bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with the use of cannabis for self-medication by adults: data from the French TEMPO cohort study
Authors: Wallez Solène , Kousignian Isabelle , Hecker Irwin , Rezag Bara Selma Faten , Andersen Astrid Juhl , Melchior Maria , Cadwallader Jean-Sébastien , Mary-Krause Murielle 
Published: April 2024

AbstractBackgroundMedical cannabis, legalized in many countries, remains illegal in France. Despite an experiment in the medical use of cannabis that began in March 2021 in France, little is known about the factors associated with the use of cannabis for self-medication among adults.MethodsData came from the French TEMPO cohort and were collected between December 2020 and May 2021. Overall, 345 participants aged 27–47 were included. Cannabis for self-medication was defined using the following questions: ‘Why do you use cannabis?’ and ‘In what form do you use cannabis?’. The penalized regression method “Elastic net” was used to determine factors associated with the use of cannabis for self-medication, with the hypothesis that it is mainly used for pain in individuals who have already used cannabis.ResultsMore than half of the participants reported having ever used cannabis (58%). Only 10% used it for self-declared medical reasons (n = 36). All self-medication cannabis users, except one, were also using cannabis for recreational purposes. The main factors associated with cannabis use for self-medication vs. other reasons included cannabis use trajectories, the presence of musculoskeletal disorders, tobacco smoking, and parental divorce.ConclusionsEngaging in cannabis use during adolescence or early adulthood may increase the likelihood of resorting to self-medication in adulthood. Due to the propensity of individuals with cannabis use during adolescence to resort to uncontrolled products for self-medication, this population should be more systematically targeted and screened for symptoms and comorbidities that may be associated with cannabis use.
Quality and quantity of clinical trials on low back pain published by Indian physiotherapists
Authors: Suhail Ammar , Quais Sarah 
Published: April 2024

Abstract
Introduction
Clinical trials are regarded as the gold standard evidence for establishing the effectiveness and efficacy of different therapeutic strategies. LBP is a globally prevalent health symptom that is commonly encountered clinically by the physiotherapist. Physiotherapeutic strategies are essential in managing individuals with low back pain (LBP). High-quality clinical trials are required to establish the efficacy/effectiveness of physiotherapeutic management strategies. A clinical trial’s generalizability depends on various factors such as geographical location, population, and healthcare facilities. Evaluating the publication trends and quality of clinical trials conducted by Indian physiotherapists will help determine the effectiveness of physiotherapeutic strategies in managing LBP with respect to the Indian context. Therefore, the study aimed to assess the publication trends and quality of clinical trials conducted by Indian physiotherapists.

Methods
The authors used MEDLINE and the PEDro database to screen for eligible trials. The research encompassed clinical trials addressing low back pain that were authored by Indian physiotherapists and were published between January 2005 and December 2021. The included studies were analyzed for quality using the PEDro Scale. The authors also evaluated sample size calculation, trial registration status, and adherence to the CONSORT checklist.

Results
A total of 866 studies were screened, of which 37 studies were included for final analysis. Most of the studies were published in the southern states of India (Maharashtra and Karnataka), and most were published in 2019. Methodological quality evaluation by PEDro yielded a mean score of 5.17 (range, 2–9). The major missing elements from PEDro items were blinding and intention to treat analysis. Sample size calculation was not found in 83.7% of the studies. Trial registrations were reported in only 10.8% of the studies, and the trials did not report adherence to standard guidelines such as CONSORT.

Conclusion
Included studies showed poor to fair methodological quality according to the PEDro Scale. There has been an increase in the number of RCTs published by Indian physiotherapists. However, there is significant room for improvement in the conduct and reporting of trials.
Structural interpretation of the basement beneath the Southern Desert of Iraq based on aeromagnetic data
Authors: Al-Bahadily Hayder A. , Fairhead James D. , Al-Rahim Ali M. 
Published: April 2024

