bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency and implications of malnutrition in systemic sclerosis
Authors: Fairley Jessica L , Hansen Dylan , Quinlivan Alannah , Proudman Susanna , Sahhar Joanne , Ngian Gene-Siew , Walker Jennifer , Host Lauren V , Morrisroe Kathleen , Stevens Wendy , Ross Laura , Nikpour Mandana 
Published: March 2024

Abstract

Objectives
To quantify the frequency and impact of malnutrition in systemic sclerosis (SSc), as diagnosed by the Global Leadership Initiative on Malnutrition (GLIM) criteria, based on weight loss, BMI and muscle atrophy.

Methods
Australian Scleroderma Cohort Study participants meeting ACR/EULAR criteria for SSc with ≥1 concurrent weight and height measurement were included. The chi-squared test, two-sample t-test or Wilcoxon’s rank-sum test was used for between-group comparison as appropriate. Multivariable logistic regression models were used to establish the determinants of malnutrition diagnosis. Kaplan–Meier and Cox proportional hazard models were used for survival analyses, based on malnutrition diagnosis, and individual GLIM criteria (percentage weight loss, BMI thresholds and presence of muscle atrophy).

Results
In this study of 1903 participants, 43% were diagnosed with malnutrition according to GLIM criteria, of whom 33% had severe malnutrition. Participants diagnosed with malnutrition were older, and more likely to have diffuse cutaneous SSc (dcSSc), higher SSc severity scores and RNA polymerase-3 positivity. Gastrointestinal (GI) involvement, multimorbidity, cardiopulmonary disease, raised inflammatory markers, hypoalbuminaemia and anaemia were more common in malnourished participants (P &lt; 0.01). Multimorbidity (odds ratio [OR] 1.6; 95% CI: 1.2, 2.0; P &lt; 0.01), pulmonary arterial hypertension (OR 2.1; 95% CI: 1.4, 2.0; P &lt; 0.01) and upper GI symptoms (OR 1.6; 95% CI: 1.3, 2.0; P &lt; 0.01) were all associated with malnutrition. Health-related quality-of-life (HRQoL) and physical function were poorer in malnourished participants. Survival was worse in those with malnutrition after adjusting for age, sex and dcSSc (hazard ratio 1.4; 95% CI: 1.1, 1.7; P &lt; 0.01).

Conclusion
Malnutrition is common in SSc and confers poorer survival, HRQoL and physical function.
A New Path of Women’s Organizing: An Analysis of Female Folk Custom Groups in the Yimeng Mountain Area of China
Authors: Huang Cui , Ma Hongying 
Published: March 2024

Abstract
Female organizational development is the foundation for enhancing women’s political and economic capabilities. This study focuses on the urgent need for women’s participation in China’s rural revitalization and emphasizes the crucial role of promoting the organizational development of rural women. Drawing upon the innovation theory in evolutionary economics, we conducted a field survey in the Yimeng Mountain area of Shandong Province, China, involving 900 rural women. The study explores a new path of women’s organizing, specifically the innovation and transformation of rural female folk custom groups into formal organizations. Empirical analysis reveals that Village Two Committees exert the most influential positive effect on the organizational innovation of female folk custom groups among organizational factors. Additionally, institutional factors such as rural revitalization and culture construction significantly contribute to this transformation. Moreover, individual factors such as relative income levels and the exemplary role of rural capable women also exhibit significant positive influence.
A Path to High-Value Gastric Cancer Surgery Care Delivery
Authors: Teh Swee H. , Shiraga Sharon , Kellem Aaron M. , Li Robert A. , Le David M. , Arsalane Said P. , Khayat Fawzi S. , Li Yan , Gong I-Yeh , Lee Jessica M. 
Published: March 2024

Objective:
To evaluate the feasibility, safety, and effectiveness of a comprehensive regional program, including the Minimally Invasive Recovery and Empowerment Care (MIREC) pathway, that can significantly reduce hospital stays after laparoscopic gastrectomy without increasing adverse events.

Background:
Cost-effectiveness and improving patient outcomes are crucial in providing quality gastric cancer care worldwide.

Methods:
To compare the outcomes of gastric cancer surgery using 2 different models of care within an integrated healthcare system from February 2012 to March 2023. The primary endpoint was the length of hospital stay. The secondary endpoints were the need for intensive care unit care, emergency room (ER) visits, readmission, reoperation, and death within 30 days after surgery.

