bluuebunny/crossref_metadata_2025_split huggingface dataset:
Real-world treatment patterns in patients with systemic lupus erythematosus: associations with comorbidities and damage
Authors: Eviatar Tali , Yahalom Roni , Livnat Idit , Elboim Moran , Elkayam Ori , Chodick Gabriel , Rosenberg Vered , Paran Daphna 
Published: September 2024

ObjectiveTo assess treatment patterns and the association between long-term glucocorticoid (GC) and hydroxychloroquine (HCQ) use and damage accrual in patients with systemic lupus erythematosus (SLE).MethodsA retrospective study including patients with SLE using the computerised database of a large health maintenance organisation. Patients were matched with subjects from the general population. Multivariable logistic regression models were used to assess the association between GC cumulative daily doses, HCQ and comorbidities: Osteoporosis, cardiovascular disease (CVD), hypertension and diabetes mellitus. Models were adjusted for age, sex, socioeconomic status, smoking, disease duration and HCQ use.ResultsA total of 1073 patients with SLE were included, 87.79% were women. The age at first diagnosis was 37.23±14.36 and the SLE disease duration was 12.89±6.23 years. Initiation of HCQ within 12 months of SLE diagnosis increased from 51.02% in 2000 to 83.67% in 2010 and 93.02% in 2018. The annual usage of GC gradually decreased from 45.34% in 2000 to 30.76% in 2020. CVD and osteoporosis were more prevalent in SLE than in the general population. Multivariable logistic regression models revealed increased odds for comorbidities in patients receiving a mean daily dose of prednisone of more than 5 mg/day compared with those receiving 5 mg/day or less.ConclusionsCVD and osteoporosis were more prevalent in SLE than in the general population. The dose and frequency of GC treatment in patients with SLE have decreased over the years. Prednisone usage in doses exceeding 5 mg/day is associated with significantly increased odds of osteoporosis and CVD.
Tongue pressure, respiratory muscle and limb strength and functional exercise capacity in oesophageal cancer
Authors: Fukushima Takuya , Yamasaki Makoto , Yamamoto Nobuyuki , Arima Yasuaki , Harino Takashi , Hori Soshi , Hashimoto Yuki , Kotsuka Masaya , Inoue Kentaro , Hase Kimitaka , Nakano Jiro 
Published: September 2024

Objectives
Preoperative management of oesophageal cancer requires effective prehabilitation. This study investigates the relationship between tongue pressure, respiratory muscle, handgrip and lower limb muscle strengths, and functional exercise capacity in patients with oesophageal cancer to develop a novel prehabilitation strategy.

Methods
This prospective, single-centre, observational study analysed data from 29 pretreatment patients with oesophageal cancer. We evaluated tongue pressure, maximal inspiratory and expiratory pressures, handgrip and lower limb muscle strengths, functional exercise capacity and dysphagia scores before treatment. The relationship between parameters was identified using Spearman’s correlation analysis.

Results
Maximal inspiratory and expiratory pressures were significantly associated with handgrip and lower extremity muscle strengths and functional exercise capacity. However, tongue pressure was not associated with maximal inspiratory and expiratory pressures, handgrip and lower extremity muscle strengths and functional exercise capacity. Rather, tongue pressure was significantly associated with clinical T, dysphagia and nutritional status scores.

Conclusions
Respiratory muscle strength was associated with conventional sarcopenia and functional exercise capacity. Tongue pressure was not associated with respiratory muscle strength, conventional sarcopenia and functional exercise capacity. Rather, tongue pressure was associated with clinical T, dysphagia and nutritional status scores. Preoperative management of oesophageal cancer requires prehabilitation consisting of exercise and nutritional therapy and an additional swallowing programme, such as tongue resistance training, for patients without progress in oral intake, based on tongue pressure evaluation.
TEMPORAL AND SPATIAL MODELING OF THE SPREAD OF DENGUE FEVER IN BRAZIL
Authors: RIOS ADRIANO NICOLA , AMAKU MARCOS 
Published: September 2024