The Southern Desert (SD) of Iraq is located in the southernmost region of Iraq and is tectonically located on the stable part (proximal domain) of the Arabian Platform. The area is characterized by a considerable thickness of nonmagnetic Phanerozoic sediments overlying a reworked Proterozoic basement. Due to the intense nature of the karst near-surface geology, the basement has neither been seismically imaged nor drilled. In such situations, potential field (gravity and magnetic) exploration methods can often help to identify and map the deep structure of the basement. Here, the aeromagnetic field data, which cover all of the SD, are used to determine the structure and approximate depth of the basement. We use the combined results of the tilt derivative and phase preserving dynamic range compression (PPDRC) methods to qualitatively delineate the main basement structures and then use the source parameter imaging (SPI), tilt-depth (TD), and finite SPI (FSPI) methods to determine the basement depths. The qualitative interpretation of the tilt derivative and PPDRC methods identifies three north–south to northeast–southwest-trending linear negative anomalies that could represent extensional grabens in the basement surface. These grabens divide the basement into three blocks: the northwest block, the central block, and the southeast block. The magnetic anomalies over the basement blocks suggest that the northwest and central blocks are cut by a set of north–south to north-northwest–south-southeast and northeast–southwest faults. Depth estimation methods over the uplifted blocks have minimum depths between 4 and 5 km, whereas, over the graben, the depths range from 7 km to in excess of 12 km. The FSPI method, unlike the SPI and TD methods that use an infinite depth source body, gives depths generally deeper by up to 1.1 km if the assumed Curie-point depth is 21 km. A more realistic Curie-point depth of 32 km is used in the final interpretation model. These inferred basement blocks, grabens, and subbasin structures agree in general with the regional structures associated with the Arabian Peninsula and could provide an important framework for developing future hydrocarbon exploration strategies of the SD.
The Impact of High Adiposity on Endometrial Progesterone Response and Metallothionein Regulation
Authors: Murphy Alina R , Asif Huma , Cingoz Harun , Gourronc Françoise A , Ankrum James A , Klingelhutz Aloysius J , Kim J Julie 
Published: April 2024

Abstract

Context
Obesity is a disease with deleterious effects on the female reproductive tract, including the endometrium.

Objective
We sought to understand the effects of excess adipose on the benign endometrium.

Methods
A physiologic in vitro coculture system was developed, consisting of multicellular human endometrial organoids, adipose spheroids, and menstrual cycle hormones. Native human endometrial tissue samples from women with and without obesity were also analyzed. Benign endometrial tissues from premenopausal women ages 33 to 53 undergoing hysterectomy were obtained following written consent at Northwestern University Prentice Women’s Hospital, Chicago, Illinois. Gene expression, protein expression, chromatin binding, and expression of DNA damage and oxidative damage markers were measured.

Results
Under high adiposity conditions, endometrial organoids downregulated endometrial secretory phase genes, suggestive of an altered progesterone response. Progesterone specifically upregulated the metallothionein (MT) gene family in the epithelial cells of endometrial organoids, while high adiposity significantly downregulated the MT genes. Silencing MT genes in endometrial epithelial cells resulted in increased DNA damage, illustrating the protective role of MTs. Native endometrium from women with obesity displayed increased MT expression and oxidative damage in the stroma and not in the epithelium, indicating the cell-specific impact of obesity on MT genes.

Conclusion
Taken together, the in vitro and in vivo systems used here revealed that high adiposity or obesity can alter MT expression by decreasing progesterone response in the epithelial cells and increasing oxidative stress in the stroma.
A Clinical Trial of High-Dose Growth Hormone in a Patient With a Dominant-Negative Growth Hormone Receptor Mutation
Authors: Merchant Nadia , Houchin Lisa , Boucher Kimberly , Dauber Andrew 
Published: April 2024

Abstract

Context
Rare patients with short stature and growth hormone (GH) resistance have dominant-negative variants in the GH receptor. We describe a patient with GH resistance due to elevated levels of GH binding protein and demonstrate the potential for a precision medicine intervention.

Objective
To determine whether high-dose GH can overcome GH resistance in this specific patient resulting in normal insulin-like growth factor (IGF)-1 levels and improved growth rates.

