bluuebunny/crossref_metadata_2025_split huggingface dataset:
2023 International Evidence‐Based Polycystic Ovary Syndrome Guideline Update: Insights From a Systematic Review and Meta‐Analysis on Elevated Clinical Cardiovascular Disease in Polycystic Ovary Syndrome
Authors: Tay Chau Thien , Mousa Aya , Vyas Aadhya , Pattuwage Loyal , Tehrani Fahimeh Ramezani , Teede Helena 
Published: August 2024

Background
Polycystic ovary syndrome (PCOS) is the most prevalent female endocrinopathy. Although increased cardiovascular risk factors are well established for the syndrome, PCOS remains overlooked within the realm of cardiology. We conducted a systematic review and meta‐analysis on the risk of clinical cardiovascular disease (CVD) events in women with PCOS to inform the 2023 International Evidence‐Based PCOS Guideline.

Methods and Results

A systematic review and meta‐analysis was conducted comparing the risk of clinical CVD events in women with and without PCOS. Medline (Ovid), PsycInfo (Ovid), EMBASE, All EBM (Ovid), and CINAHL were searched from January 1, 2017, until March 1, 2023, to update the 2018 PCOS Guideline. Pooled odds ratios (ORs), incidence rate ratios (IRRs), and hazard ratios (HRs) were calculated. Twenty studies involving 1.06 million women (369 317 with PCOS and 692 963 without PCOS) were included. PCOS was associated with higher risk of composite CVD (OR, 1.68 [95% CI, 1.26–2.23]; I
2
= 71.0%), composite ischemic heart disease (OR, 1.48 [95% CI, 1.07–2.05]; I
2
= 81.0%), myocardial infarction (OR, 2.50 [95% CI, 1.43–4.38]; I
2
= 83.3%), and stroke (OR, 1.71 [95% CI, 1.20–2.44]; I
2
= 81.4%). The relationship with cardiovascular mortality was less clear (OR, 1.19 [95% CI, 0.53–2.69]; I
2
= 0%). Meta‐analyses of IRRs support these findings. Results from pooled HRs were limited by the small number of studies and significant heterogeneity.

Conclusions
This review provides evidence and highlights the importance of recognizing PCOS as a significant risk factor for CVD morbidity. The 2023 International Evidence‐Based PCOS Guideline now recommends awareness of increased CVD risk and comprehensive risk assessment in PCOS to help mitigate the burden of CVD in this common and high‐risk condition.
Efficacy and safety of hydromorphone for cancer pain: a systematic review and meta-analysis
Authors: Alinejadfard Mohammadreza , Rajai Firouzabadi Shahryar , Mohammadi Ida , Oraee Soroush , Golsorkh Hossein , Mahdavi Sajjad 
Published: August 2024

Abstract
Background
Cancer pain significantly impacts individuals’ quality of life, with opioids being employed as the primary means for pain relief. Nevertheless, concerns persist regarding the adverse reactions and effectiveness of opioids such as morphine. Hydromorphone, recognized as a potent opioid, is a viable alternative for managing cancer-related pain. The goal of this systematic review and meta-analysis was to determine the effectiveness and safety characteristics of hydromorphone in comparison to other opioids, as well as different methods of administering this medication within the scope of cancer pain treatment.

Methods
The PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases were searched on December 25th, 2023. Following the PRISMA guidelines, a systematic investigation of databases was carried out, and suitable studies were chosen according to predetermined criteria (PICO framework). The meta-analyses were performed using a random-effects model.

Results
This review included 18 RCTs with 2271 patients who compared hydromorphone with morphine, oxycodone, or fentanyl, as well as other types of hydromorphone. Hydromorphone demonstrated efficacy similar to that of morphine and oxycodone in reducing cancer pain intensity, decreasing additional analgesic consumption, and improving quality of life. However, morphine showed slight superiority over hydromorphone in reducing breakthrough pain. Adverse events were comparable between hydromorphone and morphine or oxycodone. Patient-controlled and clinician-controlled hydromorphone administration routes yielded similar outcomes.

