bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive rehabilitation effects on grey matter volume and Go-NoGo activity in progressive multiple sclerosis: results from the CogEx trial
Authors: Rocca Maria A , Valsasina Paola , Romanò Francesco , Tedone Nicolò , Amato Maria Pia , Brichetto Giampaolo , Boccia Vincenzo Daniele , Chataway Jeremy , Chiaravalloti Nancy D , Cutter Gary , Dalgas Ulrik , DeLuca John , Farrell Rachel A , Feys Peter , Freeman Jennifer , Inglese Matilde , Meza Cecilia , Motl Robert W , Salter Amber , Sandroff Brian M , Feinstein Anthony , Filippi Massimo 
Published: May 2024

BackgroundResearch on cognitive rehabilitation (CR) and aerobic exercise (EX) to improve cognition in progressive multiple sclerosis (PMS) remains limited. CogEx trial investigated the effectiveness of CR and EX in PMS: here, we present MRI substudy volumetric and task-related functional MRI (fMRI) findings.MethodsParticipants were randomised to: ‘CR plus EX’, ‘CR plus sham EX (EX-S)’, ‘EX plus sham CR (CR-S)’ and ‘CR-S plus EX-S‘ and attended 12-week intervention. All subjects performed physical/cognitive assessments at baseline, week 12 and 6 months post intervention (month 9). All MRI substudy participants underwent volumetric MRI and fMRI (Go-NoGo task).Results104 PMS enrolled at four sites participated in the CogEx MRI substudy; 84 (81%) had valid volumetric MRI and valid fMRI. Week 12/month 9 cognitive performances did not differ among interventions; however, 25–62% of the patients showed Symbol Digit Modalities Test improvements. Normalised cortical grey matter volume (NcGMV) changes at week 12 versus baseline were heterogeneous among interventions (p=0.05); this was mainly driven by increased NcGMV in ‘CR plus EX-S’ (p=0.02). Groups performing CR (ie, ‘CR plus EX’ and ‘CR plus EX-S’) exhibited increased NcGMV over time, especially in the frontal (p=0.01), parietal (p=0.04) and temporal (p=0.04) lobes, while those performing CR-S exhibited NcGMV decrease (p=0.008). In CR groups, increased NcGMV (r=0.36, p=0.01) at week 12 versus baseline correlated with increased California Verbal Learning Test (CVLT)-II scores. ‘CR plus EX-S’ patients exhibited Go-NoGo activity increase (p<0.05, corrected) at week 12 versus baseline in bilateral insula.ConclusionsIn PMS, CR modulated grey matter (GM) volume and insular activity. The association of GM and CVLT-II changes suggests GM plasticity contributes to cognitive improvements.Trial registration numberNCT03679468.
Low Serum Apolipoprotein A1 Levels Impair Antitumor Immunity of CD8+ T Cells via the HIF-1α–Glycolysis Pathway
Authors: Lv Qiaoying , Su Tong , Liu Wei , Wang Lulu , Hu Jiali , Cheng Yali , Ning Chengcheng , Shan Weiwei , Luo Xuezhen , Chen Xiaojun 
Published: May 2024

Abstract
An immunosuppressive microenvironment promotes the occurrence and development of tumors. Low apolipoprotein A1 (ApoA1) is closely related to tumor development, but the underlying mechanisms are unclear. This study investigated the association between serum ApoA1 levels and the immune microenvironment in endometrial, ovarian, and lung cancers. The serum ApoA1 level was decreased significantly in patients with endometrial and ovarian cancers compared with healthy controls. In endometrial cancer (EC) tissues, the low serum ApoA1 level group showed increased CD163+ macrophage infiltration and decreased CD8+ T-cell infiltration compared with the normal serum ApoA1 group. Compromised tumor-infiltrating CD8+ T-cell functions and decreased CD8+ T-cell infiltration also were found in tumor-bearing Apo1-knockout mice. CD8+ T-cell depletion experiments confirmed that ApoA1 exerted its antitumor activity in a CD8+ T-cell–dependent manner. In vitro experiments showed that the ApoA1 mimetic peptide L-4F directly potentiated the antitumor activity of CD8+ T cells via a HIF-1α–mediated glycolysis pathway. Mechanistically, ApoA1 suppressed ubiquitin-mediated degradation of HIF-1α protein by downregulating HIF-1α subunit α inhibitor. This regulatory process maintained the stability of HIF-1α protein and activated the HIF-1α signaling pathway. Tumor-bearing Apoa1 transgenic mice showed an increased response to anti–PD-1 therapy, leading to reduced tumor growth along with increased infiltration of activated CD8+ T cells and enhanced tumor necrosis. The data reported herein demonstrate critical roles for ApoA1 in enhancing CD8+ T-cell immune functions via HIF-1α–mediated glycolysis and support clinical investigation of combining ApoA1 supplementation with anti–PD-1 therapy for treating cancer.
Abstract P391: Case Review of Congenital Ectopic Coronary Artery Disease
Authors: Ogundipe Ayomide , Adjei Abdul-Nasser 
Published: May 2024