Results:
There were 553 patients, 167 in the pre-(February 2012–April 2016) and 386 in the post-MIREC period (May 2016–March 2023). Perioperative chemotherapy utilization increased from 31.7% to 76.4% (P < 0.0001). Laparoscopic gastrectomy increased from 17.4% to 97.7% (P < 0.0001). Length of hospitalization decreased from 7 to 2 days (P < 0.0001), with 32.1% and 88% of patients discharged home on postoperative day 1 and postoperative day 2, respectively. When comparing pre- and post-MIREC, intensive care unit utilization (10.8% vs. 2.9%, P < 0.0001), ER visits (34.7% vs. 19.7%, P = 0.0002), and readmission (18.6% vs. 11.1%, P = 0.019) at 30 days were also considerably lower. In addition, more patients received postoperative adjuvant chemotherapy (31.4% to 63.5%, P < 0.0001), and the time between gastrectomy and starting adjuvant chemotherapy was also less (49–41 days; P = 0.002).

Conclusion:
This comprehensive regional program, which encompasses regionalization care, laparoscopic approach, modern oncologic care, surgical subspecialization, and the MIREC pathway, can potentially improve gastric cancer surgery outcomes. These benefits include reduced hospital stays and lower complication rates. As such, this program can revolutionize how gastric cancer surgery is delivered, leading to a higher quality of care and increased value to patients.
Theoretical Prediction of the 210Pb Burden in the Skeleton from Radon Exposure and Other Intake Routes
Authors: Wang Jing , Liu Yuanyuan , Wu Bin , Meng Xiangpeng , Wang Yu , Cheng Jianping 
Published: March 2024

Abstract
The 210Pb burden in the skeleton is a measurement value suitable for the estimation of the cumulative exposure to radon, based on which the resultant risk of lung cancer can be derived. There have been a handful of studies that successfully measured 210Pb activity in the bones of volunteers who had chronic exposure to high concentrations of radon occupationally or in their residences. However, the quantitative relationship between measured 210Pb activity and radon exposure remains elusive. Herein, we investigate the origin of the skeletal burden by employing the biokinetic model recommended by the International Commission on Radiological Protection and modeling various routes of intake. First, the baseline 210Pb burden for the general public regarding eating assorted foodstuffs and breathing normal air is obtained. It is found that this baseline burden ranges between 7.3 to 46.5 Bq for a 50-y-old (male) person, which characterizes a large variance due to the uncertainty of each route of intake. Next, we concentrate on radon exposure by referring to two experimental studies where the accounts of exposure and the measured 210Pb burden for each volunteer are documented in detail. From comparing our prediction and measurements, it is found that exposure to higher concentration of radon is the most significant source of 210Pb intake, and the quantitative differences can be reasonably explained by the uncertainty resulting from regular intake routes. This study establishes the theoretical foundation for assessing one’s risk of lung cancer due to radon exposure by measuring the 210Pb burden in bones.
Appropriate thromboprophylaxis strategy for COVID-19 patients on dosage, antiplatelet therapy, outpatient, and postdischarge prophylaxis: a meta-analysis of randomized controlled trials
Authors: Meng Jiahao , Tang Hang , Xiao Yifan , Liu Weijie , Wu Yumei , Xiong Yilin , Gao Shuguang 
Published: March 2024

Background:
There was controversy surrounding the optimal thromboprophylaxis strategy for coronavirus disease 2019 (COVID-19) patients. This included debates on the dosage of anticoagulants for thromboembolism prophylaxis, the requirement for additional antiplatelet therapy, and the necessity of prophylaxis for outpatients and postdischarge. To explore this, the authors performed a meta-analysis of randomized controlled trials.

Methods:
PubMed, Cochrane Library, Embase, and Web of Science were last searched on 26 July 2023 for studies comparing the effect of different dose of anticoagulation, additional antiplatelet, and postdischarge prophylaxis for COVID-19 patients. The results of eligible studies were analyzed in terms of thromboembolism events, major bleeding and all-cause mortality during follow-up.