Conclusions
The outcomes of this study substantiate the efficacy of hydromorphone in the management of cancer-related pain, demonstrating similar levels of effectiveness and safety as morphine and oxycodone. These findings are consistent with prior comprehensive analyses, suggesting that hydromorphone is a feasible choice for alleviating cancer-associated pain. Additional investigations are warranted to determine its efficacy in distinct patient cohorts and for different modes of administration.

Trial registration
Prospero registration ID: CRD42024517513. Link: https://www.crd.york.ac.uk/PROSPERO/#recordDetails.
Admission blood tests predicting survival of SARS-CoV-2 infected patients: a practical implementation of graph convolution network in imbalance dataset
Authors: Lian Jie , Huang Fan , Huang Xinhai , Lau Kitty Yu-Yeung , Ng Kei Shing , Chu Carlin Chun Fai , Lam Simon Ching , Koohli-Moghadam Mohamad , Vardhanabhuti Varut 
Published: August 2024

Abstract
Background
Predicting an individual’s risk of death from COVID-19 is essential for planning and optimising resources. However, since the real-world mortality rate is relatively low, particularly in places like Hong Kong, this makes building an accurate prediction model difficult due to the imbalanced nature of the dataset. This study introduces an innovative application of graph convolutional networks (GCNs) to predict COVID-19 patient survival using a highly imbalanced dataset. Unlike traditional models, GCNs leverage structural relationships within the data, enhancing predictive accuracy and robustness. By integrating demographic and laboratory data into a GCN framework, our approach addresses class imbalance and demonstrates significant improvements in prediction accuracy.

Methods
The cohort included all consecutive positive COVID-19 patients fulfilling study criteria admitted to 42 public hospitals in Hong Kong between January 23 and December 31, 2020 (n = 7,606). We proposed the population-based graph convolutional neural network (GCN) model which took blood test results, age and sex as inputs to predict the survival outcomes. Furthermore, we compared our proposed model to the Cox Proportional Hazard (CPH) model, conventional machine learning models, and oversampling machine learning models. Additionally, a subgroup analysis was performed on the test set in order to acquire a deeper understanding of the relationship between each patient node and its neighbours, revealing possible underlying causes of the inaccurate predictions.

Results
The GCN model was the top-performing model, with an AUC of 0.944, considerably outperforming all other models (p < 0.05), including the oversampled CPH model (0.708), linear regression (0.877), Linear Discriminant Analysis (0.860), K-nearest neighbours (0.834), Gaussian predictor (0.745) and support vector machine (0.847). With Kaplan-Meier estimates, the GCN model demonstrated good discriminability between low- and high-risk individuals (p < 0.0001). Based on subanalysis using the weighted-in score, although the GCN model was able to discriminate well between different predicted groups, the separation was inadequate between false negative (FN) and true negative (TN) groups.

Conclusion
The GCN model considerably outperformed all other machine learning methods and baseline CPH models. Thus, when applied to this imbalanced COVID survival dataset, adopting a population graph representation may be an approach to achieving good prediction.
Reversible cerebral vasoconstriction syndrome post-cardiac transplantation: a therapeutic dilemma: case report
Authors: Montarello Natalie L. , Irvine Iain , Warner Victoria , Hare James , Kaye David , Cloud Geoffrey C. 
Published: August 2024

Abstract
Background
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by diffuse, multifocal segmental narrowing of cerebral arteries and can result in ischaemic stroke. Causal factors, identified in 60% of cases, include immunosuppressant pharmacotherapy. The few reports following heart transplantation are almost all in Asian recipients. We report on a Caucasian Australian patient with immunotherapy induced RCVS post heart transplantation to highlight the state of knowledge of the condition and the treatment dilemma it poses.

