bluuebunny/crossref_metadata_2025_split huggingface dataset:
HDL-C mediates the causal relationship between serum urate and aortic aneurysm: a Mendelian randomization study
Authors: Xu Yani , Wu Chenyang , Yao Lina , Liu Yanping , Hao Panpan 
Published: September 2024

Background and purpose:
Studies have indicated a close relationship between serum urate and an increased risk of aortic aneurysm or aortic dissection. However, the causality between them and the mediators of this association have not been identified. This study employs bidirectional and multivariable Mendelian randomization (MR) to investigate the causality between serum urate and aortic aneurysm or dissection and identify mediators of this relationship.

Methods:
We first investigated the causal association between serum urate and aortic aneurysm or aortic dissection using two-sample bidirectional MR, with the inverse-variance-weighted method as the principal analysis technique. Subsequently, we applied multivariable MR to determine probable mediators.

Results:
Genetically serum urate levels were linked to an increased risk of aortic aneurysm (odds ratio [OR]: 1.160, 95% confidence interval [95% CI]: 1.011–1.332, P = 0.034), with high-density lipoprotein cholesterol (HDL-C) mediating this causal relationship, accounting for 10.2% of the effect. No causal relationship was found between serum urate and aortic dissection.

Conclusions:
Serum urate is a risk factor for aortic aneurysm, and this causal relationship is mediated through HDL-C. Monitoring HDL-C levels in patients with hyperuricemia is essential to prevent and slow the progression of aortic aneurysm.
Chinese Clinical Practice Guidelines for the Prevention and Treatment of Mother-to-Child Transmission of Hepatitis B Virus (Version 2024)
Authors: Liu Jinfeng , Zeng Qinglei , Ji Fanpu , Ren Hong , Zhang Wenhong , Li Lanjuan , Zhao Yingren ,   Infectious Diseases Physicians Branch of Chinese Medical Doctor Association, Chinese Society of Infectious Diseases of Chinese Medical Association
Published: September 2024

Abstract
The Chinese Clinical Practice Guidelines for the prevention and treatment of mother-to-child transmission of hepatitis B virus, developed by the Chinese Society of Infectious Diseases of the Chinese Medical Association in 2019, serves as a valuable reference for standardizing the process of preventing mother-to-child transmission in China. As new evidence emerges, it is crucial that timely and regular updates are made to the clinical practice guidelines so as to optimize guidance for clinical practice and research. To this end, the Infectious Disease Physician Branch of Chinese Medical Doctor Association and the Chinese Society of Infectious Diseases of Chinese Medical Association, in collaboration with multidisciplinary experts, have updated the guidelines based on the latest domestic and international research advancements and clinical practice, in order to provide guidance and reference for clinicians and maternal and child healthcare workers.
A Web-Based Education Program About Primary Palliative Care for Heart Failure
Authors: Togashi Shintaro , Wakabayashi Rumi , Takehara Ayumu , Higashitsuji Asahiko , Ikarashi Aoi , Nakashima Naoko , Tanaka Naoko , Nakano Naomi , Shibata Tatsuhiro , Oishi Shogo , Sakashita Akihiro 
Published: September 2024

Background
The number of patients with heart failure (HF) is rapidly increasing as palliative care is being integrated into HF management and the need for a nursing workforce to meet these demands grows. To address this, we have developed a Web-based educational program on primary palliative care for HF among general registered nurses caring for patients with HF in Japan.

Objective
The aim of this study was to evaluate the program's effectiveness on nurse-reported palliative care practice, difficulty, and knowledge.

Methods
In this open-label, individual-level, wait-listed randomized controlled trial, 150 Japanese general registered nurses, with experience in caring for patients with HF and clinical ladder level ≥ 2 in inpatient, outpatient, and home-visiting care settings, will be randomly divided (1:1 ratio) into a Web-based educational program group and a wait-list control group. The follow-up period is 6 months after the intervention. The primary outcome is the nurse-reported practice score in primary palliative care, and the secondary outcomes are the nurse-reported difficulties score and knowledge score.

