bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global burden, trends, and inequalities of ischemic heart disease among young adults from 1990 to 2019: a population-based study
Authors: Wu Peng , Yu Shuixiu , Wang Jun , Zou Shenglan , Yao De-Shan , Xiaochen Yuan 
Published: November 2023

BackgroundIschemic heart disease (IHD) is a major global health concern, and its burden among young adults aged 25–49 years remains underexplored. This study aims to provide a comprehensive assessment of the global burden and trends of IHD over the past 30 years (1990–2019) among this age group, as well as to analyze the health inequalities related to socioeconomic development.MethodsData from Global Burden of Disease Study 2019 (GBD 2019) were utilized to analyze the prevalence, mortality, and disability-adjusted life years (DALYs) rate of IHD among young adults globally. Joinpoint regression analysis was applied to examine the trends over the study period. Health inequality analysis was performed to investigate the disparities in IHD burden related to the Socio-Demographic Index (SDI) of countries.ResultsAccording to GBD 2019 data, in 2019, the global numbers of young adults with IHD cases, deaths, and DALYs were 18,050,671 (95% UI, 15,551,940–21,254,746), 597,137 (548,250–647,778), and 28,692,968 (26,397,448–31,178,464), respectively, accounting for 9.15%, 6.53%, and 15.7% of the total global cases. Over the past 30 years, the mortality [AAPC = −0.4%, 95% CI (−0.7% to −0.1%)] and DALYs rate [AAPC = −0.3%, 95% CI (−0.6% to −0.1%)] of IHD among young adults decreased, while the prevalence rate [AAPC = 0.4%, 95% CI (0.4%–0.4%)] and YLDs rate [AAPC = 0.4%, 95% CI (0.3%–0.4%)] increased. Furthermore, countries with lower levels of socio-demographic index (SDI) disproportionately bore a higher burden of IHD among young adults. The inequality slope index for young adult IHD shifted from −56.6 [95% CI (−480.4–370.2)] in 1990 to −583.0 [95% CI (−996.8 to −169.2)] in 2019, and the concentration index moved from −8.2 [95% CI (−8.5 to −7.9)] in 1990 to −13.2 [95% CI (−13.9 to −12.4)] in 2019.ConclusionsWhile the mortality and DALYs rate of IHD among global young adults have decreased over the past 30 years, the degree of inequality related to SDI among countries has continued to increase. Decision-makers in various countries should allocate resources wisely and implement effective strategies to improve the burden of young adults IHD globally and address the health inequalities associated with it.
Smoking influence in Takotsubo syndrome: insights from an international cohort
Authors: Núñez-Gil Iván J. , Santoro Francesco , Vazirani Ravi , Novo Giuseppina , Blanco-Ponce Emilia , Arcari Luca , Uribarri Aitor , Cacciotti Luca , Guerra Federico , Salamanca Jorge , Musumeci Beatrice , Vedia Oscar , Mariano Enrica , Fernández-Cordón Clara , Caldarola Pasquale , Montisci Roberta , Brunetti Natale Daniele , El-Battrawy Ibrahim , Abumayyaleh Mohammad , Akin Ibrahim , Eitel Ingo , Stiermaier Thomas 
Published: November 2023

AimsTo assess the influence of tobacco on acute and long-term outcomes in Takotsubo syndrome (TTS).MethodsPatients with TTS from the international multicenter German Italian Spanish Takotsubo registry (GEIST) were analyzed. Comparisons between groups were performed within the overall cohort, and an adjusted analysis with 1:1 propensity score matching was conducted.ResultsOut of 3,152 patients with TTS, 534 (17%) were current smokers. Smoker TTS patients were younger (63 ± 11 vs. 72 ± 11 years, p &lt; 0.001), less frequently women (78% vs. 90%, p &lt; 0.001), and had a lower prevalence of hypertension (59% vs. 69%, p &lt; 0.01) and diabetes mellitus (16% vs. 20%, p = 0.04), but had a higher prevalence of pulmonary (21% vs. 15%, p &lt; 0.01) and/or psychiatric diseases (17% vs. 12%, p &lt; 0.01). On multivariable analysis, age less than 65 years [OR 3.85, 95% CI (2.86–5)], male gender [OR 2.52, 95% CI (1.75–3.64)], history of pulmonary disease [OR 2.56, 95% CI (1.81–3.61)], coronary artery disease [OR 2.35, 95% CI (1.60–3.46)], and non-apical ballooning form [OR 1.47, 95% CI (1.02–2.13)] were associated with smoking status. Propensity score matching (PSM) 1:1 yielded 329 patients from each group. Smokers had a similar rate of in-hospital complications but longer in-hospital stays (10 vs. 9 days, p = 0.01). During long-term follow-up, there were no differences in mortality rates between smokers and non-smokers (5.6% vs. 6.9% yearly in the overall, p = 0.02, and 6.6%, vs. 7.2% yearly in the matched cohort, p = 0.97).ConclusionsOur findings suggest that smoking may influence the clinical presentation and course of TTS with longer in-hospital stays, but does not independently impact mortality.
Assessment of treatment response in cardiac sarcoidosis based on myocardial 18F-FDG uptake
Authors: Frischknecht Lukas , Schaab Jan , Schmauch Eloi , Yalamanoglu Ayla , Arnold Dennis D. , Schwaiger Judith , Gruner Christiane , Buechel Ronny R. , Franzen Daniel P. , Kolios Antonios G.A. , Nilsson Jakob 
Published: November 2023

