bluuebunny/crossref_metadata_2025_split huggingface dataset:
Etiological Subclassification of Stroke in Older People ≥80 Years Compared to Younger People: A Systematic Review and Meta-Analysis
Authors: Sanner Johan , Ström Jakob O. , von Euler Mia , Thommessen Bente , Fure Brynjar 
Published: May 2024

Background Due to the rapid growth of the world´s oldest population, the number of older persons with stroke is expected to rise. Knowledge of stroke etiology is essential to offer personalized and equal health care across age groups. The present systematic review aimed to investigate the prevalence of etiological subtypes of ischemic and hemorrhagic stroke in older compared to younger people. Methods MEDLINE, Embase, Cochrane, Epistemonikos, and Cinahl were systematically searched for studies regarding etiological classification in people ≥80 years compared to those <80 years with ischemic or hemorrhagic stroke. Results Out of 28 441 identified articles, eight met the inclusion criteria. In total, 8223 individuals were included in meta-analyses, of whom 2997 were 80 years or older. We demonstrated a higher prevalence of cardioembolic stroke in people ≥80 years OR 1.68 (95% CI, 1.12-2.53). Small vessel disease was significantly less common in older people OR .64 (95% CI, .50-.81). Regarding large vessel disease, no statistically significant difference between the two groups was shown OR 1.05 (95% CI, .77-1.43). Conclusion In people ≥80 years, cardioembolic stroke is more common, and small vessel disease less common compared to people <80 years. Overall, the results have to be interpreted with caution due to few studies. Large studies using validated classification systems are needed.
Structural, linear/non-linear optical, and optoelectrical properties of PVB/Bi2WO6 nanocomposite for industrial applications
Authors: Alziyadi Mohammed O , Alkabsh Asma , Said Basmat Amal M , Shalaby Mustafa S 
Published: May 2024

Nanocomposite films composed of polyvinyl butyral (PVB) and Bi2WO6 were produced through solution casting. The goal of this investigation was to examine the effects of different Bi2WO6 concentrations (0%, 2%, and 4% wt.) on the linear/non-linear optical and optoelectrical properties, as well as the structure and dispersion of films of PVB/Bi2WO6 nanocomposite. The direct band gap Eg1 value falls from 5.1 eV to 3.83 eV with the progressive increase in Bi2WO6 content from 0% to 4% wt., while indirect band gap Eg2 decreased from 4.1 eV to 2.89 eV. Conversely, the PVB + 4% Bi2WO6 nanocomposite increased Urbach’s energy (EU) from 1.00 eV for pure PVB to 1.97 eV. Moreover, our research has documented the impact of different concentrations of Bi2WO6 on a range of optical properties, including the refractive index ( n), extinction coefficient ( k), and other pertinent parameters. Utilizing the real and imaginary components of the dielectric constants εr and εi, an investigation was carried out into the dielectrics’ behavior and the optoelectrical parameters’ calculation. Furthermore, investigations were performed on the linear optical susceptibility, the non-linear refractive index, and the third-order non-linear optical susceptibility concerning the concentrations of Bi2WO6. In addition, the results indicated that varying Bi2WO6 concentrations substantially affect the oscillator strength, average oscillator wavelength, and optical conductivity. The nanocomposite films of PVB/Bi2WO6 concentrations exhibited favorable associations between their optoelectrical and non-linear/linear optical parameters, rendering them viable candidates for implementation in flexible electronic devices and radiation shielding.
Antimicrobial resistance determinants in the oropharyngeal microbiome of ‘men having sex with men’ attending an sexually transmitted infection clinic
Authors: Djusse Marielle Ezekielle , Gaspari Valeria , Morselli Sara , Rapparini Luca , Foschi Claudio , Ambretti Simone , Lazzarotto Tiziana , Piraccini Bianca Maria , Marangoni Antonella 
Published: May 2024