Coronary artery anomalies (CAAs), rare congenital conditions affecting approximately 1% of adults, are associated with adverse cardiac events, including sudden cardiac death. This article reviews three recent clinical cases involving CAAs, delving into their origins, clinical presentations, diagnostics, treatments, and outcomes. CAAs involve irregularities in coronary artery origin, distribution, and termination. Notably, the left coronary artery arising from the right sinus (0.15%) and the right coronary artery from the left sinus (0.92%) are common variations. Other anomalies include the left circumflex artery (LCX) originating from the right coronary sinus and the left main coronary artery or Left anterior descending artery (LAD) emerging from opposite sinuses, leading to diverse clinical presentations.
Case 1 features a 70-year-old female with hypertension presenting with exertional angina. Surgical revascularization was performed after coronary angiography revealed an ectopic LAD. In Case 2, a 72-year-old male with hypertension presented with chest pain and NSTEMI. Coronary angiography showed an ectopic LCX and significant stenosis in LAD and RCA, treated with PCI. Case 3, involving a 49-year-old female with hypertension and syncope, was managed medically as angiography revealed an anomalous RCA origin without significant obstructive disease.
Treatment approaches for CAAs are patient-specific due to limited guidelines. Case 1 underwent coronary artery bypass surgery, Case 2 received PCI, and Case 3 was treated medically. Diagnostic methods encompass stress testing, coronary angiography, and coronary CT angiography (CCTA). CCTA is particularly valuable for distinguishing benign and clinically significant ectopic origins. For intramural courses, coronary unroofing is the preferred surgical technique, while absent intramural courses may require coronary translocation or reimplantation.Percutaneous coronary intervention (PCI) primarily addresses downstream atherosclerotic lesions without directly addressing the CAA. Treatment choice depends on patient-specific risk factors and pathology.
In summary, CAAs pose challenges in interventional cardiology, warranting early and accurate diagnosis to prevent adverse events. A personalized approach, considering patient characteristics, is crucial due to the lack of robust guidelines. Advanced imaging technologies like CCTA and MRA aid in assessing CAAs' clinical significance and guiding treatment decisions. Further research is required to establish optimal treatment strategies, including investigating CAAs' prevalence in specific regions such as Arkansas.Top of Form Bottom of Form
Abstract P429: Coffee Intake is Associated With Enhanced Insulin Sensitivity, Lower Post-Load Glucose Responses, and Lower Truncal Adiposity
Authors: Sevilla-Gonzalez Magdalena , Tobias Deirdre K , LeBoff Meryl , Demler Olga , Pradhan Aruna D , Mora Samia , Lee I-Min , Buring Julie , Manson JoAnn , Li Jun 
Published: May 2024

Higher coffee consumption has been associated with lower type 2 diabetes (T2D) risk, but the underlying mechanisms remain unclear.
We tested the hypothesis that coffee intake is associated with improved glycemia insulin sensitivity, and reduced adiposity.
We leveraged data in the VITamin D and OmegA-3 Trial (VITAL), a completed placebo-controlled 5-year trial including 25871 participants. Coffee intake was assessed by a diet questionnaire at baseline and year 2. In the VITAL clinical subcohort (n= 1054), glucose metabolism and insulin resistance were assessed by a 2-hr oral glucose tolerance test, body composition was measured by the dual X-ray absorptiometry, at baseline and year 2. We analyzed the association of coffee intake with glycemic traits and body composition, leveraging repeated assessments using multivariable-adjusted linear mixed models. Secondarily, we tested associations between coffee intake and T2D risk, in 22327 initially T2D-free individuals (482 cases in 5 years of follow-up) using multivariable-adjusted Cox regression.