ObjectiveImmunosuppressive therapy for cardiac sarcoidosis (CS) still largely consists of corticosteroid monotherapy. However, high relapse rates after tapering and insufficient efficacy are significant problems. The objective of this study was to investigate the efficacy and safety of non-biological and biological disease-modifying anti-rheumatic drugs (nb/bDMARDs) considering control of myocardial inflammation assessed by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of the heart.MethodsWe conducted a retrospective analysis of treatment response to nb/bDMARDs of all CS patients seen in the sarcoidosis center of the University Hospital Zurich between January 2016 and December 2020.ResultsWe identified 50 patients with CS. Forty-five patients with at least one follow-up PET/CT scan were followed up for a mean of 20.5 ± 12.8 months. Most of the patients were treated with prednisone and concomitant nb/bDMARDs. At the first follow-up PET/CT scan after approximately 6.7 ± 3 months, only adalimumab showed a significant reduction in cardiac metabolic activity. Furthermore, comparing all serial follow-up PET/CT scans (143), tumor necrosis factor inhibitor (TNFi)-based therapies showed statistically significant better suppression of myocardial 18F-FDG uptake compared to other treatment regimens. On the last follow-up, most adalimumab-treated patients were inactive (n = 15, 48%) or remitting (n = 11, 35%), and only five patients (16%) were progressive. TNFi was safe even in patients with severely reduced left ventricular ejection fraction (LVEF), and a significant improvement in LVEF under TNFi treatment was observed.ConclusionTNFi shows better control of myocardial inflammation compared to nbDMARDs and corticosteroid monotherapies in patients with CS. TNFi was efficient and safe even in patients with severely reduced LVEF.
Effect of insulin levels and plasma fasting glucose on refractive status in the United States population aged 12–19 years
Authors: Hu Pengcheng , Liu Jialing , He Ming , Fu Yuxian , Wang Menglei 
Published: November 2023

PurposeThe causes of myopia are varied, and both genetic and environmental influences play an essential role. The prevalence of myopia is increasing among adolescents and is expected to be more than one-third the global population by 2050. Some animal studies suggest that hyperinsulinemia may be a cause of myopia. In this context, the purpose of this paper is to investigate the potential effects of insulin levels and plasma fasting glucose on the refractive status of adolescents.MethodsData were collected from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2008. Weighted multivariable linear regression models were used to assess the effect of insulin levels, plasma fasting glucose on refractive status. We used a smooth curve fit to reveal the nonlinear relationship between the variables.ResultsIn the multivariate regression model, as insulin levels increased, there was a shift towards myopia in refractive status (β = −0.013, 95% CI: −0.023 to −0.004). This correlation was also evident in the male adolescent subgroup (β = −0.021, 95% CI: −0.035 to −0.007). Similar findings indicated that in Mexican Americans, there was a myopic shift in refractive status as insulin levels increased (β = −0.018, 95% CI: −0.033 to −0.002). However, grouping by differences in insulin measurement showed no significant correlation in Mexican-Americans. At the same time, there was no significant correlation between plasma fasting glucose and refractive status (β = −0.041, 95% CI: −0.174 to 0.091).ConclusionThe present cross-sectional study demonstrated that higher insulin levels may promote the development of myopia in adolescents, but there may be variations across gender and ethnicity. More basic research is needed to reveal the mechanistic reasons for the association.
Age-induced aortic modifications are accompanied by alterations in the antioxidant defense system in female rats
Authors: Asad Sabahat Binte , Qian Xin , Wang Jiao , Asad Wajeeha , Gao Qiang , Cao Yang , Huang Yujia , Bin Jardan Yousef A. , Shah Tawaf Ali , Wondmie Gezahign Fentahun , Bourhia Mohammed , Lu Chunmei , Zhu Hui 
Published: November 2023

