bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ideational robustness of liberal democracy in the wake of the pandemic: comparing the Danish and Swedish cases
Authors: Knaggård Åsa , Triantafillou Peter 
Published: March 2024

Abstract
The Covid-19 pandemic sparked unprecedented political responses dramatically affecting societies, markets, and the lives of individuals. Under great uncertainty and turbulent conditions, governments adopted far-reaching political interventions to curb the pandemic. These interventions might therefore be expected to challenge key ideas underpinning liberal democracy. We analyze and compare how the political interventions seeking to curb the spread of the coronavirus in Denmark and Sweden challenged and possibly adapted three key ideas underpinning liberal democracy, namely, constitutionality, parliamentarism, and public responsiveness. When ideas are adapted in ways that advance their ability to stay relevant when faced with turbulence, we understand them as robust. Our study found both similarities and differences between the two countries. The idea of constitutionality was challenged in Denmark but remained robust in Sweden. The idea of parliamentarism appeared robust in both countries, whereas the idea of public responsiveness was adapted in neither country but challenged further in Sweden than in Denmark. Paradoxically, Denmark saw fewer adaptations to the liberal democratic ideas than Sweden yet appeared better prepared to protect lives during turbulent times. Our study suggests that liberal democracies must very carefully balance trade-offs between individual liberties and the protection of public health to preserve the core public ideas of constitutionality, parliamentarism, and public responsiveness.
Genotoxicity and cytotoxicity of antineoplastic drugs at environmentally relevant concentrations after long-term exposure
Authors: da Cunha de Medeiros P , Nunes E A , Barcelos G R M , Perobelli J E 
Published: March 2024

Abstract

Introduction
5-fluorouracil (5-FU) and methotrexate (MTX) are the antineoplastic drugs most commonly used worldwide. Considered cytotoxic, these pharmaceuticals exhibit low specificity, causing damage not only to cancer cells but also to healthy cells in organisms. After being consumed and metabolized, these drugs are excreted through urine and feces, followed by wastewater treatment. However, conventional treatments do not have the capacity to completely remove these substances, risking their introduction into freshwater systems. This could pose a risk to human health even at low concentrations.

Aims
Thus, the present study aimed to investigate the genotoxicity, cytotoxicity, and mutagenicity of 5-FU and MTX at environmentally relevant concentrations after a long-term exposure, using adult male rats as an experimental model.

Methods
Male Wistar rats (70 days old) were distributed into 4 groups (n = 10/group): control, received only vehicle; MTX, received methotrexate at 10ngL−1; 5-FU received 5-fluorouracil at 10ngL−1; and MTX + 5-FU, received a combination of MTX and 5-FU at 10ngL−1 each. The period of exposure was from postnatal day (PND) 70 to PND 160, through drinking water. After that, the animals were euthanized and the samples (liver, testis, femoral bone marrow, and peripheral blood) were obtained.

Results
Increased DNA fragmentation was observed in the peripheral blood, liver, and testis, altering the parameters of the tail moment and tail intensity in the Comet assay. Besides, the change in the ratio between PCE and NCE indicates bone marrow suppression.

Conclusion
These findings warn the adverse effects for the general population worldwide chronically exposed to these drugs at trace concentration unintentionally.
Characterization of individual bile acids in vivo utilizing a novel low bile acid mouse model
Authors: Taylor Rulaiha , Yang Zhenning , Henry Zakiyah , Capece Gina , Meadows Vik , Otersen Katherine , Basaly Veronia , Bhattacharya Anisha , Mera Stephanie , Zhou Peihong , Joseph Laurie , Yang Ill , Brinker Anita , Buckley Brian , Kong Bo , Guo Grace L 
Published: March 2024

