bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term sustainability of response to upadacitinib among patients with active rheumatoid arthritis refractory to biological treatments: results up to 5 years from SELECT-BEYOND
Authors: van Vollenhoven Ronald F , Hall Stephen , Wells Alvin F , Meerwein Sebastian , Song Yanna , Tanjinatus Oishi , Fleischmann Roy 
Published: July 2024

ObjectiveTo evaluate the long-term sustainability of response to the Janus kinase inhibitor upadacitinib among patients with rheumatoid arthritis and an inadequate response or intolerance to biological disease-modifying antirheumatic drugs (bDMARD-IR) in the SELECT-BEYOND phase 3 trial.MethodsPatients on background conventional synthetic DMARDs (csDMARDs) were treated once daily with upadacitinib 15 mg or placebo. Patients who completed the week 24 visit could enter a long-term extension of up to 5 years. The sustainability of response was assessed based on achievement of Clinical Disease Activity Index (CDAI), Simplified Disease Activity Index (SDAI) and Disease Activity Score 28-joint count using C-reactive protein (DAS28 (CRP)) targets and evaluated up to week 260 in all patients receiving the approved upadacitinib 15 mg dose, including those randomised to upadacitinib 15 mg and those who switched from placebo to upadacitinib 15 mg at week 12.ResultsIn this bDMARD-IR population, 45% (n=104/229) and 79% (n=172/219) of patients treated with upadacitinib 15 mg plus background csDMARD(s) achieved CDAI remission or CDAI low disease activity (LDA) at any point during the 5-year study, respectively. Of those who achieved CDAI remission/LDA, 25%/43% maintained their initial response through 240 weeks of follow-up after first achieving response. Most patients who lost remission or LDA were able to recapture that response by the cut-off date. Similar overall results were observed for SDAI and DAS28 (CRP). No strong predictors of response were identified.ConclusionsOver three-quarters of bDMARD-IR patients achieved CDAI LDA with upadacitinib, and almost half of those maintained LDA through 240 weeks of follow-up. Remission was achieved by nearly half of all patients and maintained in approximately a quarter of those achieving remission.Trial registration numberNCT02706847.
Navigation‐Assisted One‐Stage Total Knee Arthroplasty With Extra‐Articular Corrective Osteotomy for Knee Osteoarthritis With Femoral and Tibial Extra‐Articular Deformity: A Case Report
Authors: Kubo Mitsuhiko , Hirobe Sho , Maeda Tsutomu , Kumagai Kosuke , Amano Yasutaka , Nosaka Yuki , Hasegawa Takahide , Imai Shinji 
Published: July 2024

Background: Knee osteoarthritis (OA) with extra‐articular deformity (EAD) is a rare condition for which achieving accurate alignment with total knee arthroplasty (TKA) is difficult. Extra‐articular corrective osteotomy may be necessary for severe deformities.Case Presentation: A 76‐year‐old man underwent TKA for knee OA with EAD due to malunion after fractures of the femur and tibia. The femoral varus and the tibial valgus/recurvatum deformities were mild and corrected by intra‐articular osteotomy using navigation (i.e., navigation‐assisted standard TKA). However, the femoral antecurvatum deformity was severe, and we performed extra‐articular corrective osteotomy simultaneously with TKA. Navigation was used not only for TKA but also for extra‐articular corrective osteotomies. The osteotomy site was fixed with a cemented stem and metaphyseal sleeve. The postoperative hip–knee–ankle angle was 1° varus, the femoral implant was implanted at 0.5° varus/0.5° flexion, and the tibial implant was implanted at 0.5° varus/0° posterior slope. Two years after surgery, improvements were obtained in the range of motion from 15°–95° to 0°–110°, the Knee Society Score from 39 to 92 points, and the functional score from 35 to 100 points.Conclusions: One‐stage TKA with extra‐articular corrective osteotomy achieved good clinical results due to accurate alignment using navigation and firm fixation of the osteotomy site using cemented‐stem and metaphyseal sleeve without any fixation devices.
Integrative Metabolomics Differentiate Coronary Artery Disease, Peripheral Artery Disease, and Venous Thromboembolism Risks
Authors: Lee Jiwoo , Gilliland Thomas C. , Dron Jacqueline , Koyama Satoshi , Nakao Tetsushi , Lannery Kim , Wong Megan , Peloso Gina M. , Hornsby Whitney E. , Natarajan Pradeep 
Published: July 2024