Conclusions and Clinical Implications
We herein describe the study protocol of a wait-listed randomized controlled trial regarding a Web-based educational program, which is a novel approach for these nurses. If the results of this study support our hypothesis, they could help expand primary palliative care, including daily nursing practices, such as symptom management and interdisciplinary collaboration, in the field of cardiovascular nursing.
Ten-year evaluation on efficacy, safety, and predictability of femtosecond laser corneal small incision lenticule extraction for correction of myopia and myopic astigmatism: a case series
Authors: Zhao Guo-Hong , Zhang Li-Jun , Sun Yan , Wang Jin-Da , Chen Chang-Xi , Cao Kai 
Published: September 2024

Objective:
The objective was to evaluate the 10-year long-term outcomes of patients undergoing small incision lenticule extraction (SMILE).

Methods:
In this continuous case series, the authors enrolled a total of 113 patients (208 eyes) who underwent SMILE 10 years prior. Measured parameters included uncorrected visual acuity (UCVA), corrected distance visual acuity (CDVA), and cycloplegia spherical equivalent error (SER).

Results:
One hundred thirteen patients were enrolled in this study. Patients’ age ranged from 18 to 44 years (mean: 30.2 years). One hundred ninety-three eyes (92.8%) and 176 eyes (84.6%) had an UCVA≥20/20 at 3 months and 10 years postoperatively. The mean efficacy index, measured at 3 months and 10 years postoperatively, were 1.041 and 1.023, respectively; the difference was not statistically significant. Three months after the operation, best-corrected visual acuity (BCVA) decreased by 1 line in 19 eyes (9.1%), remained unchanged in 158 eyes (76.0%), and increased by ≥1 line in 31 eyes (14.9%). Ten years after operation, BCVA decreased by 2 lines in 15 eyes (7.2%) and by 1 line in 35 eyes (16.8%); remained unchanged in 142 eyes (68.3%); increased ≥1 line in 16 eyes (7.7%). The mean safety index, measured at 3 months and 10 years postoperatively, were 1.147 and 1.331, respectively; the difference was not statistically significant. The mean SER at 3 months and 10 years postoperatively was −0.112 and −0.276, respectively; the difference was statistically significant.

Conclusion:
There was a decrease in SER 10 years after SMILE surgery compared with 3 months postoperatively, there was no significant decrease in the efficacy index or safety index.
Knowledge attitude and practice towards foreign body aspiration management among kindergarten teachers in south-west Amhara, rural Ethiopia
Authors: Belete Kumlachew G. , Tamire Tadese , Sisay Amanuel , Asmare Mekuanint , Dessie Belayneh , Muluadam Belete , Adamu Abrehet , Dessalegn Kaletsidk , Yalew Getachew A. , Oumer Keder E. 
Published: September 2024

Background:
Aspiration of a foreign body (FB) is the act of unintentionally ingesting food, drink, or typically items. In every country on earth, it is the main cause of death. Aspirations of a foreign body in kids are typically emergency situations and account for a significant part of accidental fatalities. Problems are made worse by a lack of community understanding about foreign body aspiration.

Objective:
To assess the level and determinants of knowledge, attitude, and practice towards the first aid management of foreign body aspiration and airway obstruction among kindergarten teachers in northwest Amhara, Ethiopia, 2022.

Methods:
An institution-based cross-sectional study was undergone on kindergarten teachers.

Result:
The result of this study showed that 78.4% of the participants had good knowledge or scored equal or more than the mean score. The total score of the attitude was calculated by rating the respondent’s correct-full responses on the attitude questions; a total of 337 (93.4%) answered all the six questions above the mean level of 5.98, indicating that 93.4% of the respondents have a positive attitude.

Discussion:
In the present study, 78.4% of kindergarten teachers demonstrated good knowledge. In contrast, a study conducted in Addis Ababa, and Ethiopia, revealed that only 37% of participants exhibited good knowledge regarding foreign body aspiration management, significantly lower than the current study’s findings. Additionally, the same study found that 93% of kindergarten teachers held a positive attitude toward foreign body aspiration management, aligning with the results of a cross-sectional study in Addis Ababa, and Ethiopia, where the attitude score was 95.1%.