Abstract
Bile acids (BAs) are signaling molecules synthesized in the liver initially by CYP7A1 and CYP27A1 in the classical and alternative pathways, respectively. BAs are essential for cholesterol clearance, intestinal absorption of lipids, and endogenous modulators of farnesoid x receptor (FXR). FXR is critical in maintaining BA homeostasis and gut-liver crosstalk. Complex reactions in vivo and the lack of suitable animal models impede our understanding of the functions of individual BAs. In this study, we characterized the in vivo effects of three-day feeding of cholic acid (CA), deoxycholic acid (DCA), or ursodeoxycholic acid (UDCA) at physiological/non-hepatotoxic concentrations in a novel low-BA mouse model (Cyp7a1−/−/Cyp27a1−/−, DKO). Liver injury, BA levels and composition and BA signaling by the FXR-fibroblast growth factor 15 (FGF15) axis were determined. Overall, higher basal inflammation and altered lipid metabolism in DKO mice might be associated with low BAs. CA, DCA, and UDCA feeding activated FXR signals with tissue specificity. Dietary CA and DCA similarly altered tissue BA profiles to be less hydrophobic, while UDCA promoted a more hydrophobic tissue BA pool with the profiles shifted toward non-12α-OH BAs and secondary BAs. However, UDCA did not offer any overt protective effects as expected. These findings allow us to determine the precise effects of individual BAs in vivo on BA-FXR signaling and overall BA homeostasis in liver physiology and pathologies.
Ethynylestradiol feminizes gene expression partly in testis developing as ovotestis and disrupts asymmetric Müllerian duct development by eliminating asymmetric gene expression in Japanese quail embryos
Authors: Abe Natsuko , Sakiyama Akari , Suzuki Maho , Win-Shwe Tin-Tin , Suzuki Takehiro , Kawashima Takaharu , Tsukahara Shinji 
Published: March 2024

Abstract
In avian embryos, xenoestrogens induce abnormalities in reproductive organs, particularly the testes and Müllerian ducts (MDs). However, the molecular mechanisms remain poorly understood. We investigated the effects of ethynylestradiol (EE2) exposure on gene expression associated with reproductive organ development in Japanese quail embryos. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) analysis revealed that the left testis containing ovary-like tissues following EE2 exposure highly expressed the genes for steroidogenic enzymes (P450scc, P45017α, lyase, and 3β-HSD) and estrogen receptor-β, compared to the right testis. No asymmetry was found in these gene expression without EE2. EE2 induced hypertrophy in female MDs and suppressed atrophy in male MDs on both sides. RNA sequencing analysis of female MDs showed 1,366 differentially expressed genes between developing left MD and atrophied right MD in the absence of EE2, and these genes were enriched in Gene Ontology terms related to organogenesis, including cell proliferation, migration and differentiation, and angiogenesis. However, EE2 reduced asymmetrically expressed genes to 21. RT-qPCR analysis indicated that genes promoting cell cycle progression and oncogenesis were more highly expressed in the left MD than in the right MD, but EE2 eliminated such asymmetric gene expression by increasing levels on the right side. EE2-exposed males showed overexpression of these genes in both MDs. This study reveals part of the molecular basis of xenoestrogen-induced abnormalities in avian reproductive organs, where EE2 may partly feminize gene expression in the left testis, developing as the ovotestis, and induce bilateral MD malformation by canceling asymmetric gene expression underlying MD development.
Digital assets and private law: is there a need for a uniform law?
Authors: Bazinas Spyridon V 
Published: March 2024

Abstract
The various legislative initiatives around the world on the private law aspects of digital assets are a clear indication of both the importance and the urgency of preparing rules of law to adjust private law in general and secured transactions law in particular to address emerging technologies. All these initiatives raise the question whether principles would be sufficient or whether a uniform law would need to be prepared. The purpose of this article is not to attempt to answer this question but rather to advance the discussion setting out some arguments in favour and against, and to suggest a mechanism, a procedure through which States and industry could reach consensus on the most appropriate answers.
Non-Operative Treatment of Humeral Shaft Fractures with Immediate Functional Bracing versus Coaptation Splinting and Delayed Functional Bracing: A Retrospective Study
Authors: Muhammad Maaz , Foster Jeffrey A. , Griffin Jarod T. , Kinchelow Daria L. , Sierra-Arce Carlos R. , Southall Wyatt G. S. , Albitar Ferras , Moghadamian Eric S. , Wright Raymond D. , Matuszewski Paul E. , Zuelzer David A. , Primm Daniel D. , Hawk Gregory S. , Aneja Arun 
Published: March 2024

OBJECTIVES:
To compare radiographic and clinical outcomes in non-operative management of humeral shaft fractures treated initially with coaptation splinting (CS) followed by delayed functional bracing (FB) versus treatment with immediate FB.