Background ‘Men having sex with men’ (MSM) represent a key population with a significant prevalence of pharyngeal Neisseria gonorrhoeae (NG) infections and a high rate of antimicrobial resistance genes in the pharyngeal microbiome. As NG can acquire antibiotic resistance genes from other commensal oropharyngeal bacteria, monitoring the prevalence of these resistance determinants is critical to curtail the spread of NG-resistant strains. Purpose and Research Design Here, we assessed the distribution of five resistance genes ( pen (A), mtr (R), gyr (A), par (C), msr (D)) in the oropharynx of 164 MSM, attending an Outpatient clinic for STI screening. Results The most frequently detected resistance gene was msr (D) (88.4%), followed by gyr (A) (67.1%). The distribution of resistance genes was not influenced by pharyngeal gonorrhea nor by the HIV status, whereas a younger age was associated with mtr (R) presence ( p = .008). Subjects using mouthwash exhibited significantly lower levels of mtr (R) ( p = .0005). Smoking habit was associated with a higher prevalence of par (C) ( p = .02). A noteworthy association was observed between the presence of msr (D) gene and the use of antibiotics ( p = .014). Conclusions Our findings reveal an enrichment of antimicrobial resistance genes in the oropharynx of MSM. These insights could aid in the development of screening programs and antimicrobial stewardship initiatives targeting populations at heightened risk of pharyngeal gonorrhea.
Patterns of Palliative Care Consultation in Neurosurgical Patients
Authors: Kieffer Sawyer , Arce John , Ogilvie Amy , Oya Hiroyuki , Hagiwara Yuya 
Published: May 2024

Numerous neurosurgical (NSG) conditions entail high morbidity, mortality, and prolonged ICU stays. Palliative care (PC) serves to alleviate suffering, align treatment with patient preferences, and is linked to enhanced patient and family outcomes as well as reduced care costs. Notably, no studies have addressed demographic and clinical factors associated with PC receipt in NSG patients. Our aim is to identify characteristics and outcomes, particularly end of life outcomes, of hospitalized NSG patients associated with a PC consult compared with usual NSG care. A retrospective chart review was performed of patients admitted to the NSG service from January 1, 2017 to December 31, 2018 at the University of Iowa Hospitals & Clinics. Data regarding demographics, clinical outcomes, and GOC and ACP documentation were collected. The most common reasons for a PC consult were goals of care, end of life issues, and comfort care. Of 121 total decedent patients, 97 (80.2%) had PC referrals. Patients with a PC referral had longer hospital stays (10.3 days vs 4 days) and had the majority of care in the ICU (90.7% vs 83.3%). However, fewer PC patients died in the ICU (42.3% vs 75%) and more had PCA/NCA use (51.5% vs 8.3%), code status changes to DNR (90.7% vs 62.5%), GOC documented (78.4% vs 0%) and ACP documentation (35.1% vs 16.7%). In conclusion, in NSG patients, the integration of PC may contribute to improved end-of-life care.
Integrating Network Pharmacology and Molecular Docking Approach to Elucidate the Mechanism of Commiphora wightii for the Treatment of Rheumatoid Arthritis
Authors: Abdel-Maksoud Mostafa A , Askar Mostafa A , Abdel-rahman Ibrahim Y , Gharib Mustafa , Aufy Mohammed 
Published: May 2024

Background: Rheumatoid arthritis (RA) is considered a notable prolonged inflammatory condition with no proper cure. Synovial inflammation and synovial pannus are crucial in the onset of RA. The “tumor-like” invading proliferation of new arteries is a keynote of RA. Commiphora wightii ( C wightii) is a perennial, deciduous, and trifoliate plant used in several areas of southeast Asia to cure numerous ailments, including arthritis, diabetes, obesity, and asthma. Several in vitro investigations have indicated C wightii’s therapeutic efficacy in the treatment of arthritis. However, the precise molecular action is yet unknown. Material and methods: In this study, a network pharmacology approach was applied to uncover potential targets, active therapeutic ingredients and signaling pathways in C wightii for the treatment of arthritis. In the groundwork of this research, we examined the active constituent-compound-target-pathway network and evaluated that (Guggulsterol-V, Myrrhahnone B, and Campesterol) decisively donated to the development of arthritis by affecting tumor necrosis factor (TNF), PIK3CA, and MAPK3 genes. Later on, docking was employed to confirm the active components’ efficiency against the potential targets. Results: According to molecular-docking research, several potential targets of RA bind tightly with the corresponding key active ingredient of C wightii. With the aid of network pharmacology techniques, we conclude that the signaling pathways and biological processes involved in C wightii had an impact on the prevention of arthritis. The outcomes of molecular docking also serve as strong recommendations for future research. In the context of this study, network pharmacology combined with molecular docking analysis showed that C wightii acted on arthritis-related signaling pathways to exhibit a promising preventive impact on arthritis. Conclusion: These results serve as the basis for grasping the mechanism of the antiarthritis activity of C wightii. However, further in vivo/ in vitro study is needed to verify the reliability of these targets for the treatment of arthritis.
Impact of inflammatory bowel disease on women’s reproductive life: a questionnaire-based study
Authors: Zingone Fabiana , Borsato Alessandro , Maniero Daria , Della Loggia Francesco , Lorenzon Greta , Zanini Annalisa , Canova Cristina , Barberio Brigida , Savarino Edoardo Vincenzo 
Published: May 2024