Case presentation
A 51-year-old female underwent orthotopic heart transplantation at our institution. Induction immunotherapy comprised basiliximab, mycophenolate mofetil and methylprednisolone. On day 6 post-transplantation the patient was transitioned to oral prednisolone and tacrolimus. On day 7 the patient began to experience bilateral, severe, transient occipital and temporal headaches. On day 9 tacrolimus dose was up-titrated. A non-contrast computed tomography brain (CTB) was normal. Endomyocardial biopsy on day 12 demonstrated moderate Acute Cellular Rejection (ACR), which was treated with intravenous methylprednisolone. That evening the patient experienced a 15-minute episode of expressive dysphasia. The following morning she became confused, aphasic, and demonstrated right sided neglect and right hemianopia. A CT cerebral perfusion scan demonstrated hypoperfusion in the left middle cerebral artery (MCA) territory and cerebral angiography revealed widespread, focal multi-segmental narrowing of the anterior and posterior circulations. A diagnosis of RCVS was made, and nimodipine was commenced. As both steroids and tacrolimus are potential triggers of RCVS, cyclosporin replaced tacrolimus and methylprednisolone dose was reduced. A further CTB demonstrated a large left MCA territory infarct with left M2 MCA occlusion. The patient made steady neurological improvement. She was discharged 34 days post-transplantation with mild residual right lower limb weakness and persistent visual field defect on verapamil, cyclosporine, everolimus, mycophenolate mofetil and prednisolone.

Conclusion
Reversible cerebral vasoconstriction syndrome is rare after orthotopic heart transplantation. Until now, RCVS has been almost exclusively described in Asian recipients, and is typically caused by immunotherapy. The condition may lead to permanent neurological deficits, and in the absence of definitive treatments, early recognition and imaging based diagnosis is essential to provide the opportunity to remove the causal agent(s). Co-existent ACR, can pose unique treatment difficulties.
The positive solitude scale (PS): psychometric properties among Chinese older
Authors: Fan Zhiguang , Cai Huilin , Shi Xiaoli , Yu Ningyao , Chen Lei 
Published: August 2024

Abstract
Background
Positive solitude, taken as a meaningful activity, contributes to the improvement of health, well-being, and quality of life of older adults. The purpose of this study was to examine the reliability and validity of the Positive Solitude Scale (PS) among Chinese older to provide a reference for related research.

Methods
A convenience sample of 608 older people from 10 provinces in China was used to conduct the survey.

Results
The Chinese version of the PS consisted of 9 items with a unidimensional structure, which could explain 60.91% of the variance. The factor loadings of each item ranged from 0.67 to 0.82, and the communality ranged from 0.44 to 0.68. The confirmatory factor analysis showed good model fit (χ2/df = 2.771, RMSEA = 0.076, CFI = 0.972, IFI = 0.972, TLI = 0.959, PNFI = 0.665, PCFI = 0.675). It was found from the criterion-related validity test that PS scores were significantly and positively correlated with Satisfaction With Life Scale (SWLS), Autonomy, Competence, and Relatedness scores (r = 0.45 to 0.44); PS scores were significantly and negatively correlated with Short-Form UCLA Loneliness Scale (ULS-6), Kessler Psychological Distress Scale (K10), Ego Depletion Scale (EDS), and Acceptance and Action Questionnaire-2nd Edition (AAQ-II) (r = -0.27 to -0.36). The Cronbach’s α coefficient value for the scale was 0.917; the split-half reliability coefficient value was 0.928. In addition, the PS showed cross-gender consistency.

Conclusions
The PS presented favorable psychometric characteristics in older people, which can be used as a valid tool for assessing older people’s positive solitude.
Workload disparities and their role in the health of migrants and natives in Germany
Authors: Ingwersen Kai , Thomsen Stephan L. 
Published: August 2024

Abstract
Background
This study explores the health status differences between migrants and native Germans, focusing on potential disparities in their workloads. Physical and mental workloads can negatively impact individual health. Since various occupations come with distinct health-related patterns, occupational selection may contribute to systematic health disparities among socio-economic groups. Given the generally poorer health of migrants, they might experience systematic workload differences overall.

Methods
We suggest a conceptual framework for the empirical analysis based on the theory of health as a durable good with health consumption and health investment as key parameters. We quantify the role of work tasks, job requirements and working conditions on individual health based on detailed information from the BIBB/BAuA labour force survey 2012 and 2018.

