bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Novel Porphyromonas gingivalis Infection-Related Inflammatory Response-Related Genes Signature Predicts the Prognosis of Esophageal Squamous Cell Carcinoma
Authors: Kong Jinyu , Liu Yiwen , Wang Jian , Qian Mengfan , Sun Wei , Xing Ling 
Published: September 2024

Background: Our previous research showed that Porphyromonas gingivalis ( P. gingivalis) infection can activate the inflammatory signaling pathway and promotes the malignancy development of esophageal squamous cell carcinoma (ESCC). However, the prognostic significance of inflammatory response-related genes (IRRGs) in P. gingivalis-infected ESCC requires further elucidation. Hence, our study constructed a prognostic signature based on P. gingivalis and IRRGs to forecast the survival of patients with ESCC, which may provide insight into new treatment options for ESCC patients. Methods: Differentially expressed genes (DEGs) were identified in P.gingivalis-infected and P.gingivalis-uninfected ESCC cell by RNA sequencing. A risk model was constructed and validated using the The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database by using univariate Cox regression analysis, LASSO, and the multivariate Cox regression analysis. Kaplan-Meier analysis was carried out to compare the overall survival (OS) between high-risk and low-risk groups. Single-sample gene set enrichment analysis was used to analyze the immune cell infiltration. The Genomics of Drug Sensitivity in Cancer database was used to predict drug sensitivity. Results: There were 365 DEGs between the P.gingivalis-infected and P.gingivalis-uninfected groups. Four genes including DKK1, ESRRB, EREG, and RELN were identified to construct the prognostic risk model ( P = .012, C-index = 0.73). In both the training and validation sets, patients had a considerably shorter OS in the high-risk group than those in the low-risk group ( P < .05). A nomogram was established using the risk score, gender, and N stage which could effectively forecast the prognosis of patients ( P = .016, C-index = 0.66). The high-risk group displayed lower immune infiltrating cells, such as activated dendritic cells, type 2 T helper cells, and neutrophils ( P < .05). A total of 41 drugs, including dactinomycin, luminespib, and sepantronium bromide, had a significant difference in IC50 between the 2 subgroups. Conclusion: We demonstrated the potential of a novel signature constructed from 4 P. gingivalis-related IRRGs for prognostic prediction in ESCC patients.
Five-year efficacy outcomes of ocrelizumab in relapsing multiple sclerosis: A propensity-matched comparison of the OPERA studies with other disease-modifying therapies in real-world lines of treatments
Authors: Muros-Le Rouzic Erwan , Heer Yanic , Yiu Sean , Tozzi Viola , Braune Stefan , van Hövell Philip , Bergmann Arnfin , Bernasconi Corrado , Model Fabian , Craveiro Licinio ,   on behalf of the NTD study group
Published: September 2024

Background Clinical trials comparing the efficacy of ocrelizumab (OCR) with other disease-modifying therapies (DMTs) other than interferon (IFN) β-1a in relapsing multiple sclerosis (RMS) are lacking. Objectives To compare the treatment effect of OCR vs six DMTs’ (IFN β-1a, glatiramer acetate, fingolimod, dimethyl fumarate, teriflunomide, natalizumab) treatment pathways used in clinical practice by combining clinical trial and real-world data. Methods Patient-level data from OPERA trials and open-label extension phase, and from the German NeuroTransData (NTD) MS registry, were used to build 1:1 propensity score-matched (PSM) cohorts controlling for seven baseline covariates, including brain imaging activity. Efficacy outcomes were time to first relapse and time to 24-week confirmed disability progression over 5.5 years of follow-up. Intention-to-treat analysis using all outcome data irrespective of treatment switch was applied. Results The analyses included 611 OPERA patients and 7141 NTD patients. We built 12 paired-matched cohorts (six for each outcome, two for each DMT) to compare efficacy of OCR in OPERA with each DMT treatment pathway in NTD. Post-matching, baseline covariates and PS were well balanced (standardized mean difference <.2 for all cohorts). Over 5.5 years, patients treated with OCR showed a statistically significant reduction in the risk of relapse (hazard ratios [HRs] .30 to .54) and disability progression (HRs .51 to .67) compared with all index therapies and their treatment switching pathways in NTD. Treatment switch and/or discontinuation occurred frequently in NTD cohorts. Conclusion OCR demonstrates superiority in controlling relapses and disability progression in RMS compared with real-world treatment pathways over a 5.5-year period. These analyses suggest that high-efficacy DMTs and high treatment persistence are critical to achieve greatest clinical benefit in RMS. Registration OPERA I (NCT01247324), OPERA II (NCT01412333)
Brain hemodynamic responses and fall prediction in older adults with multiple sclerosis
Authors: Holtzer Roee , Foley Frederick W , Motl Robert W , Wagshul Mark E , Hernandez Manuel E , Lipton Michael L , Picone Mary Ann , Izzetoglu Meltem 
Published: September 2024