While coffee intake was not associated with fasting glucose or insulin levels, it was significantly associated with lower levels of 2-hr post-load glucose (SD difference per cup increment β = -0.062,
P
= 0.04) and insulin (β = -0.064,
P
= 0.02), and a higher metabolic clearance rate of glucose (β= 0.057,
P
= 0.007) and insulin sensitivity index (β= 0.059,
P
= 0.02). The associations were consistent for caffeinated and decaffeinated coffee. Further, caffeinated coffee intake was associated with higher body weight (β= 0.018,
P
= 0.02), but total coffee intake was associated with a lower truncal to limb fat ratio before and after adjusting for BMI (β= -0.057,
P
= 0.03). We did not observe evidence of association with incident T2D (HR =0.63; 95% CI 0.15-2.50).

Higher coffee intake was associated with improved post-load glucose metabolism and insulin sensitivity, and lower truncal adiposity.

The figure displays result estimates of linear mixed models. Asterisks represent associations
P
< 0.05.
Financial Development and Subnational Export Performance: Evidence from the Indian States
Authors: Arora Puneet Kumar , Mukherjee Jaydeep 
Published: May 2024

The present study investigates the relationship between export performance and the level of financial development for 30 Indian states and union territories (UTs) from 2011–12 to 2020–21. The study first ranks the states and UTs on the parameters of financial development and physical infrastructure using the robust principal component analysis method. By applying the instrumental variable fixed effects panel data technique, the study observes that the level of financial development has a significant positive impact on the export performance of the states. The study also finds a positive effect of the availability of physical infrastructure, quality of governance and fiscal position on states’ export performance but does not observe a significant role of political stability in this context. The results suggest that export growth in the economically laggard and Himalayan states can come through policy interventions to improve financial development. In contrast, landlocked states need better physical infrastructure to facilitate easier production and transportation of export goods. The study lends new perspectives to the nascent literature on inter-regional disparities in India’s export performance and is expected to provide insights into improving the sub-national export performance of other developing countries as well. JEL Codes: F14, F36, F4
Attitudes of cardiac rehabilitation and stroke teams towards integration of stroke survivors into adapted cardiac rehabilitation: A focus group study
Authors: Clague-Baker Nicola , Robinson Thompson , Hagenberg Annegret , Drewry Sophie , Singh Sally 
Published: May 2024

Objective To explore the attitudes and beliefs of cardiac rehabilitation and stroke teams towards adapted cardiac rehabilitation, and the broader topics of exercise, healthy lifestyles and health behaviour change, for people with mild-to-moderate severity stroke in the sub-acute phase of recovery. Design Qualitative focus group-based study. Setting Acute and community national health service trusts. Participants Stroke and cardiac rehabilitation team members. Intervention Adapted cardiac rehabilitation. Main measures Focus groups. Thematic analysis was applied to the transcribed data. Results Overall, 57 health professionals participated in 12 focus groups. Positive impacts for teams and stroke survivors were identified particularly confidence. However, there were negatives, barriers and adaptations identified. In addition, there was a lack of knowledge for cardiac rehabilitation teams in relation to stroke survivors and stroke teams in relation to cardiac rehabilitation, exercise and healthy lifestyles. Conclusions Cardiac rehabilitation and stroke staff attitudes to cardiac rehabilitation for stroke survivors showed a range of benefits, negatives, barriers and adaptations needed. Confidence and knowledge of the cardiac rehabilitation and stroke teams needs to be addressed. Registration ISRCTN65957980.
Novel composite BPH3 trifecta for robotic assisted simple prostatectomy (RASP) versus BPH6: A multicenter outcomes comparison
Authors: Bove Alfredo Maria , Pallares-Méndez Rigoberto , Brassetti Aldo , Mastroianni Riccardo , Tuderti Gabriele , Anceschi Umberto , D’Annunzio Simone , Ferriero Mariaconsiglia , Flammia Rocco Simone , Misuraca Leonardo , Proietti Flavia , Amparore Daniele , Porpiglia Francesco , Leonardo Costantino , Simone Giuseppe 
Published: May 2024