Results:
Our study included a total of 25 randomized controlled trials, involving 17 911 patients. Our results revealed that, compared to prophylactic dose, therapeutic dose showed lower thrombotic risk (RR, 0.66; 95% CI: 0.45–0.96) but had similar major bleeding risk for critically ill patients with COVID-19. On the other hand, intermediate dose and prophylactic dose demonstrated similar thromboembolism risk and major bleeding risk. For noncritically ill patients with COVID-19, therapeutic dose of anticoagulants was associated with lower thrombotic risk (RR, 0.50; 95% CI: 0.34–0.72) but, at the same time, increased the risk of major bleeding (RR, 2.01; 95% CI: 1.22–3.33). However, intermediate dose showed lower thromboembolism risk (RR, 0.38; 95% CI: 0.21–0.69) while maintaining a similar major bleeding risk. In critically ill patients, additional antiplatelet therapy showed similar thromboembolism, major bleeding risk, and mortality when compared to no treatment. For outpatients, additional prophylactic anticoagulation showed similar thromboembolism, major bleeding risk, and mortality when compared to no treatment. For postdischarge patients, postdischarge prophylaxis reduced thromboembolism risk (RR, 0.49; 95% CI: 0.31–0.76) but increased major bleeding risk (RR, 2.63; 95% CI: 1.13–6.14).

Conclusion:
For noncritically ill patients, therapeutic dose prophylactic anticoagulation significantly reduced venous thromboembolism but increases major bleeding risk. Intermediate dose effectively lowered venous thromboembolism without raising major bleeding risk. The optimal dose and need for additional antiplatelet therapy in critically ill patients, as well as the necessity of prophylactic anticoagulation in outpatient and postdischarge patients, required further investigation and confirmation through rigorous evidence studies.
Serial changes in diffusion tensor imaging metrics and therapeutic effects of repetitive transcranial magnetic stimulation in post-traumatic headache and depression: A case report
Authors: Yun Young-Ji , Kim Gi-Wook 
Published: March 2024

Background:
Mild traumatic brain injury patients commonly complain headache and central pain, and the pain accompanies depressive mood change. This case study reports the therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) in mild traumatic brain injury patient with headache and depression through objective serial changes of diffusion tensor imaging (DTI).

Methods:
The 51-year-old man complained of headache and depression despite conventional treatment for 13 months. We applied 15 times rTMS on the left dorsolateral prefrontal cortex. We checked the pain and depression through numeric rating scale (NRS) and Beck depression inventory (BDI) when admission, discharged, and 1 month after discharge. DTI was performed 3 times; before, during-day of rTMS 6th stimulation, and after-day of rTMS 15th stimulation. Then the reconstructed White matter related to pain and depression was obtained.

Results:
NRS and BDI showed significant improvement and it was maintained 1 year after discharge. DTI-based metrics of the White matters related to pain and depression gradually increased before – during – after rTMS.

Conclusion:
Studies focused on examining changes in pain, depression and DTI-based metrics of White matter are rare. This case is significant in that not only pain and depression improved after the rTMS, but also serial changes in White matter were observed in DTI.
Bibliometric and visualized analysis of DME from 2012 to 2022
Authors: Liu Yi , Zhu Qiuyan , Jiang Pengfei , Yang Yang , Wang Mingyun , Liang Hao , Peng Qinghua , Zhang Qiuyan 
Published: March 2024

Background:
Diabetic macular edema (DME) is the main cause of irreversible vision loss in patients with diabetes mellitus (DM), resulting in a certain burden to patients and society. With the increasing incidence of DME, more and more researchers are focusing on it.

Methods:
The papers related to DME between 2012 and 2022 from the Web of Science core Collection were searched in this study. Based on CiteSpace and VOS viewer, these publications were analyzed in terms of spatiotemporal distribution, author distribution, subject classification, topic distribution, and citations.

Results:
A total of 5165 publications on DME were included. The results showed that the research on DME is on a steady growth trend. The country with the highest number of published documents was the US. Wong Tien Yin from Tsinghua University was the author with the most published articles. The journal of Retina, the Journal of Retinal and Vitreous Diseases had a large number of publications. The article “Mechanisms of macular edema: Beyond the surface” was the highly cited literature and “Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema” had the highest co-citation frequency. The treatment, diagnosis, pathogenesis, as well as etiology and epidemiological investigation of DME, have been the current research direction. Deep learning has been widely used in the medical field for its strong feature representation ability.

Conclusions:
The study revealed the important authoritative literature, journals, institutions, scholars, countries, research hotspots, and development trends in in the field of DME. This indicates that communication and cooperation between disciplines, universities, and countries are crucial. It can advance research in DME and even ophthalmology.
Littoral cell angioma of the spleen: A study of 10 cases case series and literature review
Authors: Shen Huaping , Zhu Yingjie , Zhong Jiajie , Shen Yang , Huang Yang , Song Pengtao , He Jian , Zhou Shiyu , Wu Xiaochang 
Published: March 2024

Background:
Current study aimed to investigate the clinical characterization, differential diagnosis, and treatment of splenic littoral cell angioma (LCA).