Background: Inflammatory bowel diseases (IBDs) have a peak incidence between the second and fourth decades of life and can affect women’s reproductive life. Objectives: Our study aimed to assess the impact of IBD on the reproductive life of female patients with this condition. Design: Cross-sectional study. Methods: Women with IBD followed at our IBD Unit and a group of healthy controls were enrolled. Data on reproductive life were collected using a dedicated questionnaire. Results: The study included 457 women, of whom 228 had IBD, and 229 age-matched healthy controls. No differences were found in the use of contraceptives, infertility, and endometriosis. The risk of spontaneous and voluntary abortions was significantly higher in IBD patients than in healthy controls [odds ratio (OR) 2 and 3.62, respectively]. The risk of obstetrical complications in the IBD population was more than six times higher in patients who experienced disease reactivations during pregnancy than in those with persistent remission [OR 6.9, 95% confidence interval (CI) 1.51–31.28]. Finally, we found that the chances of breastfeeding were 66% lower in patients with IBD than in controls (OR 0.44, 95% CI 0.22–0.91). Conclusion: Our study underlines the negative impact of IBD on women’s reproductive life, supporting the need for proactive preconception counseling.
Major Selection as Iteration: Observing Gendered Patterns of Major Selection Under Elective Curriculums
Authors: Dalberg Tobias , Cortes Kalena E. , Stevens Mitchell L. 
Published: May 2024

Social scientists have long recognized field of study as an important mechanism of gender differentiation and stratification in U.S. higher education, but they have rarely attended to how elective curriculums mediate gender differentiation in major selection. Under elective curriculums, major selection is an iterative process, in which students select courses in stepwise fashion at the beginning of each academic term, and are able to change majors early in their undergraduate careers. We observe how an elective curriculum mediates gendered patterns of major selection, using a novel data set describing 11,730 students at a large public research university. We find (a) gender and intended major are strongly correlated upon college entry; (b) large proportions of students change majors between entry and declaration; (c) because most changes are to academically adjacent fields, gendered patterns in field of study persist through the undergraduate career. Findings suggest the value of an iterative conception of major selection and offer tractable means for intervening in the process through which students select majors. JEL codes: I21, I24, I26, J16.
Analysis of the intestinal microbiota and profiles of blood amino acids and acylcarnitines in neonates with hyperbilirubinemia
Authors: Li Junguo , Ye Shenglin , Huang Xinyuan , Yang Guolong , Wang Yijin , Zeng Jianghui , Lai Chunhui 
Published: May 2024

Abstract
Objective
This study aimed to discuss the distinctive features of the intestinal microbiota in neonates with hyperbilirubinemia and to comprehensively analyse the composition of the intestinal microbiota as well as the levels of free amino acids and acylcarnitines in the peripheral blood of neonates experiencing hyperbilirubinemia.

Results
At the phylum level, Proteobacteria, Firmicutes, Actinobacteria, Bacteroidetes, and Chloroflexi were the five predominant microbial groups identified in both the hyperbilirubinemia and control groups. Alpha diversity analysis, encompassing seven indices, showed no statistically significant differences between the two groups. However, Beta diversity analysis revealed a significant difference in intestinal microbiota structure between the groups. Linear discriminant analysis effect size (LEfSe) indicated a significant reduction in the abundance of Gammaproteobacteria and Enterobacteriaceae within the hyperbilirubinemia group compared to that in the control group. The heatmap revealed that the control group exhibited increased abundances of Escherichia and Bifidobacterium, while the hyperbilirubinemia group exhibited increased levels of Enterococcus and Streptococcus. Regarding blood amino acids and acylcarnitines, there were greater concentrations of citrulline (Cit), arginine (Arg), ornithine (Orn), and valine (Val) in the hyperbilirubinemia group than in the control group. The hyperbilirubinemia group also exhibited significant increases in medium-chain fatty acids (C6, C8), long-chain fatty acids (C18), and free carnitine (C0).

