bluuebunny/crossref_metadata_2025_split huggingface dataset:
Repetitive transcranial magnetic stimulation for post-stroke non-fluent aphasia: a systematic review and meta-analysis of randomized controlled trials
Authors: Cheng Jing , Jiang Yijing , Rao Ting , Yang Yihan , Liu Yanping , Zhan Ying , Yang Shanli 
Published: May 2024

ObjectiveTo systematically evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) on language function in patients with non-fluent aphasia post-stroke.MethodsWe selected randomized clinical trials (RCT) that involved stroke patients with non-fluent aphasia, whose intervention was rTMS vs. no therapy or other therapy. Two researchers autonomously reviewed the literature based on the specified criteria for inclusion and exclusion and completed the process of data extraction, data verification, and quality evaluation. Meta-analysis was performed using RevMan 5.41 and Stata MP 172, while the assessment of risk of bias was carried out utilizing the Risk of Bias version 2 tool (RoB2)3.ResultsThe meta-analysis involved 47 RCTs, encompassing 2,190 patients overall. The indexes indicated that rTMS has the potential to decrease the severity of non-fluent aphasia in stroke patients, including improvement of the capability of repetition, naming, and spontaneous language. The determination of BDNF in the serum of patients was also increased. In addition, rTMS reduced the likelihood of depression in stroke patients.ConclusionTo summarize the relevant studies, rTMS has significant effects on improving the language abilities of stroke patients suffering from non-fluent aphasia, including the abilities of repetition, naming, and spontaneous language.
Factors affecting functional disability in patients with non-specific chronic low back pain: a cross-sectional study
Authors: Zhang Shenyue , Yang Huan , Luo Beier , Cheng Yajun , Niu Shengbo , Yang Changwei 
Published: May 2024

BackgroundKnowledge about factors affecting functional disability in patients with non-specific chronic low back pain (NSCLBP) is helpful in guiding treatment, but there has been little systematic research on this topic. This study aimed to identify independent factors contributing to functional disability in NSCLBP patients especially the impact of sagittal parameters and body postures in work, learning, and daily life.MethodsSociodemographic data, sagittal parameters, Oswestry Disability Index (ODI), Numeric Rating Scale (NRS), and 36-item Short Form Health Survey (SF-36) of NSCLBP patients were collected. Patients were divided into a low-functional disability group (ODI ≤ 20) and a high-functional disability group (ODI &gt; 20), and the ODI was converted to ranked ODI (RODI) accordingly. Sociodemographic data, sagittal parameters, NRS, and SF-36 were compared by univariate analysis between both groups. A correlation analysis of the aforementioned factors with the RODI was conducted. The sociodemographic data and sagittal parameters related to the RODI were analyzed by logistic regression to select potential RODI-associated factors. The level of significance was set at P &lt; 0.05.ResultsAge, educational background, daily main posture while working or learning (DMPWL), daily standing time while working or learning (DSTTWL), daily sitting time while resting (DSITR), sacral slope–pelvic tilt (SS-PT), spinosacral angle (SSA), NRS, and SF-36 (except mental health, MH) were different between the two groups (P &lt; 0.05). Correlation analysis showed that they were related to the RODI (P &lt; 0.05). The logistic regression analysis indicated that the regression coefficients of a college degree, postgraduate diploma, DSITR, and SSA were (B = −0.197; P = 0.003), (B = −0.211; P = 0.006), (B = −0.139; P = 0.039), and (B = −0.207; P = 0.001), respectively, and the odds ratio (OR) and 95% confidence interval (CI) were 0.489 (0.308; 0.778), 0.299 (0.125; 0.711), 0.875 (0.772; 0.993), and 0.953 (0.925; 0.981), respectively.ConclusionEducational background, DSITR, and SSA are independent factors affecting functional disability in NSCLBP patients. NSCLBP patients with a lower educational background, shorter DSITR, or smaller SSA should be taken into account in clinical practice and therapeutic choices. Extending sitting time for rest and the avoidance of a forward-leaning standing position are beneficial for reducing functional disability in NSCLBP.
Short-term functional outcomes of patients with acute intracerebral hemorrhage in the native and expatriate population
Authors: Akhtar Naveed , Kate Mahesh , Kamran Saadat , Joseph Sujatha , Morgan Deborah , Uy Ryan , Babu Blessy , Shanti Shobhna , Shuaib Ashfaq 
Published: May 2024