Methods:
A retrospective analysis was performed for 10 LCA cases admitted to Huzhou Central Hospital from 2007 to 2023, for clinical manifestations, hematological tests, imaging features, pathological features, treatment methods, and prognosis along with the relevant literature was also reviewed.

Results:
During examinations, no specific clinical manifestations and hematological abnormalities were seen in all 10 cases of LCA. Imaging observations depicted single or even multiple spherical lesions in the spleen. Plains shown by computed tomography (CT) were found somewhat equal or slightly lower in density. On the other hand, magnetic resonance imaging (MRI) plain scans viz. T1 weighted image showed equal low and mixed signals while T2-weighted showed high and low mixed signals. Moreover, punctate low signals could be seen in high signals named “freckle sign” in MRI scans. On contrast-enhanced CT scans, the enhancement of the lesions was not obvious in the arterial phase, and some of the lesions showed edged ring-like enhancements and “filling lake” progressive enhancement during the venous phase and delayed phase. In multiple lesions, the number of enhanced scan lesions showed a variable changing pattern “less-more-less.” MRI-enhanced scan showed the characteristics of “fast in and slow out.” Microscopic examinations identified tumor tissue actually composed of sinus-like lacunae that anastomosed with each other in the form of a network. Furthermore, cystic expansion and pseudopapillary protrusions were also seen in the dilated sinus cavity which was lined with single-layer endothelial cells having conspicuous cytoplasmic hemosiderin. High immunophenotypic expressions of vascular endothelial cell phenotype (CD31, CD34, FVIII) and tissue cell phenotype (CD68) were also seen. Total and partial splenectomy were performed in 8 and 2 patients, respectively, and follow-up examinations showed survival in all patients with no recurrence.

Conclusion:
LCA is a rare splenic benign lesion with atypical clinical manifestations. CT and MRI imaging are important tools in preoperative diagnosis based on pathomorphological and immunohistochemical examinations. Splenectomy is a superior therapeutic choice with significant impacts and prognosis.
Health benefits of short Taichi Qigong exercise (STQE) to University Students’ core strength, lower limb explosive force, cardiopulmonary endurance, and anxiety: A Quasi experiment research
Authors: Wang Feng , Syed Ali Syed Kamaruzaman Bin 
Published: March 2024

Background:
College students’ physical fitness has declined over the past decades. Taichi Qigong exercise offers numerous health benefits and could serve as a suitable option for them. Traditional programs, however, are time-consuming and necessitate long-term commitments. Therefore, a more cost-effective intervention is needed.

Methods:
The study enrolled a total of 31 students who actively participated in a 5-week STQE program, consisting of three 60-minute sessions per week. Physical and mental health assessments included the Plank test, vital capacity measurement, 1000/800 m run test, standing jump, and the Zung Self-Rating Scale. Data analysis was performed using SPSS.

Results:
Following the STQE intervention, participants showed improvement in core strength (28.1 seconds in the Plank test, P = .025) and lower limb explosive force (6.52 cm in the standing jump test, P = .011), accompanied by a decrease in anxiety levels (a reduction of 3.41 in the Zung Self-Rating Scale, P = .039). However, no significant improvements were observed in cardiopulmonary endurance, as evidenced by a non-significant increase of 237.84 mL in vital capacity (P = .134) and a non-significant reduction of 1.6 seconds in the 1000/800 m run test (P = .764).

Conclusion:
The study suggests that the STQE program effectively improves core strength, lower limb explosive force, and reduces anxiety levels among university students.
Puerperal septic shock complicated with symmetrical peripheral gangrene: A case report
Authors: Wang Yue , Tang Cen , Li Yajin , Hu Wanqin 
Published: March 2024