Conclusion
By comparing neonates with hyperbilirubinemia to those without, a significant disparity in the community structure of the intestinal microbiota was observed. The intestinal microbiota plays a crucial role in the bilirubin metabolism process. The intestinal microbiota of neonates with hyperbilirubinemia exhibited a certain degree of dysbiosis. The abundances of Bacteroides and Bifidobacterium were negatively correlated with the bilirubin concentration. Therefore, the fact that neonates with hyperbilirubinemia exhibit some variations in blood amino acid and acylcarnitine levels may provide, to a certain degree, a theoretical basis for clinical treatment and diagnosis.
The effect of deep and awake extubation on emergence agitation after nasal surgery: a randomized controlled trial
Authors: Suo Lulu , Lu Lu , Li Jingjie , Qiu Lin , Liu Jinxing , Shi Jinya , Sun Zhujie , Lao Wei , Zhou Xuhui 
Published: May 2024

Abstract
Background
Post-anesthetic emergence agitation is common after general anesthesia and may cause adverse consequences, such as injury as well as respiratory and circulatory complications. Emergence agitation after general anesthesia occurs more frequently in nasal surgery than in other surgical procedures. This study aimed to assess the occurrence of emergence agitation in patients undergoing nasal surgery who were extubated under deep anesthesia or when fully awake.

Methods
A total of 202 patients (18–60 years, American Society of Anesthesiologists classification: I–II) undergoing nasal surgery under general anesthesia were randomized 1:1 into two groups: a deep extubation group (group D) and an awake extubation group (group A). The primary outcome was the incidence of emergence agitation. The secondary outcomes included number of emergence agitations, sedation score, vital signs, and incidence of adverse events.

Results
The incidence of emergence agitation was lower in group D than in group A (34.7% vs. 72.8%; p < 0.001). Compared to group A, patients in group D had lower Richmond Agitation-Sedation Scale scores, higher Ramsay sedation scores, fewer agitation episodes, and lower mean arterial pressure when extubated and 30 min after surgery, whereas these indicators did not differ 90 min after surgery. There was no difference in the incidence of adverse events between the two groups.

Conclusions
Extubation under deep anesthesia can significantly reduce emergence agitation after nasal surgery under general anesthesia without increasing the incidence of adverse events.

Trial registration
Registered in Clinicaltrials.gov (NCT04844333) on 14/04/2021.
Dental caries prevalence in children during temporary protective care according to type of abuse
Authors: Nakamura Yuki , Nogami Yukiko , Iwase Yoko , Hozawa Mio , Sotome Tetsuya , Saitoh Issei , Ohuchi Akitsugu , Hayasaki Haruaki 
Published: May 2024

Abstract
Background
This study investigated the correlation between the prevalence of dental caries and the presence and type of abuse.

Methods
Participants were 534 children admitted for care at two child guidance centers (CGCs) in Niigata, Japan. Data pertaining to abuse, including the reason for temporary protective care and the type of abuse, and the oral examination results of the children, were collected. These results were then compared with those of a national survey and analyzed in relation to the presence and type of abuse.

Results
The odds ratio for decayed teeth was 4.1, indicating a higher risk in children admitted to the CGCs. However, no significant association was found between the presence of decayed, filled, or caries-experienced teeth and the presence of abuse. A significant positive association was observed between dental caries and one type of abuse, indicating a greater prevalence of dental caries in cases of neglect. The findings of this study suggest that the type of abuse, rather than its presence, is associated with dental caries.

Conclusions
Our findings suggest that proactive support should be provided to children in problematic nurturing environments, regardless of whether they have been subjected to abuse.
Identification of hub genes and therapeutic siRNAs to develop novel adjunctive therapy for Duchenne muscular dystrophy
Authors: Li Na , Xiahou Zhikai , Li Zhuo , Zhang Zilian , Song Yafeng , Wang Yongchun 
Published: May 2024

Abstract
Objective
Duchenne muscular dystrophy (DMD) is a devastating X-linked neuromuscular disorder caused by various defects in the dystrophin gene and still no universal therapy. This study aims to identify the hub genes unrelated to excessive immune response but responsible for DMD progression and explore therapeutic siRNAs, thereby providing a novel treatment.