BACKGROUND:
Arterial and venous cardiovascular conditions, such as coronary artery disease (CAD), peripheral artery disease (PAD), and venous thromboembolism (VTE), are genetically correlated. Interrogating underlying mechanisms may shed light on disease mechanisms. In this study, we aimed to identify (1) epidemiological and (2) causal, genetic relationships between metabolites and CAD, PAD, and VTE.

METHODS:
We used metabolomic data from 95 402 individuals in the UK Biobank, excluding individuals with prevalent cardiovascular disease. Cox proportional-hazards models estimated the associations of 249 metabolites with incident disease. Bidirectional 2-sample Mendelian randomization (MR) estimated the causal effects between metabolites and outcomes using genome-wide association summary statistics for metabolites (n=118 466 from the UK Biobank), CAD (n=184 305 from CARDIoGRAMplusC4D 2015), PAD (n=243 060 from the Million Veterans Project), and VTE (n=650 119 from the Million Veterans Project). Multivariable MR was performed in subsequent analyses.

RESULTS:

We found that 196, 115, and 74 metabolites were associated (
P
<0.001) with CAD, PAD, and VTE, respectively. Further interrogation of these metabolites with MR revealed 94, 34, and 9 metabolites with potentially causal effects on CAD, PAD, and VTE, respectively. There were 21 metabolites common to CAD and PAD and 4 common to PAD and VTE. Many putatively causal metabolites included lipoprotein traits with heterogeneity across different sizes and lipid subfractions. Small VLDL (very-low-density lipoprotein) particles increased the risk for CAD while large VLDL particles decreased the risk for VTE. We identified opposing directions of CAD and PAD effects for cholesterol and triglyceride concentrations within HDLs (high-density lipoproteins). Subsequent sensitivity analyses including multivariable MR revealed several metabolites with robust, potentially causal effects of VLDL particles on CAD.

CONCLUSIONS:
While common vascular conditions are associated with overlapping metabolomic profiles, MR prioritized the role of specific lipoprotein species for potential pharmacological targets to maximize benefits in both arterial and venous beds.
Antimicrobial Activities of a New Alkaloid from Marine-Derived Fungus, Penicillium sp. OM01
Authors: Pham Van Cuong , Nguyen Thi Hue , Nguyen Thuy Linh , Nguyen Mai Anh , Vu Thi Quyen , Vu Thi Thu Huyen , Le Thi Hong Minh , Huong Doan Thi Mai 
Published: July 2024

Objectives This study focused on the isolation, structural elucidation, and antimicrobial activities of compounds from the culture broth of the strain Penicillium sp. OM01 (isolated from the marine mollusk sample Spondylus squamosus (Schreibers, 1793)). Methods Various chromatographic methods were used to isolate compounds from the ethyl acetate and MeOH extracts of the strain Penicillium sp. OM01. Their structures were elucidated using HR-ESI-MS and NMR data. The compounds were evaluated for antimicrobial effects using the dilution turbidimetric broth method. Results One new alkaloid, penicritin (1), together with seven known compounds, including phenol A acid (2), topsentisteron D3 (3), ergostanol (4), (22 E,24 R)-24-methylcholesta-5,22-diene-3 β, 7 β-diol (5), 5 α,6 α-epoxy-(22 E,24 R)-ergosta-8,22-diene-3 β,7 α-diol (6), staphylopeptide A (7), and 4-hydroxybenzoic acid (8) were isolated from the culture broth of the marine-derived fungus Penicillium sp. OM01. Compounds 2-4 and 6 exhibited antibacterial activity against Gram-(+) bacteria, Enterococcus faecalis, Staphylococcus aureus, Bacillus cereus, and yeast Candida albicans with MIC values ranging from 32 to 256 µg/mL. Conclusions This is the first report of the strain Penicillium sp. OM01 from the marine mollusk sample S. squamosus (Schreibers, 1793). One new and seven known compounds were isolated from the strain Penicillium sp. OM01 (isolated from the marine mollusk sample S. squamosus (Schreibers, 1793). Compound 4 is a potential antibacterial agent.
Applying Market Basket Analysis to Determine Complex Coassociations Among Food Allergens in Children With Food Protein-Induced Enterocolitis Syndrome (FPIES)
Authors: Banerjee Ankona , Nobleza Kenneth , Haddad Cynthia , Eubanks Joshua , Rana Ruchit , Rider Nicholas L. , Pompeii Lisa , Nguyen Duc , Anvari Sara 
Published: July 2024