ObjectivesFunctional outcomes in patients with intracerebral hemorrhage (ICH) have not been well characterized in the Middle East and North Africa Region. We report the 30 and 90-day clinical outcomes in the native and expatriate of Qatar with ICH.MethodsWe evaluated the Glasgow Coma Scale (GCS), NIHSS, and imaging in the Qatar Stroke Registry (2013–22). The outcome measures were a modified Rankin Scale (mRS) at 90 days and mortality at 30 and 90 days. Unfavorable outcome was defined as mRS of 4–6. We performed non-parametric ROC analyses to measure the concordance index (C-index) to assess the goodness-of-fit of ICH score for predicting 30 day and 90-day mortality and functional outcome.Results1,660 patients (median age of 49 (41.5–58) years; male 83.1%, expatriates 77.5%) with ICH, including supratentorial deep in 65.2%, cortical in 16.2%, infratentorial 16% and primary intraventricular in 2.5% were studied. The median baseline ICH volume was 7.5 (3.2–15.8) ml. An unfavorable outcome was seen in 673 (40.5%) patients at 90 days. The unfavorable 90-day outcome (mRS 4–6) was 49.2% in the native population vs. 44.4% in Africans, 39.0% in South Asian, 35.3% in Far Eastern, and 7.7% in Caucasians, p &lt; 0.001. Mortality at 30 days and 90 days was 10.4 and 15.1%. Increasing age [OR (95% CI), 1.02 (1.00–1.03)], lower GCS [0.77 (0.73–0.80)], prior use of antiplatelet medications [1.82 (1.19–2.08)], higher ICH volume [1.03 (1.02–1.04)], and presence of any intraventricular hemorrhage [1.57(1.19–2.08)], were associated with unfavorable outcome.ConclusionIn this relatively younger ICH cohort more than 75% were expatriates. The ICH volume, 90-day unfavorable outcome and mortality was lower in the expatriates compared to the local Arab population, likely related to the younger age and smaller size of the hemorrhages. Prognostic scoring systems may have to be modified in this population to avoid early withdrawal of care.
Association of physical activity and vitamin D deficiency with cognitive impairment in older adults: a population based cross-sectional analysis
Authors: Guo Jing , Mo Hongfei , Zuo Longfei , Zhang Xu 
Published: May 2024

ObjectivesThe global aging situation is becoming increasingly critical and cognitive impairment in the elderly has become a public health burden of concern. Physical activity (PA) and vitamin D may play a key role in improving cognitive impairment. However, little studies have examined the interaction between these two. The purpose of this study was to assess the association of PA and vitamin D with cognitive impairment in older adults, as well as the interactions of PA and vitamin D.Materials and methodsThis study was conducted by multi-stage random sampling of elderly people ≥60 years old, and a total sample of 2,492 (1,207 male and 1,285 female, mean age of 69.41 ± 6.75 years) with complete data was included in the analysis. PA was assessed by the Global Physical Activity Questionnaire, and &lt; 600 MET-min/week was used as the division criteria. Serum vitamin D was measured by high-performance liquid chromatography tandem mass spectrometry, and 25-hydroxyvitamin D2/D3 concentration &lt; 20 ng/mL was used as a vitamin D deficiency criterion. Cognitive function was assessed by three subtests: the Consortium to Establish a Registry for Alzheimer’s disease word learning test (CERAD-WL) for immediate and delayed learning, the Animal Fluency Test (AFT) for verbal fluency; and the Digit Symbol Substitution Test (DSST) for information processing speed and switching attention. All three subtests were scored at less than the lowest quartile of the score as a criterion for cognitive impairment. Statistical analysis was performed using SPSS for chi-square test, rank sum test, interaction analysis, subgroup analysis, and regression analysis.ResultsLower level of PA is associated with higher odds of cognitive impairment (CERAD W-L: OR = 1.596, 95% CI: 1.338–1.905, p &lt; 0.001; AFT: OR = 1.833, 95% CI: 1.534–2.190, p &lt; 0.001; DSST: OR = 1.936, 95% CI: 1.609–2.329, p &lt; 0.001). Vitamin D deficiency has significant effects in AFT (OR = 1.322, 95% CI: 1.103–1.584, p = 0.003) and DSST (OR = 1.619, 95% CI: 1.345–1.948, p &lt; 0.001). After adjusted for covariates, PA and vitamin D have multiplicative interaction on AFT (OR = 0.662, 95% CI: 0.448–0.977, p = 0.038) and DSST (OR = 0.775, 95% CI: 0.363–0.868, p = 0.009). The interaction between PA and vitamin D was not significant in the CERAD W-L (OR = 0.757, 95% CI: 0.508–1.128, p = 0.172).ConclusionThe results showed that lower level of PA and vitamin D deficiency were associated with higher odds of cognitive impairment in the elderly population and that there was a multiplicative interaction between PA and vitamin D on cognitive function, with a significant effect of vitamin D on cognitive impairment in high PA conditions.
Two compound heterozygous variants in the CLN8 gene are responsible for neuronal cereidolipofuscinoses disorder in a child: a case report
Authors: Baltar Federico , Simoes Camila , Garagorry Francisco , Graña Martín , Rodríguez Soledad , Haydée Aunchayna María , Tapié Alejandra , Cerisola Alfredo , González Gabriel , Naya Hugo , Spangenberg Lucía , Raggio Víctor 
Published: May 2024