Methods
Single patient trial of ascending doses of GH followed by a dose stable phase: total 12 months of treatment. The patient has a heterozygous variant in the GH receptor resulting in elevated levels of GH binding protein manifesting as GH resistance and severe short stature. Daily subcutaneous GH was administered, starting at 50 µg/kg/day and escalating to 250 µg/kg/day until goal IGF-1 achieved. The subject continued on 250 µg/kg/day for a total treatment duration of 12 months. The primary outcome measure was the dose of GH required to achieve an IGF-1 level above the midpoint of the normal range. Secondary endpoints included height velocity and the change in height SDS during the first year of treatment.

Results
A dose of GH of 250 µg/kg/day achieved the target IGF-1 level. The patient's annualized height velocity was 8.7 cm/year, an increase of 3.4 cm/year from baseline, resulting in a 0.81 SD gain in height.

Conclusion
A precision medicine approach of extremely high dose GH was able to overcome GH resistance in a patient with a dominant-negative variant in the GH receptor resulting in elevated GH binding protein levels.
Management of Intraosseous Subarcuate Loop of the Anterior Inferior Cerebellar Artery During Trigeminal Schwannoma Resection: 2-Dimensional Operative Video
Authors: De Bonis Alessandro , Plou Pedro , Leonel Luciano César P. C. , Donato Glaudir , Carlson Matthew L. , Peris-Celda Maria 
Published: April 2024

The intraosseous subarcuate loop is an anatomic variant of the anterior inferior cerebellar artery (AICA), in which the artery gives off the subarcuate artery at the apex of the loop, entrapped in the subarcuate fossa (SF) of the temporal bone. First reported by Tanriover and Rhoton,
1
few others
2-5
have addressed this additional challenge during cerebellopontine angle surgery, occurring in 0.6%–4%.
3,6
We present a case of the safe mobilization of the intraosseous variant of the AICA and resection of a trigeminal schwannoma through a retrosigmoid approach with reverse anterior petrosectomy. Illustration of the same anatomic variation in a specimen is also provided.
A 42-year-old male patient presented with intermittent right trigeminal neuropathy. MRI identified an extra-axial dumbbell-shaped heterogeneously contrast-enhancing lesion extending from the right Meckel cave into the cerebellopontine angle. The 3D-CISS sequence demonstrated a possible vascular loop of the right AICA within the SF. Physical examination was negative.
Documented and verified informed consent was obtained.
A right retrosigmoid craniotomy with reverse anterior petrosectomy was performed. The subarcuate artery was coagulated and divided, and the intraosseous loop of the AICA was safely mobilized, with the steps demonstrated on a specimen. The extra-axial mass was exposed, and gross total resection was achieved. The Doppler signal in AICA was appropriate at the end of the operation. The patient recovered well with mild ipsilateral trigeminal sensory loss and no new neurological deficits.
Intraosseous AICA loop in the SF is a relatively common anatomic variation. Identification and safe mobilization are essential to avoid intraoperative lesion of AICA.
Voluntary Wheel Running Reduces Cardiometabolic Risks in Female Offspring Exposed to Lifelong High-Fat, High-Sucrose Diet
Authors: GONZALEZ KASSANDRA , MERLIN ANDREA CHIÑAS , ROYE ERIN , JU BEOMSOO , LEE YOUNGIL , CHICCO ADAM J. , CHUNG EUNHEE 
Published: April 2024

ABSTRACT

Purpose
Maternal and postnatal overnutrition has been linked to an increased risk of cardiometabolic diseases in offspring. This study investigated the impact of adult-onset voluntary wheel running to counteract cardiometabolic risks in female offspring exposed to a life-long high-fat, high-sucrose (HFHS) diet.

Methods
Dams were fed either an HFHS or a low-fat, low-sucrose (LFLS) diet starting from 8 wk before pregnancy and continuing throughout gestation and lactation. Offspring followed their mothers’ diets. At 15 wk of age, they were divided into sedentary (Sed) or voluntary wheel running (Ex) groups, resulting in four groups: LFLS/Sed (n = 10), LFLS/Ex (n = 5), HFHS/Sed (n = 6), HFHS/Ex (n = 5). Cardiac function was assessed at 25 wk, with tissue collection at 26 wk for mitochondrial respiratory function and protein analysis. Data were analyzed using two-way ANOVA.