METHODS:

Design: Retrospective cohort study

Setting:
Academic Level 1 Trauma Center

Patient Selection Criteria:
Patients with closed humeral shaft fractures managed non-operatively with initial CS followed by delayed FB or with immediate FB from 2016 to 2022. Patients younger than 18 years and/or with less than 3 months follow-up were excluded.

Outcome Measures and Comparisons: The primary outcome was coronal and sagittal radiographic alignment assessed at final follow-up. Secondary outcomes included rate of failure of non-operative management (defined as surgical conversion and/or fracture nonunion), fracture union, and skin complications secondary to splint/brace wear.

RESULTS:
Ninety-seven patients were managed non-operatively with delayed FB (n=58) or immediate FB (n=39). Overall, the mean age was 49.9 years (range 18-94), and 64 (66%) patients were female. The immediate FB group had less smokers (p=0.003) and lower incidence of radial nerve palsy (p=0.025), with more proximal third humeral shaft fractures (p=0.001). There were no other significant differences in demographic or clinical characteristics (p>0.05). There were no significant differences in coronal (p=0.144) or sagittal (p=0.763) radiographic alignment between groups. In total, 33 (34.0%) humeral shaft fractures failed non-operative management, with 11 (28.2%) in the immediate FB group, and 22 (37.9%) in the delayed FB group (p=0.322). There were no significant differences in fracture union (p=0.074) or skin complications (p=0.259) between groups.

CONCLUSIONS:
This study demonstrated that non-operative treatment of humeral shaft fractures with immediate functional bracing did not result in significantly different radiographic or clinical outcomes compared to treatment with coaptation splinting followed by delayed functional bracing. Future prospective studies assessing patient reported outcomes (PROs) will further guide clinical decision making.

LEVEL OF EVIDENCE:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Measures and Impact of Caseload Surge During the COVID-19 Pandemic: A Systematic Review*
Authors: Neupane Maniraj , De Jonge Nathaniel , Angelo Sahil , Sarzynski Sadia , Sun Junfeng , Rochwerg Bram , Hick John , Mitchell Steven H. , Warner Sarah , Mancera Alex , Cooper Diane , Kadri Sameer S. 
Published: March 2024

OBJECTIVES:COVID-19 pandemic surges strained hospitals globally. We performed a systematic review to examine measures of pandemic caseload surge and its impact on mortality of hospitalized patients.DATA SOURCES:PubMed, Embase, and Web of Science.STUDY SELECTION:English-language studies published between December 1, 2019, and November 22, 2023, which reported the association between pandemic “surge”-related measures and mortality in hospitalized patients.DATA EXTRACTION:Three authors independently screened studies, extracted data, and assessed individual study risk of bias. We assessed measures of surge qualitatively across included studies. Given multidomain heterogeneity, we semiquantitatively aggregated surge–mortality associations.DATA SYNTHESIS:Of 17,831 citations, we included 39 studies, 17 of which specifically described surge effects in ICU settings. The majority of studies were from high-income countries (n= 35 studies) and included patients with COVID-19 (n= 31). There were 37 different surge metrics which were mapped into four broad themes, incorporating caseloads either directly as unadjusted counts (n= 11), nested in occupancy (n= 14), including additional factors (e.g., resource needs, speed of occupancy;n= 10), or using indirect proxies (e.g., altered staffing ratios, alternative care settings;n= 4). Notwithstanding metric heterogeneity, 32 of 39 studies (82%) reported detrimental adjusted odds/hazard ratio for caseload surge–mortality outcomes, reporting point estimates of up to four-fold increased risk of mortality. This signal persisted among study subgroups categorized by publication year, patient types, clinical settings, and country income status.CONCLUSIONS:Pandemic caseload surge was associated with lower survival across most studies regardless of jurisdiction, timing, and population. Markedly variable surge strain measures precluded meta-analysis and findings have uncertain generalizability to lower-middle-income countries (LMICs). These findings underscore the need for establishing a consensus surge metric that is sensitive to capturing harms in everyday fluctuations and future pandemics and is scalable to LMICs.
Initial Experience with Unidirectional Barbed Suture for Abdominal Donor Site Closure in Deep Inferior Epigastric Perforator Flap Breast Reconstruction
Authors: Finkelstein Emily R. , Ali Abdel-Moneim Mohamed , Holton Tripp , Slavin Benjamin , Taghioff Susan , Mella-Catinchi Juan , Singh Devinder 
Published: March 2024