Rationale:Puerperal sepsis is a life-threatening condition caused by infection that can rapidly progress to multisystem infection and toxin-mediated shock. Symmetrical peripheral gangrene is defined as symmetrical distal ischemic damage in two or more sites in the absence of major vascular occlusive disease. The syndrome is devastating and rare. In this study, we introduce a case of puerperal septicemia complicated by symmetrical peripheral gangrene.Patient concerns:A 23-year-old woman delivered a live female infant vaginally after cervical balloon dilatation at 39 weeks of gestation. Persistent hyperthermia developed on the first postpartum day. After experiencing ventricular fibrillation, acute liver failure, and acute pulmonary edema, she developed blackened extremities on the 5th postpartum day.Diagnoses:Puerperal septicemia complicated by symmetrical peripheral gangrene.Interventions:Upon transfer to our hospital, the patient was enrolled in the intensive care unit and underwent anti-infective and amputation surgery.Outcomes:After the surgery, the patient recovered well and was successfully discharged from the hospital.Lessons:Early detection and timely treatment is the best way to reduce the mortality and sequelae of puerperal sepsis. Physicians should be alert to the possibility of comorbid symmetrical peripheral gangrene when sepsis patients present with hepatic impairment.
Visual analysis of global hemorrhagic fever with renal syndrome research from 1980 to 2022: Based on CiteSpace and VOSviewer
Authors: Zhou Wenfang , Dong Yonghai , Si Hongyu , Yang Cheng , Zhao Jun , Chen Xiaona , Ye Zhenzhen 
Published: March 2024

Objective:
The development and current state of hemorrhagic fever with renal syndrome (HFRS) over the past 40 years are analyzed in this study, along with explored and discovered the hotspots and frontiers in the field, which serve as the foundation for future investigation.

Methods:
CiteSpace and VOSviewer analysis software were used to visually analyze the literature data on HFRS from 1980 to 2022, including the annual number of publications, countries and research institutions, authors, co-cited literature and keywords.

Results:
The number of pertinent papers published in the field of HFRS displayed an overall upward trend from 1980 to 2022. The United States, China, Germany, Sweden, and France are the top 5 countries in terms of publishing volume, with high intermediate centrality mainly concentrated in Europe and the United States. The top 10 co-occurring keywords were hemorrhagic fever, renal syndrome, infection, virus, epidemic, nephropathia epidemical, disease, hantavirus, outbreak, and transmission. According to keyword cluster analysis, there were 4 main research fields. In the HFRS-related study, there were mainly 21 notable keywords and “Korean hemorrhagic fever” had the highest hemorrhagic value (28.87).

Conclusion:
The United States, China, Germany, Sweden and other countries attached great importance to the HFRS-related research. Moreover, the collaboration between authors and institutions in various collaborator clusters should be strengthened. In recent decades, investigations have focused on the study of viral infection and the clinical symptoms and pathophysiology of HFRS. Future research may concentrate on factors affecting host population distribution and density, such as vaccine development and meteorological factors pertaining to virus transmission.
The transdifferentiation of human dedifferentiated fat cells into fibroblasts: An in vitro experimental pilot study
Authors: Lim Nam Kyu , Jeon Hong Bae , Kim Sungyeon 
Published: March 2024

Background:
Skin grafting is a common method of treating damaged skin; however, surgical complications may arise in patients with poor health. Currently, no effective conservative treatment is available for extensive skin loss. Mature adipocytes, which constitute a substantial portion of adipose tissue, have recently emerged as a potential source of stemness. When de-lipidated, these cells exhibit fibroblast-like characteristics and the ability to redifferentiate, offering homogeneity and research utility as “dedifferentiated fat cells.”

Methods and results:
We conducted an in vitro study to induce fibroblast-like traits in the adipose tissue by transdifferentiating mature adipocytes for skin regeneration. Human subcutaneous fat tissues were isolated and purified from mature adipocytes that underwent a transformation process over 14 days of cultivation. Microscopic analysis revealed lipid degradation over time, ultimately transforming cells into fibroblast-like forms. Flow cytometry was used to verify their characteristics, highlighting markers such as CD90 and CD105 (mesenchymal stem cell markers) and CD56 and CD106 (for detecting fibroblast characteristics). Administering dedifferentiated fat cells with transforming growth factor-β at the identified optimal differentiation concentration of 5 ng/mL for a span of 14 days led to heightened expression of alpha smooth muscle actin and fibronectin, as evidenced by RNA and protein analysis. Meanwhile, functional validation through cell sorting demonstrated limited fibroblast marker expression in both treated and untreated cells after transdifferentiation by transforming growth factor-β.

Conclusion:
Although challenges remain in achieving more effective transformation and definitive fibroblast differentiation, our trial could pave the way for a novel skin regeneration treatment strategy.