BackgroundNeuronal Ceroid Lipofuscinosis (NCL) disorders, recognized as the primary cause of childhood dementia globally, constitute a spectrum of genetic abnormalities. CLN8, a subtype within NCL, is characterized by cognitive decline, motor impairment, and visual deterioration. This study focuses on an atypical case with congenital onset and a remarkably slow disease progression.MethodsWhole-genome sequencing at 30× coverage was employed as part of a national genomics program to investigate the genetic underpinnings of rare diseases. This genomic approach aimed to challenge established classifications (vLINCL and EPMR) and explore the presence of a continuous phenotypic spectrum associated with CLN8.ResultsThe whole-genome sequencing revealed two novel likely pathogenic mutations in the CLN8 gene on chromosome 8p23.3. These mutations were not previously associated with CLN8-related NCL. Contrary to established classifications (vLINCL and EPMR), our findings suggest a continuous phenotypic spectrum associated with CLN8. Pathological subcellular markers further validated the genomic insights.DiscussionThe identification of two previously undescribed likely pathogenic CLN8 gene mutations challenges traditional classifications and highlights a more nuanced phenotypic spectrum associated with CLN8. Our findings underscore the significance of genetic modifiers and interactions with unrelated genes in shaping variable phenotypic outcomes. The inclusion of pathological subcellular markers further strengthens the validity of our genomic insights. This research enhances our understanding of CLN8 disorders, emphasizing the need for comprehensive genomic analyses to elucidate the complexity of phenotypic presentations and guide tailored therapeutic strategies. The identification of new likely pathogenic mutations underscores the dynamic nature of CLN8-related NCL and the importance of individualized approaches to patient management.
The effect of bupivacaine on analgesia and safety in patients undergoing hemorrhoidectomy: a meta-analysis
Authors: Lu Haixia , Cai Min , Zhou Dongxi , Li Weiwei , Cao Hanzhong 
Published: May 2024

Aim: There is no meta-analysis reporting the analgesic effect and safety of bupivacaine in patients undergoing hemorrhoidectomy. This meta-analysis provides quantitative evidence of the effect of bupivacaine in hemorrhoidectomy.Methods: Studies were searched from PubMed, Embase, the Cochrane Library, and the Web of Science. Standardized mean difference (SMD), weighted mean difference (WMD), and odds ratios (ORs) with 95% confidence interval (CI) were used as effect indicators. Heterogeneity was assessed using the I2 index, and sensitivity analysis was conducted to determine the effect of the single study on the pooled results.Results: A total of 18 studies were included in this meta-analysis. The pain level at 48 h was lower in the bupivacaine-combined other drug group than in the other drug group (WMD = −0.65, 95% CI: 1.18 to −0.11, and I2 = 37.50%). Compared to the bupivacaine group, the odds of pruritus (OR = 12.11, 95% CI: 1.49–98.59, and I2 = 0%) and urinary retention (OR = 4.45, 95% CI: 1.12–17.70, and I2 = 0%) were higher, and the pain level at 6 h (WMD = −2.13, 95% CI: 3.22 to −1.04, and I2 = 64.30%), at 12 h (WMD = −1.55, 95% CI: 2.19 to −0.90, and I2 = 56.10%), and at 24 h (SMD = −1.15, 95% CI: 1.89 to −0.42, and I2 = 82.5%) were lower in the bupivacaine-combined other drug group.Conclusion: Bupivacaine-combined other drugs had a good analgesic effect after hemorrhoidectomy, but the adverse reactions should be considered.
A review of SaiLuoTong (MLC-SLT) development in vascular cognitive impairment and dementia
Authors: Ampil Encarnita Raya , Ong Paulus Anam , Krespi Yakup , Yang Yuan-Han 
Published: May 2024