Results
The empirical results reveal that migrants, i.e. foreigners and German citizens with a migration background, have a higher perception of workload and related health afflictions within the same occupation. Native Germans, on the other hand, experience a higher burden by high job requirements, both physically and mentally. The findings imply heterogeneous health impacts of work for migrants and native Germans due to differences in health consumption.

Conclusions
The analysis shows that migrants report worse health than natives, with stronger negative effects of work-related conditions on their health, both physically and mentally. Women, in general, report poorer health conditions than men. The findings emphasize the importance of promoting human capital to reduce economic and health disparities, though caution is advised regarding affirmative actions for migrants; further research is needed to understand the underlying mechanisms and address these issues effectively.
Metabolic responses to albumin deficiency differ distinctly between partial and full ablation of albumin expression in mice
Authors: Abdollahi Afsoun , Szramowski Mirandia , Tomoo Keigo , Henderson Gregory C. 
Published: August 2024

AbstractIt had been observed that homozygous albumin knockout mice (Alb−/−) exhibit low plasma free fatty acid (FFA) concentration and improved blood glucose regulation. However, it was not yet known to what extent heterozygous albumin knockout (Alb+/−) mice would display a similar phenotype. Alb−/−, Alb+/−, and wild-type (WT) female mice were studied on a low-fat diet (LFD) or high-fat diet (HFD). On both diets, decreased plasma FFA concentration, and improved glucose tolerance test were observed in Alb−/−, but not in Alb+/−, compared to WT. Plasma adiponectin concentration showed greater elevation in Alb−/− than Alb+/−. Consistent with that, adiponectin gene expression was significantly higher in Alb−/− mice than in Alb+/− and WT mice. A dose-dependent response was observed for hepatic Acadl gene expression showing higher Acadl gene expression in Alb−/− mice than in Alb+/− and WT mice. In conclusion, although female Alb+/− mice exhibited some slight differences from WT mice (e.g., increased plasma adiponectin and hepatic Acadl gene expression), Alb+/− mice did not exhibit improved glucoregulation in comparison to WT mice, indicating that a minor suppression of albumin expression is not sufficient to improve glucoregulation. Furthermore, it is now clear that although the response of female mice to HFD might be unique from how males generally respond, still the complete albumin deficiency in Alb−/− mice and the associated FFA reduction is capable of improving glucoregulation in females on this diet. The present results have implications for the role of albumin and FFA in the regulation of metabolism.
Primary health care coverage in Portugal: the promise of a general practitioner for all
Authors: Costa Eduardo , Pestana Joana , Barros Pedro Pita 
Published: August 2024

Abstract
Background
Primary care is an essential pillar of health systems. Many countries have implemented different policies to improve access to primary care. However, persistent challenges remain. This paper offers a critical analysis of the evolution of primary care coverage in Portugal, focusing on the number of patients without an assigned general practitioner (GP).

Methods
We collected and analyzed publicly available data from 2009 to 2023 to decompose primary care coverage in three components: the number of patients enrolled in primary care units (demand-side effect), the number of GPs measured in full-time equivalent (supply-side effect), and the average number of patients on each GP’s list (patient-to-GP ratio, capturing a productivity effect). We provide national and local level estimates for these three components.

Results
Between 2009 and 2023, there was an overall decline in the number of patients enrolled in primary health care units. Concurrently, there was also a net decrease of GPs measured in full-time equivalent. Additionally, there was a progressive reduction in the average number of patients on each GP’s list. The rise in the number of patients without an assigned GP is attributed not only to a reduction in the number of physicians, but also to a decrease in the patient load per doctor.