Dengue is a viral infection caused by an arbovirus and spread through the bites of mosquitoes of the genus Aedes which causes significant human and economic damage every year. Preventive measures have been taken to reduce the proliferation of the transmitting mosquito and efforts are being made to obtain an efficient vaccine for the disease. Parallel to these measures, several studies present a model for the spread of the disease in order to determine relevant factors in the process and thus guide preventive measures and future vaccination initiatives. Within this context, this work brings a modeling for the spread of the disease through a system of differential equations where the geographic region studied (a Brazilian city) is divided into sub-regions with human circulation between them, thus making humans the spreader of the disease. Using the model, it was possible to characterize the time series of people infected with dengue in the city of Goiânia, Brazil, between 2000 and 2003 using two and three subdivisions of the geographic region studied. Seasonal cycles of the disease have been described without exhausting the number of susceptible humans.
Live Motile Sperm Sorting Device Improves Embryo Aneuploidy: A Retrospective Cohort Study
Authors: Gotsiridze Ketevan , Menabde Nana , Makhniashvili Mariam , Jokhadze Tamar 
Published: September 2024

Background: Conventional sperm selection methods, involving centrifugation, exert a detrimental effect on sperm DNA integrity due to mechanical stress. The recent noninvasive sperm selection device, CA0, based on live sperm sorting technology, facilitates the retrieval of highly motile sperm and minimizes sperm DNA fragmentation (SDF). This study was to investigate the impact of various sperm separation methods, with and without centrifugation, on embryo ploidy status. Methods: The retrospective study comprised 82 intracytoplasmic sperm injection (ICSI) cycles involving preimplantation genetic testing for aneuploidy (PGT-A) cases, with a focus on recruiting egg donation cycles to thoroughly investigate the impact of male factors. Two populations are classified based on semen quality: normozoospermic ([Formula: see text] = 33) and non-normozoospermic ([Formula: see text] = 49). Subjects were allocated to either swim-up (SU) or CA0. Preimplantation genetic testing results were recorded. Results: When comparing male characteristics between subgroups, no significant differences were observed except for a lower normal morphology rate in the CA0 group compared to SU (SU: 3 [3–4] vs. CA0: 2 [2–2.8], [Formula: see text] < 0.0001) in the non-normozoospermic cohort. There were no differences in female factors such as age and mature oocyte count (MII) number between subgroups, indicating that this model is ideal for assessing the impact of male factors on clinical outcomes. In the normozoospermic cohort, euploidy rates were similar between SU and CA0 (SU: 71.9% vs. CA0: 64.2%). However, in the non-normozoospermic cohort, CA0 showed a significantly higher euploidy rate compared to SU (SU: 53.6% vs. CA0: 74.2%) and a lower aneuploidy rate (SU: 37.1% vs. CA0: 25.8%). Additionally, CA0 minimized the incidence of mosaic embryos, whereas a mosaicism rate of 9.3% was observed with SU. This trend highlights CA0’s distinct advantage in optimizing outcomes for non-normozoospermic cases. Conclusions: CA0 is a reliable intervention to optimize paternal genetic quality before assisted insemination, thereafter effectively reducing the incidence of embryo aneuploidy associated with male factors.
Qualitative Study on Emotional Experiences and Coping Strategies in Patients With COVID‐19 During the Early Stage of Wuhan Crisis
Authors: Li Junyao , Luo Huirong , Tang Wenli , Qian Hong , Yang Huiping , Luo Qinghua 
Published: September 2024