Background Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy, characterized by delayed onset of repetitive vomiting occurring 1 to 4 h following ingestion of a food allergen. Managing FPIES requires strict avoidance of the food trigger. The concern with FPIES is determining the risk of another FPIES food trigger reaction due to potential coassociations with other foods or food groups. An effective statistical approach for analyzing FPIES-related data is essential to identify common coallergens and their associations. Methods This study employed Market Basket Analysis, a data-mining technique, to examine correlations and patterns among allergens in FPIES patients at a Houston, Texas, pediatric tertiary center. A retrospective analysis of electronic medical records from January 2018 to March 2022 for allergist diagnosed FPIES patients was conducted. The analysis utilized R software, specifically the “arules” and “arulesViz” packages, implementing the Apriori algorithm with set minimum support and confidence thresholds. Results The study included 210 FPIES cases over 4 years, with 112 patients reacting to one food trigger and 98 to more than one trigger. In the latter group, the 5 predominant triggers were cow's milk (45.9%), rice (31.6%), oats (30.6%), soy (22.4%), and avocado (19.4%). Market Basket Analysis identified significant associations between food categories, particularly between soy and dairy, egg and dairy, oat and dairy, rice and dairy, and avocado and dairy. Conclusion Market Basket Analysis proved effective in identifying patterns and associations in FPIES data. These insights are crucial for healthcare providers in formulating dietary recommendations for FPIES patients. This approach potentially enhances guidance on food introductions and avoidances, thereby improving management and the quality of life for those affected by FPIES.
Analyzing laboratory test utilization trends in belgian primary care: a decade of insights with international perspectives
Authors: Zayed Ahmed Medhat , Delvaux Nicolas 
Published: July 2024

Abstract
Background
Clinical laboratory testing, essential for medical diagnostics, represents a significant part of healthcare activity, influencing around 70% of critical clinical decisions. The automation of laboratory equipment has expanded test menus and increased efficiency to meet the growing demands for clinical testing. However, concerns about misutilization remain prevalent. In Belgium, primary care has seen a dramatic increase in lab test usage, but recent utilization data is lacking.

Methods
We conducted a comprehensive retrospective analysis of laboratory test utilization trends within the primary care settings of Belgium over a ten-year period, spanning from 2012 to 2021, incorporating a vast dataset of 189 million test records for almost 1.5 million persons. This was the first study to integrate the metadata from both the INTEGO & THIN databases, which are derived from the two major electronic medical record (EMR) systems used in primary care in Belgium, providing a comprehensive national perspective. This research provides crucial insights into patient-level patterns, test-level utilization, and offers international perspectives through comparative analysis.

Results
We found a subtle annual increase in the average number of laboratory tests per patient (ranging from approximately 0.5-1%), indicative of a deceleration in growth in laboratory test ordering when compared to previous decades. We also witnessed stability and consistency of the most frequently ordered laboratory tests across diverse patient populations and healthcare contexts over the years.