Objectives: To assess disobstructive proficiency of BPH3 trifecta in RASP according to different techniques. Methods: Baseline prostate volume (PV), uroflowmetry parameters and Validated questionnaires: IIEF, Incontinence severity index score (ISI), International prostatic symptoms score (IPSS), MSHQ, Quality of recovery (QOR), were recorded preoperatively and 12 months postoperatively. RASP was conducted using both the urethra-sparing (Madigan) technique and a non-urethral-sparing transvesical (Freyer) approach. Two groups were evaluated for achievement rates in terms of BPH-3 and BPH-6. BPH-3 was defined by a combination of: a reduction of ⩾30% in IPSS compared to baseline, ISI score ⩽ 4, and absence of complications beyond Clavien grade 1. Results: About 158 patients underwent RASP, with 93 undergoing the Madigan procedure and 65 the Freyer approach. Patients in the Madigan group were younger, with lower PV, baseline IPSS score, overactive symptoms (ISI score), but higher MSHQ and IIEF score, when compared to the Freyer population (all p < 0.02). At 12-month follow-up, patients who underwent the Madigan procedure reported shorter bladder irrigation time and time to catheter removal (both p < 0.001). As expected, Madigan patients also demonstrated superior postoperative IIEF and MSHQ scores (all p < 0.001). Postoperative complication incidence was higher in the Madigan cohort, mainly due to UTI ( p < 0.001). Although there were no differences in postoperative IPSS and Q-max between groups, the Madigan cohort presented with higher post void residue ( p < 0.001). BPH6 achievement was higher in the Madigan cohort (48% vs 28%) ( p < 0.001), while no difference was observed in BPH3 achievement rate. Conclusion: The BPH3 composite trifecta appears to be more suitable than BPH6 in assessing the proficiency in disobstructive symptoms relief after RASP.
Exploring Melezitose as a Potential Therapeutic Agent in Lung Cancer: Inhibitory Effects on Cell Proliferation and EMT-Mediated Signaling in A549 Cells
Authors: Zhou Qihui , Wu Ziyong , Cheng Xi , Zuo Zhigang , Fan Cunyu 
Published: May 2024

Background Lung cancer is one of the most common cancers worldwide and a leading cause of cancer-related deaths. The study delves into melezitose, a naturally occurring compound known for its biocompatibility. Purpose This study aims to uncover its therapeutic potential and molecular mechanisms within lung cancer, particularly in A549 cells. Melezitose’s impact on inhibiting cell proliferation and influencing epithelial-mesenchymal transitions (EMT) was the primary focus. Materials and Methods In a time-dependent manner, A549 cells, representative of lung adenocarcinoma (LUAD), underwent melezitose treatment. Analysis of cytotoxicity by MTT assay, cell migration assay, and its responsible genes were analyzed by reverse transcription polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA) kit method. Results The MTT assay indicated a significant reduction in A549 cell growth after 48 hours of melezitose treatment. Additionally, melezitose induced G1 phase cell arrest and stimulated apoptosis in A549 cells. Subsequent determination of IC50 values represents the concentration at which melezitose inhibits 50% of cell growth. The study also investigated EMT-related gene expression like claudin 1 (CLD1), E-cadherin (ECADH), SNAIL1, SLUG, and vimentin (VIM) through RT-PCR. The findings revealed strong binding associations between melezitose and these EMT targets, suggesting a potential regulatory role of melezitose in impeding EMT processes. Conclusion Overall, this study illuminates the significant role of melezitose in lung cancer. Its observed inhibition of lung cancer cell proliferation and its influential impact on EMT-related gene expression highlights. Melezitose has potential as a therapeutic agent, particularly in the context of NSCC. The multifaceted effects of melezitose on A549 cells open promising avenues for advancing our understanding of this disease and developing innovative therapeutic strategies.
Effects of a respiratory and neurological rehabilitation treatment plan in post Covid-19 affected university students. Randomized clinical study
Authors: Sánchez Milá Zacarías , Rodríguez Sanz David , Martín Nieto Ana , Jiménez Lobo Ana , Ramos Hernández Manuel , Campón Chekroun Angélica , Frutos Llanes Raúl , Barragán Casas José Manuel , Velázquez Saornil Jorge 
Published: May 2024