Objective: In the early stage of COVID‐19 pandemic from December 2019 to March 2020, COVID‐19 patients endured huge mental stress combined with constant physiological suffering. We aimed to summarize the emotional experiences of patients with COVID‐19 during the early stages of the Wuhan crisis and present the coping strategies they used during the extreme time.Methods: We did a qualitative study using an empirical phenomenology approach. COVID‐19 patients with recovery and near discharge were recruited from the Dawu County Hospital of Traditional Chinese Medicine in Hubei province using purposive sampling. Semistructured face‐to‐face interviews were conducted by frontline medical staff and recorded by video and audio, then transcribed by two researchers separately. The Haase adapted version of the Colaizzi method was used to analyze the transcriptional data.Results: We included 18 adult survivors of COVID‐19 (33% female, 67% male) within the age range of 27–83 (mean age 48), and the average duration of isolation was 31.17 days. In conjunction with clinical data, we meticulously delved into the emotional trajectory of each survivor, spanning from the onset of illness through the phases of decline, improvement, and eventual recovery. Three theme categories were obtained from data analysis, including negative emotions and sources, coping strategies, and positive emotions and sources. COVID‐19 patients adopted self‐management strategies and received support from different roles when confronting high level of negative emotions.Conclusions: Early survivors of COVID‐19 experienced both negative and positive emotional experiences. Anxiety and other negative emotions were originated from both collective and individual concerns. The influence of the emotion sources differed at each stage of the disease. Patients coped with these stressors using external supports and self‐adjustment. Still, comprehensive and targeted psychological services are needed.
Clinical and Prognostic Characteristics of Acute BAD–Related Stroke: A Multicenter MRI–Based Prospective Study
Authors: Li Shengde , Wang Lihua , Liu Bin , Zhang Ping , Zhang Jiangtao , Chen Guofang , Yang Qingsong , Bian Hong , Li Xin , Wu Jian , Zhao Fengli , Liu Shifu , Bai Hongying , Zhao Weili , Yue Wei , Feng Kai , Tang Yufeng , Lu Zhengqi , Li Yusheng , Zhang Jingbo , Zhou Lixin , Zhu Yicheng , Ni Jun , Peng Bin ,   on behalf of BAD-Study Investigators
Published: September 2024

BACKGROUND:
Branch atheromatous disease (BAD)–related stroke has emerged as a meaningful subtype of ischemic stroke yet remained understudied. We aimed to investigate the demographic, clinical, therapeutic, and prognostic characteristics of BAD-related stroke.

METHODS:
The BAD-study was a nationwide, multicenter, prospective, observational cohort study in 20 Chinese hospitals from June 2021 to June 2023, enrolling patients aged 18 to 80 years with BAD-related stroke within 72 hours of onset. Eligible single subcortical infarct in the territory of lenticulostriate artery and paramedian pontine artery was included. Clinical, laboratory, and treatment data were collected at baseline. The primary outcome was a proportion of good outcomes (modified Rankin Scale score, 0–2) at 90 days. Main secondary outcomes included early neurological deterioration (END), cerebrovascular event, major bleeding, and excellent outcome (modified Rankin Scale score, 0–1) during 90-day follow-up.

RESULTS:
We finally enrolled 476 patients, with a median age of 60 (interquartile range, 53–68) years, and 70.2% were male. The median National Institutes of Health Stroke Scale score was 3 (interquartile range, 2–6) at enrollment. Involvement of the lenticulostriate artery was more common than the paramedian pontine artery (60.7% versus 39.3%). END occurred in 14.7% of patients, with a median time from onset of 38 (interquartile range, 22–62) hours. The rates of good and excellent outcomes were 86.5% and 72%, respectively. Its 90-day stroke recurrence rate was 1.9%. Acute-phase therapy (from onset to 7 days of enrollment) showed heterogeneity and was not associated with prognosis. Multivariable logistic regression analysis identified the National Institutes of Health Stroke Scale score ≥4 at admission and END as negative predictors and extracranial artery stenosis as a positive predictor of good outcomes. Age ≥60 years, National Institutes of Health Stroke Scale score ≥4 at admission, and END were negative predictors of excellent outcomes.

CONCLUSIONS:
With distinct demographic, clinical, and prognostic characteristics, along with a high incidence of END and a low risk of stroke recurrence, BAD-related stroke could be categorized as a separate disease entity. Moreover, its acute-phase treatment strategies were undetermined, awaiting further high-quality studies.
From Dependent to Self-Directed Learning in Medical Education: Can Online Modular Intervention Facilitate the Transition?
Authors: Murthy Vasantmeghna , Mohanram Arun 
Published: September 2024