Objective: We examined whether brain hemodynamic responses, gait, and cognitive performances under single- and dual-task conditions predict falls during longitudinal follow-up in older adults with multiple sclerosis (OAMS) with relapsing-remitting and progressive subtypes. Methods: Participants with relapsing-remitting ( n = 53, mean age = 65.02 ± 4.17 years, %female = 75.5) and progressive ( n = 28, mean age = 64.64 ± 4.31 years, %female = 50) multiple sclerosis (MS) subtypes completed a dual-task-walking paradigm and reported falls during longitudinal follow-up using a monthly structured telephone interview. We used functional near-infrared spectroscopy (fNIRS) to assess oxygenated hemoglobin (HbO) in the prefrontal cortex during active walking and while performing a cognitive test under single- and dual-task conditions. Results: Adjusted general estimating equations models indicated that higher HbO under dual-task walking was significantly associated with a reduction in the odds of reporting falls among participants with relapsing-remitting (odds ratio (OR) = 0.472, p = 0.004, 95% confidence interval (CI) = 0.284–0.785), but not progressive (OR = 1.056, p = 0.792, 95% CI = 0.703–1.588) MS. In contrast, faster stride velocity under dual-task walking was significantly associated with a reduction in the odds of reporting falls among progressive (OR = 0.658, p = 0.004, 95% CI = 0.495–0.874), but not relapsing-remitting (OR = 0.998, p = 0.995, 95% CI = 0.523–1.905) MS. Conclusion: Findings suggest that higher prefrontal cortex activation levels during dual-task walking, which may represent compensatory reallocation of brain resources, provide protection against falls for OAMS with relapsing-remitting subtype.
Parental experiences of raising an autistic child in Ireland: A qualitative thematic analysis
Authors: Whelan Sally , Caulfield Niall , O’Doherty Sinéad , Mannion Arlene , Leader Geraldine 
Published: September 2024