The dementia epidemic, attributed to aging populations, represents a growing socio-economic burden. It is estimated that in 2019 about 55 million people worldwide were living with dementia. With many possible causes of dementia and the possibility of mixed dementia combining Alzheimer’s disease (AD) and vascular dementia the question is whether diagnostic uncertainty exists or whether diagnostic constructs based on single etiologies are incorrect. Vascular Cognitive Impairment and Dementia (VCID) designates the extent of cognitive dysfunctions from the most benign state to that of dementia, of vascular origin. We reviewed epidemiological, pathophysiological and clinical data on VCID with a focus on VaD, as well as key data on the development of a new therapeutic solution, SaiLuoTong (MLC-SLT). From documentary research executed on different web sources (PubMed, Clintrials.gov, Z-library and Google), our initial selection for the short review of VCID and VaD was based on keywords contained in each paragraph subtitles of this article with exclusion of publications in a language other than English or published before 2010. For the review of SaiLuoTong development, there was just the language exclusion criterion. Sorted by relevance and publication date, 47 references were selected from 140 shortlisted for review. With new evidence-based classification systems, vascular cognitive impairment was proposed as umbrella term covering all forms of cognitive deficits related to vascular causes. The scope of application expanded with the VCID which includes VaD and mixed pathologies. No drugs are approved for the treatment of VaD by major Western regulatory agencies, while some traditional Chinese medicines are registered in China. VCID treatment should have a dual focus: managing the underlying cerebrovascular disease and dementia symptoms. This is the objective set for the development of the MLC-SLT, the essential data of which are reviewed in detail. To strengthen VCID and VaD research, consensus groups should attempt to consolidate scattered local research initiatives into coordinated international programs. In two VaD clinical trials, MLC-SLT improved cognitive symptoms and activities of daily living, with good safety and potential disease-modifying effect. In a placebo-controlled study in 325 patients with mild to moderate VaD and randomized according to a delayed-start design, MLC-SLT demonstrated significant improvement in memory tests and performance in executive function tasks, expanding its place in the management of VCID. At week 26, changes in VADAS-cog scores (SD) from baseline were 23.25 (0.45) for MLC-SLT 180 mg bid), 23.05 (0.45) for MLC-SLT 120 mg bid (both p &lt; 0.0001), and 20.57 (0.45) for placebo (p = 0.15). At week 52, differences between both groups MLC-SLT and placebo were 2.67 and 2.48, respectively (p &lt; 0.0001), without significant difference between MLC-SLT groups.
Exploring the link between pyrethroids exposure and dopaminergic degeneration through morphometric, immunofluorescence, and in-silico approaches: the therapeutic role of chitosan-encapsulated curcumin nanoparticles
Authors: Alotaibi Badriyah S. , Abdel-Rahman Mohamed Amany , Abd-Elhakim Yasmina M. , Noreldin Ahmed E. , Elhamouly Moustafa , Khamis Tarek , El-Far Ali H. , Alosaimi Manal E. , Dahran Naief , Alqahtani Leena S. , Nicotra Mario , El-Gamal Mohamed , Di Cerbo Alessandro 
Published: May 2024