Methods
Top ten hub genes for DMD were identified from GSE38417 dataset by using GEO2R and PPI networks based on Cytoscape analysis. The hub genes unrelated to excessive immune response were identified by GeneCards, and their expression was further verified in mdx and C57 mice at 2 and 4 months (M) by (RT-q) PCR and western blotting. Therapeutic siRNAs were deemed as those that could normalize the expression of the validated hub genes in transfected C2C12 cells.

Results
855 up-regulated and 324 down-regulated DEGs were screened from GSE38417 dataset. Five of the top 10 hub genes were considered as the candidate genes unrelated to excessive immune response, and three of these candidates were consistently and significantly up-regulated in mdx mice at 2 M and 4 M when compared with age-matched C57 mice, including Col1a2, Fbn1 and Fn1. Furthermore, the three validated up-regulated candidate genes can be significantly down-regulated by three rational designed siRNA (p < 0.0001), respectively.

Conclusion
COL1A2, FBN1 and FN1 may be novel biomarkers for DMD, and the siRNAs designed in our study were help to develop adjunctive therapy for Duchenne muscular dystrophy.
Comparison of efficacy of nadroparin and fondaparinux sodium for prevention of deep vein thromboembolism in lower extremities after total hip arthroplasty and total knee arthroplasty: a retrospective study of 592 patients
Authors: Gao Xiang , Jin Xiaowei , Huang Rui , Li Zhenxing , Zhang Hanle , Fan Pei 
Published: May 2024

Abstract
Objectives
To compare the efficacy of nadroparin and fondaparinux sodium for prevention of deep vein thromboembolism (DVT) in lower extremities after total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods
A total of 592 patients were enrolled in the study. Clinical data of patients who underwent total hip arthroplasty (THA) and total knee arthroplasty (TKA) in our hospital from December 2021 to September 2022 were retrospectively collected, which mainly included patients’ general information, surgery-related information, and DVT-related information. The patients were categorized into the nadroparin group(n = 278) and the fondaparinux sodium group(n = 314) according to the types of anticoagulants used. Anticoagulant therapy began 12–24 h after operation and continued until discharge. DVT prevalence between two groups was compared. The Statistical Package for Social Sciences (SPSS) software version 25 (SPSS, Armonk, NY, USA) was used for statistical analysis.

Results
The prevalence of DVT in the nadroparin group and the fondaparinux sodium group was 8.3% (23/278) and 15.0% (47/314), respectively(p = 0.012). Statistical analysis showed that nadroparin group showed a lower prevalence of thrombosis than fondaparinux group (OR = 1.952, P = 0.012). Subgroup analyses showed that nadroparin group had a lower prevalence of DVT than fondaparinux group in some special patients groups such as female patients (OR = 2.258, P = 0.007), patients who are 65–79 years old (OR = 2.796, P = 0.004), patients with hypertension (OR = 2.237, P = 0.042), patients who underwent TKA (OR = 2.091, P = 0.011), and patients who underwent combined spinal-epidural anesthesia (OR = 2.490, P = 0.003) (P < 0.05).

Conclusion
Nadroparin may have an advantage over fondaparinux sodium in preventing DVT in lower extremities after THA and TKA.
A rare case of spontaneous bladder wall abscess mimicking bladder tumour in young women
Authors: Alfarizi Zico Yusuf , Subekti Eko , Danarto  , Yuri Prahara 
Published: May 2024

Abstract
Introduction
Abscess of the bladder wall is a rare urological disorder, with a few cases recorded in the literature. The finding of a bladder wall mass via computed tomography (CT) imaging in a visiting patient is the subject of this report.

Case discussion
A 37-year-old woman with persistent pain in the suprapubic area and lower urinary tract symptoms was examined as a case study. Through a CT scan revealed an inhomogeneous structure in the anteroinferior part of the right bladder. A cystoscopy procedure followed by transurethral resection was performed to remove the mass, which was found to be an abscess. A Foley catheter with irrigation was administered after surgery, and the patient goes home in three days.

Conclusion
the patient had no symptoms or discomfort in the lower urinary tract after follow-up. Despite the rarity of bladder wall abscesses, cystoscopy can be used to aid diagnosis. Transurethral resection of bladder wall can reduce the mass and eliminate the possibility of malignancy.