The quality of life of autistic children and their parents is impacted by the stress they experience, their coping strategies and the availability of professional health, social and educational support services. Recent changes in the structural organisation of child disability professional supports in Ireland mean that in-depth knowledge about current experiences of parenting autistic children is necessary. This qualitative study explored parents’ perceptions and experiences regarding their challenges, stress levels, coping strategies and professional support services. Semi-structured in-depth interviews were conducted with six parents of autistic children aged 4 to 16 years. Thematic analysis identified three core themes: ‘The Autism Journey: Challenges and Rewards’, ‘Navigating a Flawed Support System’ and ‘The Importance of Social and Professional Supports’. Findings emphasised that parents face endless challenges in caring for autistic children. Dealing with autism-based support services, however, is the greatest stressor experienced by parents. It revealed that the system to access services is experienced as difficult and parents consider it is operating inadequately. This reveals a pressing need to improve systems that provide professional support services to autistic children and their families. Lay abstract Parenting an autistic child can be a challenging experience. Parents of autistic children often require social and professional support to cope with the various stresses they encounter and to ensure their children achieve their optimal potential. Recently, the way professional supports are organised in Ireland has changed. Very little previous recent research has investigated parents’ experiences of raising an autistic child in Ireland. This study interviewed six parents asking them about their challenges, stress levels, coping strategies and their perceptions regarding professional support services. The data from these interviews were organised into themes. A major finding was that parents felt the healthcare system was failing to provide help for their children, and that support services in Ireland can cause more parental distress than dealing with their child’s difficulties. Other causes of parental stress included the child’s behaviours that they found challenging, stigma, a lack of awareness about autism and isolation. This study shows that both autistic children and their parents are at increased risk of developing mental health problems due to a flawed healthcare system that requires improvement urgently.
The indoor thermal environment performance of various air-conditioning system configurations and airflow modes in a large space museum building
Authors: Zhang Qunli , Fu Xinyi , Liu Tao , Zou Yue , Jiang Feng 
Published: September 2024

Optimizing air distribution in site museums is crucial for the long-term protection of heritage sites and the thermal comfort of visitors and staff. This study examined a site museum, analyzing the traditional suspended ceiling air-conditioning system and proposing a more rational renovation. Using computational fluid dynamics (CFD) numerical simulations, the study evaluated the effects of both systems on site protection and thermal comfort. The results indicated that the retrofit scheme could significantly reduce the indoor air velocity and temperature with the same air supply parameters, which would improve human thermal comfort and also reduce the negative impact of temperature and wind speed on the site. Additionally, the retrofit scheme cut air-conditioning energy consumption by 40% and reduced initial investment costs for a unit with a rated airflow of 62,000 m³/h. The optimization of the air-conditioning system ends was also carefully considered, resulting in a safer and easier installation and maintenance process, as well as enhancing the visual appeal of the museum’s interior. The proposed retrofit scheme can provide a reference for the design of air-conditioning systems in similar types of buildings.
The role of high mobility group box-1 on the development of diabetes complications: A plausible pharmacological target
Authors: Ngcobo Nokwanda N , Sibiya Ntethelelo H 
Published: September 2024

Background Diabetes mellitus has emerged as a pressing global concern, with a notable increase in recent years. Despite advancements in treatment, existing medications struggle to halt the progression of diabetes and its associated complications. Increasing evidence underscores inflammation as a significant driver in the onset of diabetes mellitus. Therefore, perspectives on new therapies must consider shifting focus from metabolic stress to inflammation. High mobility group box (HMGB-1), a nuclear protein regulating gene expression, gained attention as an endogenous danger signal capable of sparking inflammatory responses upon release into the extracellular environment in the late 1990s. Purpose Given the parallels between inflammatory responses and type 2 diabetes (T2D) development, this review paper explores HMGB-1’s potential involvement in onset and progression of diabetes complications. Specifically, we will review and update the understanding of HMGB-1 and its inflammatory pathways in insulin resistance, diabetic nephropathy, diabetic neuropathy, and diabetic retinopathy. Conclusions HMGB-1 and its receptors i.e. receptor for advanced glycation end-products (RAGE) and toll-like receptors (TLRs) present promising targets for antidiabetic interventions. Ongoing and future projects in this realm hold promise for innovative approaches targeting HMGB-1-mediated inflammation to ameliorate diabetes and its complications.
Robotic Totally Endoscopic Off-Pump Unroofing of Myocardial Bridge: Early Experience and Midterm Outcomes
Authors: Nisivaco Sarah , Blair John , Patel Amit , Kitahara Hiroto , Allan Tess , Patel Brooke , Coleman Charocka , Balkhy Husam H. 
Published: September 2024