Results
Although maternal HFHS diet did not affect the offspring’s body weight at weaning, continuous HFHS feeding postweaning resulted in increased body weight and adiposity, irrespective of the exercise regimen. HFHS/Sed offspring showed increased left ventricular wall thickness and elevated expression of enzymes involved in fatty acid transport (CD36, FABP3), lipogenesis (DGAT), glucose transport (GLUT4), oxidative stress (protein carbonyls, nitrotyrosine), and early senescence markers (p16, p21). Their cardiac mitochondria displayed lower oxidative phosphorylation (OXPHOS) efficiency and reduced expression of OXPHOS complexes and fatty acid metabolism enzymes (ACSL5, CPT1B). However, HFHS/Ex offspring mitigated these effects, aligning more with LFLS/Sed offspring.

Conclusions
Adult-onset voluntary wheel running effectively counteracts the detrimental cardiac effects of a lifelong HFHS diet, improving mitochondrial efficiency, reducing oxidative stress, and preventing early senescence. This underscores the significant role of physical activity in mitigating diet-induced cardiometabolic risks.
Long-term complete response to anti-programmed-death-1 monotherapy in a patient with relapsed and refractory ovarian adenocarcinoma: A case report
Authors: Zhou Guang-Di , Li Qin 
Published: April 2024

BACKGROUND
Ovarian cancer is the most common malignant tumor of the female reproductive system, and the survival rate of patients with relapsed and refractory ovarian cancer is very low.
CASE SUMMARY
Here, we report a case of high-grade serous papillary adenocarcinoma of the ovary that was successfully treated with immunotherapy. Radical surgery and adjuvant chemotherapy for the 56-year-old patient were successful; however, her tumor relapsed. Subsequent second-line chemotherapy, targeted agents, and other treatments were ineffective, as the tumor continued to recur and metastasize. Anti-programmed cell death-1 (PD-1) monotherapy (tislelizumab) completely alleviated the tumor, and the multiple metastatic tumors disappeared. To date, the patient has used anti-PD-1 for 32 months, experiencing no disease progression and maintaining good health without additional treatment.
CONCLUSION
This case suggests that anti-PD-1 immunotherapy may have long-term positive effects on outcomes in some refractory recurrent solid tumors. Further research is needed to identify patients most likely to respond to anti-PD-1 therapy.
Hematochezia due to rectal invasion by an internal iliac artery aneurysm: A case report
Authors: Li Fang , Zhao Bin , Liu Yong-Qiang , Chen Guo-Qing , Qu Rong-Feng , Xu Chao , Long Zhui , Wu Jin-Song , Xiong Mao , Liu Wei-Hang , Zhu Li , Feng Xiao-Ling , Zhang Lei 
Published: April 2024

BACKGROUND
This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula, expanding the differential diagnosis for gastrointestinal bleeding. It emphasizes the importance of considering vascular origins in cases of atypical hematochezia, particularly in the absence of common gastrointestinal causes, and highlights the role of imaging and multidisciplinary management in diagnosing and treating such unusual presentations.
CASE SUMMARY
A 75-year-old man with a history of hypertension presented with 12 d of hematochezia, experiencing bloody stools 7-8 times per day. Initial computed tomography (CT) scans revealed an aneurysmal rupture near the right internal iliac artery with suspected hematoma development. Hemoglobin levels progressively decreased to 7 g/dL. Emergency arterial angiography and iliac artery-covered stent placement were performed, followed by balloon angioplasty. Despite initial stabilization, minor rectal bleeding and abdominal pain persisted, leading to further diagnostic colonoscopy. This identified a neoplasm and potential perforation at the proximal rectum. An exploratory laparotomy confirmed the presence of a hematoma and an aneurysm invading the rectal wall, necessitating partial rectal resection, intestinal anastomosis, and ileostomy. Postoperative recovery was successful, with no further bleeding incidents and normal follow-up CT and colonoscopy results after six months.
CONCLUSION
In cases of unusual gastrointestinal bleeding, it is necessary to consider vascular causes for effective diagnosis and intervention.
Incidence and predictors of post-stroke cognitive impairment among patients admitted with first stroke at tertiary hospitals in Dodoma, Tanzania: A prospective cohort study
Authors: Alphonce Baraka , Meda John , Nyundo Azan 
Published: April 2024

Introduction
Stroke survivors develop cognitive impairment, which significantly impacts their quality of life, their families, and the community as a whole but not given attention. This study aims to determine the incidence and predictors of post-stroke cognitive impairment (PSCI) among adult stroke patients admitted to a tertiary hospital in Dodoma, Tanzania.

