conclusion: Younger children with TBM have severe forms. Confirmatory results may not be available in all. A holistic approach to care including addressing complications of hydrocephalus and strokes is needed.
Exploring small stories of older adults elicited by virtual nature videos with a randomized online survey
Authors: Otten Kars , van Rompay Thomas JL , van ‘t Klooster Jan-Willem JR , Gerritsen Debby L , Westerhof Gerben J 
Published: September 2024

Objective Counteracting feelings of loneliness among older adults underscores the need to improve social well-being, for example, by sharing small stories. Interestingly, virtual representation of nature (VN) can stimulate social aspirations and trigger associations, which could be used as conversational material. Especially nature's characteristics of mystery and spaciousness seem promising. Therefore, it was investigated whether VN can elicit small stories in older adults using a randomized 2 (mystery: low vs. high) × 2 (spaciousness: low vs. high) design. Methods In total 118 participants (60 years and older) were recruited. Small stories, nature-relatedness, available nature opportunities and demographics were measured. The small stories were analysed with respect to story elements (sum range: 0–4) and storytelling characteristics (ease of storytelling, valence, social intention). Results The VN were able to elicited small stories: 97% ( N = 115) contained at least one story element. Moreover, when participants felt more related to nature and assigned more positive valence to their story, they also had stronger intentions to use their story for social interaction. The VN characteristics of mystery and spaciousness showed no effects. Conclusion Not so much the characteristics of nature (mystery and spaciousness) as the characteristics of the participants (nature-relatedness) played an important role in eliciting and sharing small stories.
Identification of required capabilities of digital health ecosystems when preventing and managing non-communicable diseases
Authors: Pikkarainen Minna , Iivari Marika , Gomes Julius F , Kaartinen Jouni , Xu Yueqiang , Hong-Gu He , Gazerani Parisa 
Published: September 2024

Objective Non-communicable diseases cause annual mortality for 41 million people worldwide. These diseases include coronary heart disease, cancer, stroke, diabetes, and musculoskeletal as well as mental disorders. Innovation ecosystems in healthcare are multifactor networks in which different stakeholders interact together to create socio-economic (patient and cost) value via research, co-creation, and traditional market activities. Although there is much evidence about the impact of digital health interventions and the capabilities needed to support individual actors and specific diseases in non-communicable disease prevention and management, the current understanding of the concept of innovation ecosystems associated with theories is not well understood. There is also a lack of research about innovation ecosystems in the healthcare context. Or understanding of the holistic perspective of the capabilities needed in innovation ecosystems to support future digital health. The objective of this study was to answer this research gap by identifying what capabilities are needed in future digital health ecosystems related to people with non-communicable diseases or at risk of non-communicable diseases. By doing this, the study will help different organisations and policies address this very challenging situation. Methods To answer this objective, a qualitative interview-based study including 34 semi-structured interviews was conducted in Finland. Complex adaptive systems theory was used as a theoretical lens to analyse empirical data. Results and conclusion Several new capabilities were identified for digital health innovation ecosystems to make organisation managers and policymakers aware of how to deal with future health system demands. From the organisational perspective, capabilities are needed to use non-medical and heterogeneous data to support better treatments and clinical decision-making and provide better and safer data access. From the management perspective, hospitals need capabilities to allow critical experts to participate in innovation work, and overall, all ecosystem actors need capabilities to orchestrate research and innovation actions in the area of digital health.
Factors Contribution to Differences of Green Innovation in China
Authors: Li Meng , Tian Zengrui , Liu Qian , Li Xinru 
Published: September 2024

Green innovation has become one of the most effective ways to deal with ecological problems such as environmental pollution, global warming and resource depletion. A comprehensive and accurate understanding of regional differences and influencing factors of green innovation level is of great significance further to promote green innovation and to realize the harmonious coexistence between man and nature. This paper analyzes the regional differences of green innovation level in China from 2011 to 2020 by using GDI, Moran’s I, Getis-Ord Gi*, and other indices at provincial, urban agglomeration and prefecture-level city scales, and identifies with geographical detectors, the leading factors influencing the spatial differentiation of green innovation level as well as their interactions. The results show that from 2011 to 2020, the overall level of green innovation in China gradually improves and the regional differences gradually decrease, and that the smaller the scale, the greater the regional differences. Green innovation level increases with the increase of urban agglomeration level and the expansion of city scale. There are differences in the spatial structure features of green innovation level at different scales, the degree of spatial agglomeration decreases as the scale reduces. At provincial and prefecture-level city scale, areas of higher green innovation level are mainly located at the east side of Hu Line, while at the urban agglomeration scale, they are mainly national urban agglomerations such as Yangtze River Delta and Pearl River Delta, and regional urban agglomerations such as Ha Chang and Shandong Peninsula Urban Agglomeration. The leading factors influencing the spatial differentiation of green innovation level and their interactions vary with the different scales. At provincial and prefecture-level city scales, the core factors are venture capital level, quality of faculty and education level. On the scale of urban agglomeration, the core factors are venture capital level and economic level. JEL Classification: M10, O32, R12.