Introduction: The synthetic pyrethroid derivative fenpropathrin (FNE), a commonly used insecticide, has been associated with various toxic effects in mammals, particularly neurotoxicity. The study addressed the hallmarks of the pathophysiology of Parkinson’s disease upon oral exposure to fenpropathrin (FNE), mainly the alteration of dopaminergic markers, oxidative stress, and molecular docking in rat models. In addition, the protective effect of curcumin-encapsulated chitosan nanoparticles (CRM-Chs-NPs) was also assessed. Methods: In a 60-day trial, 40 male Sprague Dawley rats were divided into 4 groups: Control, CRM-Chs-NPs (curcumin-encapsulated chitosan nanoparticles), FNE (15 mg/kg bw), and FNE + CRM-Chs-NPs. Results: FNE exposure induced reactive oxygen species generation, ATP production disruption, activation of inflammatory and apoptotic pathways, mitochondrial function and dynamics impairment, neurotransmitter level perturbation, and mitophagy promotion in rat brains. Molecular docking analysis revealed that FNE interacts with key binding sites of dopamine synthesis and transport proteins. On the other hand, CRM-Chs-NPs mitigated FNE’s toxic effects by enhancing mitochondrial dynamics, antioxidant activity, and ATP production and promoting anti-inflammatory and antiapoptotic responses.Conclusion: In summary, FNE appears to induce dopaminergic degeneration through various mechanisms, and CRM-Chs-NPs emerged as a potential therapeutic intervention for protecting the nervous tissue microenvironment.
Creative webs: decoding the creativity potential of Twitter followers
Authors: Hayat Tsahi 
Published: May 2024

IntroductionPrevious studies have associated creativity to one’s social networks. This study builds on this framework and examines the premise that one’s social fabric is a catalyst for creativity, specifically probing the dynamics between online social connections and creative expressions in the realm of Esports. Therefore, this research paper examined a correlation between people’s creativity and their Effective Network Size (non-redundant ties) on Twitter, to see if potentially non-redundant information is related to creativity.MethodsCreativity score was defined as the propensity of a participant to utilize specific terms relating to Esports in its emerging stages, prior to its peak popularity as evidenced by Google Trends. Effective Network Size was analyzed based on the social ties of participants on Twitter (N = 50,000).ResultsThe findings indicate that the higher the Effective Network Size score, the higher the creativity score. Furthermore, geographically dispersed social networks moderated the relationship between Effective Network Size and creativity. For people with more dispersed social networks, ENS was more constructive for creativity.DiscussionThese findings are discussed in the broader context of the relevancy of online social networking sites for creativity.
Profiling early adopters of ‘iSupport-Portugal’: a country-specific version of a worldwide adapted digital support program for informal caregivers of people with dementia
Authors: Teles Soraia , Alves Sara , Ribeiro Oscar , Freitas Alberto , Ferreira Ana , Paúl Constança 
Published: May 2024

IntroductionInformal caregivers are the backbone of dementia care. iSupport is a World Health Organization digital support program for caregivers of people with dementia (PwD) that has been culturally adapted in several countries. iSupport was previously assessed for its feasibility in Portugal, and this country-specific version is now being utilized as a remote measurement tool (RMT). It constitutes the first internationally developed iSupport platform that is technically and scientifically enhanced to collect data on sociodemographic, clinical, and psychosocial variables of dementia care dyads. This paper characterizes the early adopters of iSupport-Portugal and discusses its exploration as a RMT.MethodsCross-sectional data were collected between February and July 2023 from users registering on isupport-portugal.pt. To characterize caregivers and PwD, eligibility was limited to unpaid caregivers assisting community dwelling PwD (n = 173). Data were collected through self-administered instruments in users’ accounts. Caregivers completed psychosocial measures on burden, anxiety, depression, quality of life, desire to institutionalize and usage of community services. Textual data on caregivers’ needs underwent content analysis.ResultsAmong the early adopters of iSupport-Portugal (n = 365), 52.3% were informal caregivers, while 44.7% were health/social care professionals or others. Most caregivers were female (82.7%), middle-aged (M 51.7 years), highly educated (M 15.3 years) and supporting a parent (70.5%). Caregivers cared for a median of 24 h/week and 60.8% lived with the PwD. Neuropsychiatric symptoms were reported for 94.1% of PwD, who scored as moderately dependent (Barthel Index: M 14.0). Significant burden was reported by 88.4% of caregivers (≥21 on ZBI-22). Among caregivers scoring borderline or abnormal (≥8 on HADS) for anxiety, depression, or both (75.5%), 30.8% sought mental health counseling. Caregivers supporting a PwD not using community services scored higher on anxiety (p = 0.003), and depression (p = 0.009). Text data revealed unmet practical, emotional, and informational needs.DiscussioniSupport-Portugal has garnered fair initial interest from caregivers, particularly from those who are children, highly educated, and employed. Early adopters exhibited significant psychological distress, and both practical and emotional needs, which contrast with limited use of support services for themselves and the PwD. iSupport-Portugal shows promise for descriptive research on care dyads, particularly among newer generations of caregivers.