Background:
The deep inferior epigastric perforator (DIEP) flap is a predominant technique for autologous breast reconstruction. However, the best method of abdominal fascial closure in this technique is not well defined. This study details our initial experience with unidirectional barbed suture–only repair of abdominal donor site fascia.

Methods:
Patients who underwent DIEP flap breast reconstruction and abdominal fascial closure with Stratafix Symmetric Polydioxanone PDS Plus were retrospectively reviewed. Information regarding pertinent patient history, medical comorbidities, risk factors, and surgical technique was extracted, along with the incidence of eight separate postoperative abdominal surgical site occurrences.

Results:
Retrospective review identified 43 patients who underwent 19 unilateral and 24 bilateral DIEP flap breast reconstruction procedures (n = 67). Average patient follow-up was 791 days (range 153–1769). Six patients (14%) had a complication of the donor site. Seroma was most frequent (n = 3, 7%), followed by surgical site infection (n = 2, 5%). One patient had incisional dehiscence (2%) and another patient developed bulging (2%). No patients had chronic pain, weakness, hematoma, or hernia postoperatively. Patients with donor site complications had a history of abdominal/pelvic surgery significantly more often than the patients without donor site complications (100% versus 49%; P = 0.032).

Conclusions:
Abdominal fascial repair with Stratafix Symmetric suture alone led to low rates of abdominal donor site morbidity, including no hernia and rare bulging, following DIEP flap breast reconstruction. Additional advantages of this technique may be reduced operative times and lower operative costs compared with alternative methods of fascial repair, although prospective and randomized studies are warranted.
Low Dose Radiation and Solid Tumors Mortality Risk
Authors: Tao Xuguang (Grant) , Curriero Frank C. , Mahesh Mahadevappa 
Published: March 2024

Background
US nuclear capable shipyard workers have increased potential for occupational radiation exposure.

Objective
The aim of the study is to examine solid tumor mortality risks at low doses.

Method
437,937 workers working from 1957 to 2004 at eight US shipyards were studied.

Results
Radiation workers with a median life-time dose at 0.82 mSv had a significantly lower solid tumor mortality risk (relative risk [RR]: 0.96, 95% confidence interval [CI]: 0.94–0.98) than nonradiation workers. Among 153,930 radiation workers, the RRs of solid tumors increased with increasing dose categories without statistical significance. The dose category >0–<25 mSv had significantly lower RR (0.95, 95% CI: 0.91–0.99) versus 0 dose and the excess relative risk was 0.05/100 mSv (95% CI: 0.01–0.08).

Conclusions
Solid tumor risk might increase with radiation dose, but not linearly at low doses. Actual mortality risk may be dependent on dose received.
Posttraumatic Stress Symptoms and Predictors Among Spanish Police and Armed Forces During the COVID-19 Pandemic in Spain
Authors: Gracia-Lanchares Susana , Garrido-Hernansaiz Helena , Bueno-Guerra Nereida , Rodríguez-Rey Rocío 
Published: March 2024

Objective
To assess the psychological impact of the COVID-19 crisis on the police and armed forces.

Methods
Participants (N = 242) completed an online survey that assessed posttraumatic stress symptoms (PTSS), burnout, emotional suppression, and labor and sociodemographic variables. Mean difference, correlation, and stepwise linear regression tests were performed.

Results
One-third of participants showed severe PTSS, linked to patrolling duties, very frequent contact with other people, fear of contagion, perceived pandemic severity, living with at-risk people, taking a COVID-19 test, working more than normal, suffering an assault, having little vacation, and having to distance from loved ones. PTSS also correlated with the burnout dimensions and emotional suppression. Three-quarters had not received any support from their workplace.