Conclusions
These findings emphasize the need for continued efforts to optimize test utilization, focusing not only on tackling overutilization but on enhancing the diagnostic relevance of tests ordered. The frequently ordered tests should be prioritized in these initiatives to ensure their continued effectiveness in patient care. By consolidating extensive datasets, employing rigorous statistical analysis, and incorporating international perspectives, this study provides a solid foundation for evidence-based strategies aimed at refining laboratory test utilization practices. These strategies can potentially improve the quality of healthcare delivery while simultaneously addressing cost-effectiveness concerns in healthcare.
Biparametric MRI of the prostate radiomics model for prediction of pelvic lymph node metastasis in prostate cancers : a two-centre study
Authors: Li Chunxing , Hu Jisu , Zhang Zhiyuan , Wei Chaogang , Chen Tong , Wang Ximing , Dai Yakang , Shen Junkang 
Published: July 2024

Abstract
Objectives
Exploring the value of adding correlation analysis (radiomic features (RFs) of pelvic metastatic lymph nodes and primary lesions) to screen RFs of primary lesions in the feature selection process of establishing prediction model.

Methods
A total of 394 prostate cancer (PCa) patients (263 in the training group, 74 in the internal validation group and 57 in the external validation group) from two tertiary hospitals were included in the study. The cases with pelvic lymph node metastasis (PLNM) positive in the training group were diagnosed by biopsy or MRI with a short-axis diameter ≥ 1.5 cm, PLNM-negative cases in the training group and all cases in validation group were underwent both radical prostatectomy (RP) and extended pelvic lymph node dissection (ePLND). The RFs of PLNM-negative lesion and PLNM-positive tissues including primary lesions and their metastatic lymph nodes (MLNs) in the training group were extracted from T2WI and apparent diffusion coefficient (ADC) map to build the following two models by fivefold cross-validation: the lesion model, established according to the primary lesion RFs selected by t tests and absolute shrinkage and selection operator (LASSO); the lesion-correlation model, established according to the primary lesion RFs selected by Pearson correlation analysis (RFs of primary lesions and their MLNs, correlation coefficient > 0.9), t test and LASSO. Finally, we compared the performance of these two models in predicting PLNM.

Results
The AUC and the DeLong test of AUC in the lesion model and lesion-correlation model were as follows: training groups (0.8053, 0.8466, p = 0.0002), internal validation group (0.7321, 0.8268, p = 0.0429), and external validation group (0.6445, 0.7874, p = 0.0431), respectively.

Conclusion
The lesion-correlation model established by features of primary tumors correlated with MLNs has more advantages than the lesion model in predicting PLNM.
Parental perceptions and experiences of kangaroo care for preterm infants in neonatal intensive care units in China: a qualitative study
Authors: Cai Qian , Zhou Yunxian , Chen Danqi , Wang Fang , Xu Xinfen 
Published: July 2024

Abstract
Background
kangaroo care (KC), endorsed by the World Health Organization, is an evidence-based intervention that plays a pivotal role in mitigating preterm infant mortality and morbidity. However, this intervention has not been fully integrated into healthcare systems in China. This study aimed to gain insight into parents’ perceptions and experiences of KC for preterm infants to contribute to the KC implementation on a larger scale.

Methods
This study employed a descriptive qualitative design, using face-to-face, semi-structured, in-depth interviews. Fifteen parents participating in KC for preterm infants in the neonatal intensive care units (NICUs) were purposively sampled from four hospitals across four cities in Zhejiang Province, China. Thematic analysis was employed to analyze the data.

Results
Four themes and twelve subthemes regarding the parents’ perceptions and experiences about KC were identified. The four themes included: (1) Low motivation upon initial engagement with KC, (2) Dynamic fluctuations of emotional states during KC, (3) Unexpected gains, and (4) Barriers to participation.

Conclusions
Parents’ perceptions and experiences of KC was a staged process, with parents exhibiting distinct cognitive patterns and unique experiences at each stage. Overall, as KC progresses, parents’ experiences tended to become increasingly positive, despite potential obstacles encountered along the way. To enhance the implementation of KC, healthcare providers could utilize prenatal and postnatal education programs. These programs aim to enhance the understanding of KC among parents of preterm infants, fostering sustained engagement in KC practices.
Needs & networks: understanding the role and impact of social networks on HIV (self-)testing among GBMSM and trans people in England and Wales
Authors: Chu Isaac Yen-Hao , Weatherburn Peter , Wright Talen , Samba Phil , Nicholls Emily Jay , McCabe Leanne , Gafos Mitzy , Dunn David T , Trevelion Roy , Burns Fiona M , Rodger Alison J , Witzel T Charles 
Published: July 2024