Background COVID-19 demonstrated the possibility of neurological complications such as loss of sense of smell and taste, together with respiratory problems. Respiratory training and rehabilitation of neurological sequelae are essential to improve respiratory function and thus quality of life, and the aim of this study is to evaluate the efficacy of a pulmonary and neurological rehabilitation program. Objectives To apply a treatment to reduce dyspnea, increase exertional capacity, increase vital capacity and respiratory muscle strength, together with an increase in olfactory and gustatory sensitivity in post-SARS-CoV-2 patients. Methods A randomised controlled experimental study was conducted in 220 patients with a medical diagnosis of COVID-19 and more than 5 months of evolution, dyspnoea or perceived fatigue, including olfactory and gustatory perception problems, of whom 200 patients completed the study. 100 patients were randomly assigned to the intervention group, consisting of an inspiratory training treatment plan (Powerbreathe Plus®) combined with aerobic exercise and olfactory gustatory treatment for 31 days, and 100 patients to the control group, for 31 days without any type of therapy. Results The study was conducted in post-Covid-19 patients for 5 months. Two hundred patients were divided into an intervention group ( n = 100) and a control group ( n = 100). The comparison between the groups showed significant differences in spirometric variables; forced vital capacity ( p < .001; Eta2 (0.439); Mean: 0,6135), the ratio between both FEV1/FVC ( p < 0.01; Eta2 (0.728); Mean:9,313), peak inspiratory pressure ( p < 0.01; Eta2 (0.906); Mean:4,526); changes were observed in dyspnoea measured with the modified Borg scale ( p < 0.01; Eta2 (0.811); Mean:1,481) and the modified Medical Research Council scale ( p < 0.01; Eta2 (0.881); Mean: 0.777); finally, changes were found in neurological variables, in the questions of the Singapore Smell and Taste Questionnaire, How was your sense of smell after treatment? ( p < 0.01; Eta2 (0.813); Mean: 1,721) and How is your sense of taste after treatment? ( p < 0.01; Eta2 (0.898); Mean: 1,088). Conclusion The implementation of a respiratory rehabilitation treatment plan with the Powerbreathe Plus® device, aerobic exercise and neurorehabilitation with olfactory and gustatory training, is a therapeutic option against respiratory and neurological sequelae in patients who have suffered such sequelae due to the SARS-CoV-2 virus. Clinicaltrials.gov: NCT05195099. First posted 18/01/2022; Last Update Posted 29/06/2022.
Rifampicin in the Treatment of Refractory Diabetic Foot Ulcer and Diabetic Foot Osteomyelitis—an Observational Study
Authors: Goyal Ghanshyam , Majumdar Sujoy , Bose Usashi B. , Shrivastava Rekha , Banka Satish P. , Sharma Jugal K. , Jude Edward B. 
Published: May 2024

Introduction Refractory diabetic foot ulcer (rDFU) and osteomyelitis (diabetic foot osteomyelitis [DFO]) are a major problem in people with diabetes. Often resulting from multidrug-resistant polymicrobial infection, these may result in amputation or nonhealing ulcers. In this nonrandomized open-label study, we looked at the outcome of treatment with rifampicin in patients with nonhealing diabetic foot ulcers. Material and Methods Patients with DFUs (n = 67, n = 55 with DFO) unresponsive to conventional antimicrobial therapy for >3 months (rDFU) were taken as the study group. All patients received rifampicin for a minimum of 3 months (maximum 6 months if DUFs did not heal after 3 months) in addition to standard antibiotics and compared with similar kind of DFUs (n = 68, n = 55 DFO) who formed the control group, treated with conventional antimicrobial therapy. Patients were followed up for 12 months. Healing of DFU at 6 months and amputation were primary endpoints of the study. Results In total, 43 patients (64.2%) in the rifampicin group healed at 3 months and another 4 patients healed when rifampicin was continued for 6 months (n = 47, 70.1%). In the control group, 11 patients healed at 3 months (16.2%) and 25 patients healed at 6 months (36.8%). In total, 14 patients (20.9%) in the study group and 29 patients (42.6%) in the control group had to undergo minor amputation. Comparison between the rate of healing at 3 and 6 months and minor amputation between the study group and control group showed statistically significant results ( P ≤ .00001, <.00001, and .008, respectively). In total, 6 and 8 patients despite healing of the primary ulcer had a subsequent recurrence of ulcer in the rifampicin and control group, respectively. Conclusion Rifampicin used in conjunction with other standard poly-microbial therapy in refractory complex diabetic foot ulcer unresponsive to standard antimicrobial therapy, can significantly improve wound healing as well as decrease the need for amputation in addition to standard of care.