Conclusion and recommendation:
The result of this research shows that majority participants of this study have good knowledge and attitude towards foreign body aspiration management, but poor practice about it.
Breaking boundaries: exploring recent advances in anticoagulation and thrombosis management: a comprehensive review
Authors: Qureshi Zaheer , Altaf Faryal , Jamil Abdur , Siddique Rimsha , Shah Shivendra 
Published: September 2024

Background:
Thromboembolic disorders globally contribute to morbidity and mortality, emphasizing adequate anticoagulation and thrombosis management. Therapeutic advances are essential in preventing complications like pulmonary embolism, stroke, and myocardial infarction. This review summarizes recent anticoagulation advances, current challenges, future directions, and novel anticoagulants and drug delivery systems on clinical outcomes.

Methods:
This paper assesses the effectiveness and safety of new anticoagulants through a systematic review of recent clinical trials, meta-analyses, and guideline publications. Key studies, including PACIFIC-AF, RIVER, ENAVLE, ENVISAGE-TAVI AF, and ARCADIA, were analyzed to provide a perspective on therapeutic advancements.

Results:
The review highlights key findings from vital clinical trials. Asundexian, in the PACIFIC-AF trial, demonstrated a 34% reduction in bleeding events compared to Apixaban. In the RIVER trial, Rivaroxaban reduced significant bleeding events by 20% compared to warfarin in patients with bioprosthetic mitral valves. In the ENAVLE trial, Edoxaban achieved a 3.7% decrease in thromboembolic events compared to warfarin without increasing significant bleeding rates. In the ENVISAGE-TAVI AF trial, edoxaban was noninferior to VKAs in preventing thromboembolic events but showed a slight increase in major bleeding events by 1.5%. Lastly, the ARCADIA trial highlighted that apixaban did not significantly reduce recurrent stroke risk compared to aspirin, with both treatments having an annualized stroke rate of 4.4%.

Conclusion:
Advances in anticoagulant therapies and drug delivery systems aim to enhance patients’ clinical outcomes for thromboembolic disorders. While recent trials show promising data, ongoing patient-specific responses and monitoring challenges require further research. Continuous innovation and investigation are essential to refine anticoagulation practices and tailor treatments.
Self-diagnosis and self-medication based on internet search among Non-Medical University students of Karachi
Authors: Raja Adarsh , Bin Amin Shafin , Azeem Bazil , Raja Sandesh , Aftab Yusra , Rafi Maham , Abheman Fnu , Sukhani Kumar , Mal Piyasi , Ul-Ain Noor , Manan Fazal , Aqeel Rabbia , Rahat Hamza , Ali Pervaiz , Kumar Naresh , Khan Kiran , Sharma Varsha 
Published: September 2024

Background:
For a decade, the topic of self-diagnosis and self-medication has gained significant attention due to the widespread availability of information on the internet and over-the-counter medication. This research explores the rational considerations behind individuals’ self-diagnosis and self-medication practices. Our main objective is to find out the frequency of self-diagnosis and self-medication in the general population and its associated risks and benefits.

Methods:
A cross-sectional community-based prospective study was conducted over 7 months and included 160 students from various nonmedical universities in Karachi. A questionnaire regarding baseline characteristics, self-medication, and self-diagnosis was made, and the data was collected from the participants and then analyzed using SPSS statistical software.

Results:
One-fifth of the participants used the method of diagnosing themselves regularly, whereas 9% of the involved population demonstrated medicating themselves very often. However, most of the population had self-diagnosed (50.6) or self-medicated (61.9) sometimes. The internet was the primary source of searching (75%), and home remedies were the preferred medications (71.7%). The two primary reasons for this were the scarcity of time and resources.