Abstract
Background
Understanding how HIV self-testing (HIVST) can meet the testing needs of gay, bisexual and other men who have sex with men (GBMSM) and trans people whose social networks vary is key to upscaling HIVST implementation. We aim to develop a contextual understanding of social networks and HIV testing needs among GBMSM (cis and transgender) and trans women in SELPHI (An HIV Self-testing Public Health Intervention), the UK’s largest randomised trial on HIVST.

Methods
This study re-analysed qualitative interviews conducted from 2015 to 2020. Forty-three in-person interviews were thematically analysed using the Framework Method. Our analytic matrix inductively categorised participants based on the unmet needs for HIV testing and the extent of social network support. The role of social networks on HIVST behaviour was explored based on individuals’ testing trajectories.

Results
Four distinct groups were identified based on their unmet testing needs and perceived support from social networks. Optimisation advocates (people with high unmet needs and with high network support, n = 17) strived to tackle their remaining barriers to HIV testing through timely support and empowerment from social networks. Privacy seekers (people with high unmet needs and with low network support, n = 6) prioritised privacy because of perceived stigma. Opportunistic adopters (people with low unmet needs and with high network support, n = 16) appreciated social network support and acknowledged socially privileged lives. Resilient testers (people with low unmet needs and with low network support, n = 4) might hold potentially disproportionate confidence in managing HIV risks without sustainable coping strategies for potential seroconversion. Supportive social networks can facilitate users’ uptake of HIVST by: (1) increasing awareness and positive attitudes towards HIVST, (2) facilitating users’ initiation into HIVST with timely support and (3) affording participants an inclusive space to share and discuss testing strategies.

Conclusions
Our proposed categorisation may facilitate the development of differentiated person-centred HIVST programmes. HIVST implementers should carefully consider individuals’ unmet testing needs and perceived levels of social support, and design context-specific HIVST strategies that link people lacking supportive social networks to comprehensive HIV care.
Sex differences in formal recommendation of assets for health (social prescribing) in Aragon
Authors: Pola-Garcia Marina , Benede Azagra Carmen Belen , Enriquez Martin Natalia , Lou Alcaine Maria Luz , Melus-Palazon Elena , Mendez-Lopez Fatima , Gasch-Gallen Angel 
Published: July 2024

Abstract
Background
In primary health care, social prescribing is an important tool which is gaining popularity. It is being studied significantly, however there is not enough evidence about different related issues. The aim of this study is to analyse the differences by sex in the application of a social prescription protocol in Primary Care.

Methods
This is a cross-sectional study carried out with data from the Electronic Health Record between September 2018 and March 2021. Descriptive, bivariate and multivariate analyses of data from 2,109 records of Social Prescription protocol in primary health care centers located in Aragón in northern Spain (Europe) were performed using Jamovi Statistics software (version 2.3.28). The comparisons by sex were carried out using a Mann-Whitney U or chi-squared test to analyse differences.

Results
The protocol was used correctly 1,482 times, where it was applied more in females (74.8% female vs. 25.2% male). The median age in females was higher than males (female 72 vs. males 70; p = 0.003). There were significant differences by sex in several aspects to strengthen with the social prescribing, physical, emotional and relational skills. Most females and males regularly attended the recommended asset and there were significant differences in the group that never attended. Mean satisfaction was statistically different, with 4.74 points out of 5 for females and 4.86/5 for males (p = 0.010). It can be observed that older females in rural areas (OR = 34.15), whose social prescription acts on Emotional Skills and Relational and Social Skills (OR = 6.10–8.23), with good prior self-care and greater participant satisfaction (OR = 8.96), have greater chance of improving their health.

Conclusions
Some results showed sex differences in the use and outcomes of formal asset recommendation. However, further research is needed to assess the relationship between social prescription, sex and gender and their implications.