Objective: Myocardial bridging (MB) occurs when a coronary artery, commonly the left anterior descending (LAD), has an intramyocardial course. In symptomatic patients who fail medical therapy, surgical unroofing can provide symptomatic relief by improving coronary blood flow. We present a series of patients undergoing robotic totally endoscopic beating-heart MB unroofing. Methods: There were 34 patients with an LAD-MB who failed medical therapy and underwent robotic totally endoscopic, off-pump unroofing between January 2017 and October 2023. Patients were evaluated by a multidisciplinary team and underwent provocative coronary angiography to confirm hemodynamic significance. We reviewed perioperative outcomes and contacted patients for midterm follow-up, including completion of a modified Seattle Angina Questionnaire (SAQ). Results: The mean age was 48 ± 8 years, and 56% were female patients. One patient had prior septal myectomy via sternotomy. All patients had significant dobutamine Pd/Pa reduction on preoperative coronary angiography. One patient had atrial fibrillation and underwent concomitant ablation with left atrial appendage ligation. The mean procedure time was 140 ± 69 min. All were completed totally endoscopically off-pump without intraoperative conversions. The mean MB length was 4.5 ± 1.4 cm, and the mean depth was 1.6 ± 0.9 cm. Of the patients, 76% were extubated in the operating room. The mean intensive care unit and hospital length of stay were 0.97 ± 0.58 and 1.73 ± 1.1 days, respectively. There were no mortalities or strokes. There was 1 postoperative take-back for bleeding. At midterm follow-up (19 ± 14 months), 28 patients completed the SAQ; 86% reported “much less angina” during activity compared with before surgery, and 93% reported taking no antianginal medication since surgery. Conclusions: In appropriate patients with hemodynamically significant LAD-MB who fail medical therapy, robotic beating-heart unroofing is possible with good outcomes. Further studies are warranted.
Graphic Paper: Empowering refugee families in transit: the development of a culturally competent and compassionate training and support package
Authors: Brenchley Alex 
Published: September 2024

Background: Refugee parents who fled conflicts suffered violence and traumas and face huge challenges in supporting the health and welfare of their children while in transit. Aims: To describe the development of a culturally competent and compassionate training and support package (TSP) for nurses, social and healthcare workers and volunteers, with a focus on parenting needs among unsettled refugees fleeing conflict. Methods: The multi-method approach included: a scoping review covering parenting needs of refugees fleeing conflict zones; collection of stories from refugee parents, healthcare workers and volunteers via a mobile application; discussions between team members; a piloted and evaluated curriculum. Results: High levels of family distress and deterioration of parental identity were identified. Informed by these results, the curriculum is articulated along 20 bite-sized learning units, covering four age stages of childhood as well as targeting adults’ well-being. Pilot training was evaluated positively, confirming feasibility and usefulness of the TSP. Conclusions: Unsettled refugee parents fleeing conflicts face psycho-social and practical difficulties negatively affecting their parenting skills. The care workforce should be trained in order to provide culturally competent and compassionate support to help these families. Open access digital platforms are promising as autodidactic and self-help tools among hard-to-reach populations.
Clinical characteristics, in-hospital management, and outcomes among patients hospitalized for acute ischemic stroke in rural versus urban hospitals in China: A nationwide hospital-based study
Authors: Zhu Zhi-Kai , Jiang Ying-Yu , Yang Xin , Wang Chun-Juan , Chen Ying-Xi , Li Zi-Xiao , Wang Yong-Jun , Jiang Yong , Gu Hong-Qiu 
Published: September 2024