Conclusions
Hiring additional GPs may not suffice to enhance coverage. Achieving higher coverage may imply revisiting patient load per doctor or considering alternative care models. Understanding the challenges related to GP coverage is critical for improving the efficiency of primary care.
Shirebi granules ameliorate acute gouty arthritis by inhibiting NETs-induced imbalance between immunity and inflammation
Authors: Li Xin , Mao Xia , Jiang Hong , Xia Cong , Fu Lu , Gao Wenjing , Chen Wenjia , Li Weijie , Wang Ping , Zhang Yanqiong , Xu Haiyu 
Published: August 2024

Abstract
Background
Acute gouty arthritis (AGA) is classified as ‘arthritis’ in traditional Chinese medicine (TCM) theory. Shirebi granules (SGs), derived from the classic prescription SiMiaoWan, exerts satisfying therapeutic efficacy in ameliorating AGA clinically. However, the underlying mechanisms of SGs against AGA remain unclarified.

Methods
AGA-related biological processes, signal pathways and biomarker genes were mined from the GEO database through bioinformatics. SGs components were systematically recognized using the UPLC-Q-TOF–MS/MS. A correlation network was established based on the biomarker genes and the chemical components, from which the signal pathway used for further study was selected. Finally, we established an AGA model using SD rats injected with monosodium urate (MSU) in the ankle joint for experimental validation. A combination of behavioral tests, H&E, safranin O- fast green, western blotting, and immunofluorescence were employed to reveal the mechanism of action of SGs on AGA.

Results
The deterioration of AGA was significantly related to the imbalance between immunity and inflammation, neutrophil chemotaxis and inflammatory factor activation. HDAC5, PRKCB, NFκB1, MPO, PRKCA, PIK3CA were identified to be the candidate targets of SGs against AGA, associated with neutrophil extracellular traps (NETs) signal pathway. Animal experiments demonstrated that SGs effectively repaired cartilage damage, blocked TLR4 activation, and inhibited the expression of NETs indicators and inflammatory factors. In addition, SGs prominently alleviated joint redness and swelling, improved joint dysfunction, inhibited inflammatory infiltration of AGA rats.

Conclusion
Our data reveal that SGs may effectively alleviate the disease severity of AGA by suppressing NETs-promoted imbalance between immunity and inflammation.
Dachsous cadherin related 1 (DCHS1) is a novel biomarker for immune infiltration and epithelial-mesenchymal transition in endometrial cancer via pan-cancer analysis
Authors: Meijuan Cai , Fang Min , qian Wang 
Published: August 2024

Abstract
Background
Dachsous cadherin related 1 (DCHS1) is one of calcium-dependent adhesion membrane proteins and is mainly involved in the development of mammalian tissues. There is a lack of more detailed research on the biological function of DCHS1 in pan-cancer.

Materials and methods
We evaluated the expression, the prognostic value, the diagnostic value and genomic alterations of DCHS1 by using the databases, including TCGA, UALCAN, HPA, GEPIA2.0 and GSCA. We employed the databases of UCSC, TIMER2.0, TISIDB, GSCA to analyze the association between DCHS1 expression and the immune microenvironment, stemness, TMB, MSI and anticancer drug sensitivity. BioGRID, STRING and GEPIA2.0 were used to perform protein interaction and functional enrichment analysis. Real-time quantitative PCR, CCK8, Transwell assay and Western blot were performed to determine the function of DCHS1 in UCEC.

Results
DCHS1 is differentially expressed in many cancers and its expression is significantly associated with tumor prognosis and diagnosis. DCHS1 expression was significantly correlated with the infiltration of cancer-associated fibroblasts (CAFs), Endothelial cell (ECs), and Hematopoietic stem cell in most cancers. In addition, DCHS1 was significantly associated with sensitivity to many antitumor drugs. Functional enrichment analysis revealed that DCHS1-related proteins were involved in Focal adhesion, Endometrial cancer and Wnt signaling pathway. GSEA results showed that DCHS1 was related to epithelial-mesenchymal transition (EMT) in many cancers. In vitro experiments in UCEC showed that DCHS1 regulated cell proliferation, migration and EMT.

Conclusions
Our findings indicated that DCHS1 might be a novel prognostic and diagnostic biomarker and immunotherapy target, and plays an important role in the proliferation, migration and EMT in UCEC.