Background: Indian medical graduates are expected to be lifelong learners, and medical teachers need to find newer and more engaging ways to help them hone their lifelong learning skills. Online learning can be a stepping stone toward this goal. Methods: We conducted a pre-post design interventional study in which 22 phase two MBBS students rated their self-directedness in learning using the Self-Rating Scale of Self-directed Learning (SRSSDL) at two points in time—before and after completing a 10-week online basic psychopharmacology module. Participant feedback was obtained regarding various aspects of the online modular learning experience. Results: The participants’ mean SRSSDL scores before and after the intervention were 231.31 ± 26.64 and 227.31 ± 31.33. The difference is not significant. The students’ scores at both points in time placed them in the “high” range of level of self-directed learning, leaving less realistic scope for a large change in the given time frame. Participant feedback was encouraging, with 19 out of 22 reporting that the overall learning experience was a “positive” one. Conclusions: Second-year medical students’ self-reported self-directedness is high. Online modular learning may be a feasible addition to medical education, even though it may not increase self-directedness in the short term. A limited sample size can lead to type 2 errors.
Mechanisms of GTN-induced migraine: Role of NOS isoforms, sGC and peroxynitrite in a migraine relevant mouse model
Authors: Ernstsen Charlotte , Obelitz-Ryom Karina , Kristensen David Møbjerg B. , Olesen Jes , Christensen Sarah Louise , Guo Song 
Published: September 2024

Background Migraine research has highlighted the pivotal role of nitric oxide (NO) in migraine pathophysiology. Nitric oxide donors such as glyceryl trinitrate (GTN) induce migraine attacks in humans, whereas spontaneous migraine attacks can be aborted by inhibiting NO production. The present study aimed to investigate how GTN triggers migraine through its three nitric oxide synthase (NOS) isoforms (neuronal NOS (nNOS), endothelial NOS (eNOS) and inducible NOS (iNOS)) via a suspected feed-forward phenomenon. Methods Migraine-relevant hypersensitivity was induced by repeated injection of GTN in an in vivo mouse model. Cutaneous tactile sensitivity was assessed using von Frey filaments. Signaling pathways involved in this model were dissected using non-selective and selective NOS inhibitors, knockout mice lacking eNOS or nNOS and their wild-type control mice. Also, we tested a soluble guanylate cyclase inhibitor and a peroxynitrite decomposition catalyst (Ntotal = 312). Results Non-selective NOS inhibition blocked GTN-induced hypersensitivity. This response was partially associated with iNOS, and potentially nNOS and eNOS conjointly. Furthermore, we found that the GTN response was largely dependent on the generation of peroxynitrite and partly soluble guanylate cyclase. Conclusions Migraine-relevant hypersensitivity induced by GTN is mediated by a possible feed-forward phenomenon of NO driven mainly by iNOS but with contributions from other isoforms. The involvement of peroxynitrite adds to the notion that oxidative stress reactions are also involved.
Recurrent Varices after Surgery (REVAS), a Consensus Document
Authors: Perrin Michel R. , Guex J. Jerome , Ruckley C. Vaughan , dePalma Ralph G. , Royle John P. , Eklof Bo , Nicolini Philippe , Jantet Georges ,   REVAS group
Published: September 2024

Report of the meeting† held in Paris on 17th & 18th July 1998 with participation oft: Ugo Baccaglini, Italy; Pierre Barthelemy. France; Jean-Claude Couffinhal. France: Denis Creton. France: Simon Darke, United Kingdom; Ralph De Palma, United States of America; Bo Eklof, United States of America; Ermenegildo Enrici, Argentina; Gilbert Franco, France; Jean Pierre Gobin, France; Louis Grondin, Canada; Jean-Jerome Guex. France; Georges Jantet. France; Claude Juhan. France; Jordi Maeso y Lebrun. Spain; Philippe Nicolini. France; Andreas Oesch, Switzerland; Marcelo Paramo-Diaz. Mexico; Michel Perrin. France; Paul Puppinck, France; Eberhard Rabe, Germany: Rene Rettori, France; John Royle, Australia; Vaughan Ruckley, United Kingdom; Michel Schadeck, France; Jean Claude Schovaerdts, Belgium; John Scurr, United Kingdom; Georgio Spreafico, Italy; Jan Struckman, Denmark; Frederic Vin, France Recurrent varicose veins after surgery (REVAS) are a common, complex and costly problem. The frequency of REVAS is stated to be between 20 and 80% depending on the definition of the condition. A consensus meeting on the topic (Paris 1998, July) decided to adopt a clinical definition: the presence of varicose veins in a lower limb previously operated on for varices. The pathology of recurrent varicose veins has been poorly correlated with clinical examination and operative findings. Clinical diagnosis remains essential but does not allow a precise assessment of REVAS. Consequently, the use of imaging investigations is essential. Duplex scan is considered as the method of choice. Both clinical diagnosis and imaging investigations allow the development of a classification for every day usage and future studies. This new classification of CEAP needs to be expanded to define the sites, nature and sources of recurrence, the magnitude of the reflux and other (possible) contributory factors. Methods for REVAS treatment include compression, drugs, sclerotherapy and redo surgery. There was no general consensus in favour of sclerotherapy, surgery or both to treat REVAS. Very few data were available to assess the results of treatment. Factors responsible for recurrence and recommendations for primary prevention were debated and are presented in this article. Guidelines for well-planned prospective studies have been produced.
Homocysteinemia as a Risk Factor for Atherosclerosis: A Review
Authors: Nehler M. R. , Taylor L. M. , Porter J. M. 
Published: September 2024