Conclusion:
Overall, our study points out the significance of self-medication and self-diagnosis among different nonmedical students of Karachi. Teaching people about medicines, enforcing strong prescription policies, and providing medical facilities are vital steps toward preventing this problem. The role of doctors and medical students is significant; therefore, detailed doctor-patient communication needs to be encouraged.
A case of invasive Aspergillus niger spondylodiscitis with epidural abscess following COVID-19 infection in an immunocompromised host with literature review
Authors: Borni Mehdi , Kammoun Brahim , Elleuch Kammoun Emna , Boudawara Mohamed Z. 
Published: September 2024

Introduction and Importance:
Aspergillosis is defined as an opportunistic infection that may spread hematogenously. COVID-19 infection has not been reported as a direct cause or risk factor. Its treatment (e.g. corticosteroids) significantly increases the risk for invasive infections. The respiratory system remains the main target, and the Aspergillus fumigatus is the most responsible subtype. Other species like Aspergillus (A) flavus, A. niger, and A. nidulans follow in frequency. Other included sites are the skeletal muscular system and the entire spine leading to spondylodiscitis. Only a total of 118 cases of Aspergillus spondylodiscitis have been reported in the literature, and only 21 cases reporting spinal epidural abscess were identified.

Case Presentation:
The authors report a new rare case of invasive A. Niger spondylodiscitis with epidural and iliopsoas abscesses in a 63-year-old North African female patient with a history of coronavirus infection (COVID-19) treated with high doses of corticosteroids. The patient had favorable medical and radiological outcomes after 6 months of antibiotic and antifungal therapy.

Clinical Discussion:
Fungal spondylodiscitis is a rare pathology that may be lethal. Immunosuppression plays a determining role. Discovertebral contamination results from hematogenous dissemination, found in the majority of cases in adults. The main symptom is segmental spinal pain, with an inflammatory pattern most often predominating in the thoracolumbar spine. Clinical signs of spinal cord compression, such as paresthesias, radiculalgia, and paraplegia, can sometimes be associated. Diagnosis of such spondylodiscitis is based on cultures and/or histology, whereas in most cases, it was made by MRI. Epidural abscess remains a rare entity. The authors will explore the current literature in more detail to dissect and explain this rare entity.

Conclusion:
Aspergillus spondylodiscitis remains a rare and very demanding clinical entity. Early diagnosis and well-targeted medical treatment seem the ideal solution given that this type of infection has a poor prognosis.
Trends in malignant neoplasm of bone and articular cartilage related mortality among older adults in United States (1999–2020)
Authors: Haseeb Abdul , Muhammad Umer Nasrullah Rana , Siddiq Mohammad Arham , Alim Ur Rahman Hafsah , Ali Syed Muhammad Sinaan , Advani Damni , Kumar Laksh , Shafique Muhammad Ashir , Mustafa Muhammad Saqlain , Raja Sandesh , Raja Adarsh , Abbasher Hussien Mohamed Ahmed Khabab 
Published: September 2024

Introduction:
Malignant neoplasms of bone and articular cartilage, although rare, are associated with substantial morbidity and mortality, posing a serious health burden. Understanding the trends in mortality related to these cancers is crucial for developing targeted interventions and improving patient outcomes. This study aims to analyze long-term mortality trends, identify demographic and geographic disparities, and uncover potential factors driving changes in mortality rates.

Methods:
This retrospective study analyzed mortality rates among individuals aged 65 and older from 1999 to 2020 using CDC WONDER death certificate data, abstracting demographics, geographic factors, and urban/rural status.

Results:
From 1999 to 2020, 18,205 adults aged 65 and older died from malignant neoplasms of bone and cartilage. The age-adjusted mortality rate (AAMR) started at 20 per 100,000 in 1999 and steadily declined until 2012 (APC: −1.12). However, from 2012 onwards, there was a notable reversal, with the AAMR rising sharply to 23.8 by 2020 (APC: 4.73). Men had higher mortality rates than women, with NH Black individuals showing the highest rates among races. Southern states and nonmetropolitan areas had elevated AAMRs, suggesting targeted interventions for better outcomes and lower death rates.