Methodology
A prospective cohort study was conducted at tertiary hospitals in the Dodoma region, central Tanzania. A sample size of 158 participants with the first stroke confirmed by CT/MRI brain aged ≥ 18 years met the criteria. At baseline, social-demographic, cardiovascular risks and stroke characteristics were acquired, and then at 30 days, participants were evaluated for cognitive functioning using Montreal Cognitive Assessment (MoCA). Key confounders for cognitive impairment, such as depression and apathy, were evaluated using the Personal Health Questionnaire (PHQ-9) and Apathy Evaluation Scale (AES), respectively. Descriptive statistics were used to summarise data; continuous data were reported as Mean (SD) or Median (IQR), and categorical data were summarised using proportions and frequencies. Univariate and multivariable logistic regression analysis was used to determine predictors of PSCI.

Results
The median age of the 158 participants was 58.7 years; 57.6% of them were female, and 80.4% of them met the required criteria for post-stroke cognitive impairment. After multivariable logistic regression, left hemisphere stroke (AOR: 5.798, CI: 1.030–32.623, p = 0.046), a unit cm3 increase in infarct volume (AOR: 1.064, 95% CI: 1.018–1.113, p = 0.007), and apathy symptoms (AOR: 12.259, CI: 1.112–89.173, p = 0.041) had a significant association with PSCI.

Conclusion
The study revealed a significant prevalence of PSCI; early intervention targeting stroke survivors at risk may improve their outcomes. Future research in the field will serve to dictate policies and initiatives.
Health and economic burden of insufficient physical activity in Saudi Arabia
Authors: Alqahtani Saleh A. , AlAhmed Reem , Hamza Mariam M. , Alessy Saleh A. , Alqunaibet Ada , AlGhammas Amal , Watkins David , Msemburi William , Alkhattabi Fadiah , Pickersgill Sarah , Rakic Severin , Alsukait Reem F. , Herbst Christopher H. , Al-Hazzaa Hazzaa M. 
Published: April 2024

Background
Insufficient physical activity (PA) was estimated to cause 4.8% of deaths and 2.6% of disability-adjusted life-years (DALYs) due to noncommunicable diseases in Saudi Arabia in 2019. While Saudi Arabia is already achieving great improvements, we predict the health and economic burden of insufficient PA up to 2040 to present a case for policy makers to invest more in the uptake of PA.

Methods
Using a population health model to estimate avoidable health loss, we identified four causes of health loss related to low PA (cardiovascular diseases, diabetes, breast cancer, and colorectal cancer) and estimated the deaths and DALYs from these causes. We projected the expected disease burden until 2040 under alternative assumptions about future PA levels and trends by using three health scenarios: baseline (no change in 2019 PA levels), intervention (81% of the population achieving sufficient PA levels), and ideal (65% of population: moderate PA, 30%: high PA, and 5%: inactive). We applied an “intrinsic value” approach to estimate the economic impact of each scenario.

Results
Overall, we estimate that between 2023 and 2040, about 80,000 to 110,000 deaths from all causes and 2.0 million to 2.9 million DALYs could be avoided by increasing PA levels in Saudi Arabia. The average annual economic loss from insufficient PA is valued at 0.49% to 0.68% of the current gross domestic product, with an average of US$5.4 billion to US$7.6 billion annually till 2040. The most avoidable disease burden and economic losses are expected among males and because of ischemic heart disease.

Conclusions
This study highlights that low PA levels will have considerable health and economic impacts in Saudi Arabia if people remain inactive and do not start following interventions. There is an urgent need to develop innovative programs and policies to encourage PA among all age and sex groups.