In industrialized nations, the leading cause of death and disability is atherosclerosis. Despite a widespread research effort spanning decades, there remains no clearly defined cause or cure for this disease that directly or indirectly affects the lives of almost all individuals in the western world. Autopsy findings show atherosclerosis to some degree in nearly all aged people, suggesting it should be regarded as a normal aging process as well as a disease. Any investigation of atherosclerosis etiology therefore requires a distinction between atherosclerosis normally observed with aging, and pathologic atherosclerosis causing disease and/or death. Atherosclerosis is most appropriately regarded as a disease when associated with both rapid progression and clinical symptoms. Widely accepted risk factors for atherosclerotic disease include advanced age, diabetes, tobacco use, arterial hypertension, hypercholesterolemia, hypertriglyceridemia, decreased high-density lipoprotein, some hypercoaguable states, sedentary life-style, and elevated plasma homocysteine. The study of lipid metabolism has dominated research into atherosclerosis etiology for decades, although now it is widely recognized that a large number of people with symptomatic atherosclerotic disease have no detectable evidence of abnormal lipid metabolism [1, 2]. Elevation in plasma homocysteine has also been widely studied as an independent risk factor for atherosclerosis. A description of the metabolism of homocysteine, its relationship to vascular disease, evidence supporting its role as an independent risk factor for atherosclerotic vascular disease, and the potential role of treatment will form the basis for this review.
Concanavalin: A Loaded Chitosan Nanoparticles Synthesis and Characterization to Inhibit the Proliferation of Lung Cancer
Authors: Yang Na , Chang Ying 
Published: September 2024

Background Non-small-cell lung cancer is the most ubiquitous malignancy, and the present treatments do not offer the most effective outcomes for therapy. Natural drug therapy, which directly targets tumor cells, is now recognized as a safe technique for cancer treatment. The use of tailored nanoparticles also improves the efficacy of cancer therapy. Purpose To synthesize, characterize, and evaluate the natural drug concanavalin A (ConA) coated with chitosan nanoparticles (ConA-CS NPs) for cytotoxicity against lung cancer cell line (NCI-H358). Methods The current study demonstrates the development of ConA-CS NPs as well as their unique characteristics, anticancer processes, and possible applications in treatment. Using UV–Vis, Fourier transform infrared, X-ray diffraction, field emission scanning electron microscopy, and dynamic light scattering studies, ConA-CS NPs were generated and evaluated. The mitochondrial toxicity test assay was used to examine ConA-CS NP-induced cytotoxicity. Dual (acridine orange/ethidium bromide) staining was performed to examine apoptotic modifications, and mitochondrial membrane potential levels in NCI-H358 cells were examined using the appropriate fluorescence staining assays. Results and Conclusion The use of ConA-CS NPs for enhanced tumor treatment, which combines natural drugs to eradicate the tumor and prevent relapses, is supported by in vitro investigations. The ability of ConA-encapsulated CS NPs to impede human lung carcinoma cell growth has not yet been investigated. Therefore, this investigation may provide a new paradigm for cancer detection and therapy, and the results may surely help to enhance the quality of life for cancer patients.