Conclusions
Effective interventions to optimize these professionals’ personal, social, and working conditions are needed.
Circulating 25-hydroxyvitamin D concentration can predict bowel resection risk among individuals with inflammatory bowel disease in a longitudinal cohort with 13 years of follow-up
Authors: Dan Lintao , Wang Sidan , Chen Xuejie , Sun Yuhao , Fu Tian , Deng Minzi , Chen Jie , Du Zhongyan , Wang Xiaoyan 
Published: March 2024

Background:
Although the beneficial properties of vitamin D in anti-inflammation and immunity-modulation are promising in the management of inflammatory bowel disease (IBD), data were limited for the critical IBD prognosis. The association between serum vitamin D levels and the risk of bowel resection in individuals with IBD remains largely unknown.

Materials and Methods:
The authors performed a longitudinal cohort study among 5474 individuals with IBD in the UK Biobank. Serum 25-hydroxyvitamin D [25(OH)D] was measured using direct competitive chemiluminescent immunoassay. Bowel resection events were ascertained via national inpatient data. Multivariable-adjusted Cox proportional hazard regression was used to examine the association between serum 25(OH)D and bowel resection risk, presented with hazard ratios (HRs) and 95% CIs. Restricted cubic spline (RCS) was used to evaluate dose-response associations.

Results:
During a mean follow-up of 13.1 years, the authors documented 513 incident bowel resection cases. Compared to participants with vitamin D deficiency, nondeficient participants showed a significantly reduced bowel resection risk in IBD (HR 0.72, 95% CI: 0.59–0.87, P=0.001), Crohn’s disease (CD, HR 0.74, 95% CI: 0.56–0.98, P=0.038), and ulcerative colitis (UC, HR 0.73, 95% CI: 0.57–0.95, P=0.020). When comparing extreme quintiles of 25(OH)D level, participants with IBD showed a 34% reduced risk of bowel resection (95% CI: 11–51%, P=0.007) and participants with UC showed a 46% reduced risk (95% CI: 19–64%, P=0.003), while this association was not significant in CD (HR 0.93, 95% CI: 0.59–1.45, P=0.740). Linear dose-response associations were observed using the RCS curve (all P-nonlinearity>0.05).

Conclusion:
Increased serum level of 25(OH)D is independently associated with reduced bowel resection risk in IBD. This association was significant in UC but may not be stable in CD. Vitamin D deficiency is a risk factor for bowel resection in individuals with IBD, and may be an effective metric in predicting and risk-screening surgical events.
Savings in social expenditures for work incapacity in patients with inflammatory bowel disease depend on access to innovative therapies in Poland
Authors: Zagórowicz Edyta , Binowski Grzegorz , Strządała Dominik , Pruszko Cezary , Kucha Piotr , Reguła Jarosław 
Published: March 2024

Objectives
Inflammatory bowel diseases (IBD) are an increasing burden for societies. We examined Polish Social Insurance Institution (ZUS) work incapacity expenditures for people with IBD compared with the general population.

Methods
Aggregate data were obtained on ZUS expenditures between 2012 and 2021 in Polish zlotys (PLN). Annual work incapacity benefit expenditures were analyzed and IBD benefit expenditures were examined relative to innovative IBD drug utilization in individual provinces.

Results
Between 2012 and 2021, annual ZUS expenditures per person increased, while expenditures per IBD patient decreased. Proportionally, absenteeism was the largest ZUS expenditure in the general population, while disability pensions were the largest in the IBD population. ZUS expenditures due to absenteeism in the general population increased by PLN 282 per person; those due to disability pensions decreased by PLN 85. Disability pension spending due to Crohn’s disease (CD) and ulcerative colitis (UC) decreased by PLN 371 and PLN 284, respectively, while absenteeism spending per person with CD and UC decreased (PLN 58 and PLN 35, respectively). Nationwide in 2021, 8.5% of people with CD and 1.9% of those with UC received innovative drugs. The percentage of people receiving innovative drugs and ZUS expenditure per person were inversely related in 9/16 provinces for CD and 5/16 for UC.

Conclusion
Polish state spending on work incapacity benefits increased in the general population but decreased in people with IBD between 2012 and 2021. Use of innovative drugs was associated with reduced spending per person with IBD in some provinces.