Background: Efforts to improve rural stroke care have intensified in China. However, high-quality comprehensive data on the differences in care and outcomes between rural and urban hospitals are limited. Methods: We analyzed data on patients with acute ischemic stroke hospitalized in the China Stroke Center Alliance hospitals from 2015 to 2022. The in-hospital management measures assessed included nine acute and five discharge management measures. Outcomes evaluated included death or discharge against medical advice (DAMA), major adverse cardiovascular events (MACE), disability at discharge, and in-hospital complications. Results: We enrolled 1,583,271 patients with acute ischemic stroke from 1930 hospitals, comprising 1086 (56.3%) rural sites with 735,452 patients and 844 (43.7%) urban sites with 847,891 patients. Patients in rural hospitals demonstrate suboptimal management measures compared to those in urban hospitals, including lower rates of intravenous recombinant tissue plasminogen activator within 4.5 h (26.0% vs 28.3%; difference: –2.3% (–2.5% to −2.0%)), endovascular treatment (0.6% vs 1.9%; difference: –1.3% (–1.3% to −1.2%)), vessel assessment (88.5% vs 92.0%; difference: –3.5% (95% confidence interval (CI): –3.6% to −3.4%)), and anticoagulants for atrial fibrillation at discharge (42.9% vs 47.7%; difference: –4.8% (95% CI: –5.4% to −4.2%)). Overall, the rural-urban disparity in in-hospital outcomes was small. Rural patients had a slightly higher rate of in-hospital death/DAMA (9.0% vs 8.0%; adjusted odds ratio (OR): 1.22 (95% CI: 1.20–1.23); adjusted risk difference (aRD): 1.3% (95% CI: 1.2%–1.4%)) and a slightly lower rate of complications (10.9% vs 13.0%; aOR: 0.83 (95% CI: 0.82–0.84); aRD: –1.3% (95% CI: –1.3% to –1.3%)). No notable rural-urban differences were observed in MACE and disability at discharge. Conclusion: Patients in rural hospitals demonstrated suboptimal management measures and had higher rates of in-hospital death/DAMA compared to those in urban hospitals. Prioritizing the allocation of health resources to rural hospitals is essential to improve healthcare quality and outcomes. Data access statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request.
Enhancing self-management of patients with inflammatory bowel disease: the role of autonomy support in health goal pursuit
Authors: Horvát Barbara , Orbán Kata , Dávid Anett , Sallay Viola , Rafael Beatrix , Njers Sanela , Molnár Tamás , Csabai Márta , Csordás Georgina , Martos Tamás 
Published: September 2024

Background: Inflammatory bowel disease (IBD) is a chronic condition that significantly affects patients’ physical, mental, and social health, as well as their overall quality of life. Effective management of the disease demands self-management skills, enabling patients to navigate the daily challenges associated with IBD, such as unpredictable flare-ups, frequent hospitalization, severe symptoms, pain, and physical changes. Objectives: This study examines the motivational aspects of self-management for patients with IBD and focuses on the role of autonomy and directive support from healthcare professionals in enhancing their self-concordance and self-efficacy. Design: From November 2022 to February 2023, a cross-sectional questionnaire study was conducted at the IBD Center of Internal Medicine Clinic in Szeged, Hungary. Methods: A total of 374 adult patients with IBD completed the paper–pencil questionnaire, of whom 241 patients (64.4%) had Crohn’s disease, and 133 patients (35.6%) had ulcerative colitis. Results: Based on the findings of the path analysis (χ2 (8) = 18.914, p = 0.01, comparative fit index = 0.935, TLI = 0.837, root mean squared error of approximation = 0.06), autonomy support positively predicted self-concordance (β = 0.48) and self-efficacy (β = 0.02), particularly during disease relapse. In addition, self-concordance and self-efficacy predicted more positive (βs = 0.28 and 0.35) and fewer negative emotional experiences (βs = −0.09 and −0.20). The model’s associations varied between the relapse and remission groups, indicating distinct impacts on different states of the disease. Conclusion: Overall, autonomy support from healthcare professionals has been shown to enhance self-management in patients with IBD, particularly during disease relapse. Meanwhile, self-concordance and self-efficacy act as positive internal factors, thus reducing negative emotional experiences, especially during remission. In sum, this study underscores the need for further exploration of the motivational aspects of self-management and provides insights into developing interventions that promote the health behaviors of patients with IBD.