Conclusion:
The findings highlight significant inequities, with Southern states and nonmetropolitan areas showing elevated age-adjusted mortality rates (AAMRs). These geographic disparities underscore the urgent need for targeted public health interventions in these regions to improve cancer outcomes and reduce mortality. Addressing these gaps is essential for achieving more equitable health outcomes, particularly in high-risk populations.
Prevalence of Axial Spondyloarthritis in Young People With Chronic Low Back Pain at a Hospital-Based Health Management Organization
Authors: Tobar Jaramillo Mayra Alejandra , Marín Zúcaro Nicolas M. , Duarte Vanesa Mariel , Marcos Josefina , Marin Josefina , Rosa Javier , Soriano Enrique R. 
Published: September 2024

Introduction
There is scarce information on the prevalence of axial spondylarthritis (axSpA) using the Assessment of SpondyloArthritis International Society (ASAS) criteria and even less in Latin America. This study aimed to estimate the prevalence of axSpA by applying the ASAS 2009 criteria to a medical records review study of young people with chronic low back pain (LBP) at a university hospital–based health management organization.

Methods
Electronic medical records from the Hospital Italiano de Buenos Aires health management organization were reviewed to estimate the prevalence of axSpA (radiographic axSpA [r-axSpA] and nonradiographic axSpA [nr-axSpA]) using the ASAS 2009 axSpA criteria in all patients with chronic LBP (≥3 months) aged <45 years at the first LBP appointment, observed between 2009 and 2019.

Results
Among 795 young people with CLBP, the estimated prevalence of axSpA was 5.78% (r-axSpA, 2.76%; nr-axSpA, 3.02%). Ten of 46 patients (21.74%) with axSpA (all nr-axSpA) were undiagnosed, with an undiagnosed axSpA prevalence of 1.26%. The median interval between the first LBP appointment and diagnosis was 34.6 months for axSpA (58.7 vs. 23.1 months for r-axSpA vs. nr-axSpA). Previously diagnosed r-axSpA and nr-axSpA patients had comparable use of biological disease-modifying antirheumatic drugs (bDMARDs) (45% vs. 36%) and delays between nonsteroidal anti-inflammatory drug failure and bDMARD initiation (median, 2.76 vs. 2.66 months).

Conclusion
In our cohort of young persons with chronic LBP, the prevalence of axSpA was approximately 6%, with a high prevalence of undiagnosed axSpA, which could explain the low prevalence of axSpA reported in previous studies in Latin America.
3D Printing of Multiscale Scaffolds with Microtopography for Guiding Tissue Organization and Regeneration
Authors: Fu Rao , Jones Evan , Sun Boyuan , Ameer Guillermo , Sun Cheng , Ding Yonghui 
Published: September 2024

AbstractEngineering biomaterial scaffolds with multiscale structures, integrating anatomically accurate macroscale architecture (millimeters to centimeters) with microtopographic features (sub-microns to tens of microns), is critical for guiding cellular organization and tissue regeneration. However, fabricating such multiscale scaffolds remains challenging due to the limitations of conventional manufacturing techniques and the trade-off between speed and resolution in current 3D printing methods. Here, we present a multiscale micro-continuous liquid interface production (MµCLIP) technique that enables rapid, one-step 3D printing of centimeter-scale scaffolds with spatially tunable microtopography of various sizes and geometries in just a few minutes (up to 1 mm/min). To showcase the versatility of our technique, we printed a one-centimeter-long tubular scaffold with dual microtopographic patterns, i.e. 20 µm axially aligned grooves on the internal surface and 15 µm circumferentially aligned rings on the external surface. These scaffolds induced the simultaneous orientation of vascular endothelial cells along the axial grooves and vascular smooth muscle cells along the circumferential rings, mimicking the orthogonally aligned bilayer architecture of natural arteries. Moreover, the groove patterns significantly accelerated endothelial cell migration, potentially enhancing endothelialization in vascular implants. This approach provides a versatile tool for designing advanced scaffolds and medical devices that harness microtopography to guide tissue organization and enhance regeneration.