IntroductionAging leads to significant structural and functional changes in blood vessels, which disrupt their normal function and impact cardiovascular health. Current research is actively exploring the NRF2 antioxidative pathway, recognizing its role in protecting cells by preserving their antioxidant defenses against damage. However, there has been limited exploration into the role of the NRF2 pathway in vascular aging. The primary objective of this study was to determine whether age-related changes in the aorta are associated with variations in the baseline levels of antioxidant enzymes, with a particular emphasis on how the NRF2 pathway operates in the aortic wall.MethodsA group of healthy aging female SD rats was compared with their younger counterparts. Various assessments were conducted, including measuring blood pressure, analyzing serum lipid profiles, examining aortic tissue, and assessing the expression of antioxidant enzymes.ResultsThe results revealed significant differences in both blood pressure and serum lipid levels between the aged and younger rats. The examination of the aorta in older rats showed structural alterations, increased apoptosis, and the accumulation of fatty deposits. In the older rats, levels of SOD-1 (superoxide dismutase) and GSS (glutathione synthetase) were lower, whereas NRF2, KEAP-1 (Kelch-like ECH-associated protein 1), and HO-1 (Heme oxygenase 1) were higher.DiscussionThis study advances our understanding of how aging affects the antioxidant system in blood vessels, particularly in relation to the regulation of the NRF2/HO-1 pathway in the aorta. These findings suggest that targeting the NRF2/HO-1 pathway could present anovel therapeutic approach for addressing age-related vascular issues.
A comprehensive transcriptomic analysis of the bisphenol A affected kidney in mice
Authors: Wiszpolska Marta , Lepiarczyk Ewa , Paukszto Łukasz , Makowczenko Karol Gustaw , Lipka Aleksandra , Maździarz Mateusz Artur , Polak Iwona , Makowska Krystyna , Gonkowski Sławomir , Correia-de-Sá Paulo , Majewska Marta 
Published: November 2023

Introduction: Bisphenol A (BPA) is a substance belonging to the endocrine-disrupting chemicals, globally used in the production of polycarbonate plastics. It has been found that BPA enhances carcinogenesis, triggers obesity and exerts a pathogenic effect in several disorders, such as type 2 diabetes, asthma, or increased blood pressure. Recent studies have revealed, that BPA has a harmful impact on the kidneys function, therefore, the current research aimed to explore the specific molecular changes triggered in these organs after oral BPA exposure in mice.Materials and Methods: The experiment was carried out on 12 (3-month-old) female mice. Six mice served as controls. The other 6 mice were treated with BPA in the drinking water at a dose of 50 mg/kg b. w. for 3 months. Then animals were euthanized, the kidneys were collected, and extracted RNA was used to perform RNA-seq.Results: Applied multistep bioinformatics revealed 433 differentially expressed genes (DEGs) in the BPA-treated kidneys (232 upregulated and 201 downregulated). Additionally, 95 differentially expressed long-noncoding RNAs (DELs) were revealed in BPA samples. The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) annotations indicated that BPA exposure resulted in profound changes in several essential processes, such as oxidative phosphorylation, mitochondrial and ribosome function, or chemical carcinogenesis.Conclusion: The obtained novel results suggest that BPA has a harmful impact on the fundamental processes of the kidney and significantly impairs its function by inducing mitochondrial dysfunction leading to oxidative stress and reactive oxygen species production.
Study on the association between pregnancy-associated plasma protein-A and acute cerebral infarction
Authors: Zheng Sihang , Hossain Mohammad Showkat , Wu Hongliang , Nao Jianfei 
Published: November 2023

ObjectiveWe aimed to study the correlation between pregnancy-associated plasma protein-A (PAPP-A) and acute cerebral infarction (ACI).MethodsPatients who had the symptoms of paralysis, aphasia, or sudden neurological impairment from June 2020 to October 2021 were chosen. There were 159 patients diagnosed with ACI as the experimental group and 102 patients without ACI as the control group. We collected clinical data and observed whether they have a certain impact on plasma PAPP-A levels. The ACI group was divided into two groups: mild neurological deficit group (NIHSS score &lt; 3) and moderate and severe neurological deficit group (NIHSS score &gt; 3). The ACI group was divided into the atherosclerotic-type group and the arteriolar occlusion-type group according to the TOAST classification. The ACI group was divided into a good prognosis group (mRS ≤ 2 points) and a poor prognosis group (mRS &gt; 2 points) using the Modified Rankin Scale (mRS) for 90 days of follow-up. Plasma PAPP-A levels were compared between those groups.Results(1) The plasma PAPP-A level in patients with ACI (1.840 ± 0.281) was significantly higher than that in the control group (1.690 ± 0.260). Smoking history, leukocyte count, cystatin C, homocysteine, and plasma PAPP-A levels were independently correlated with ACI. (2) The level of PAPP-A in patients with moderate and severe neurological impairment was lower than that in patients with mild neurological impairment. (3) The level of PAPP-A in patients in the arteriolar occlusion-type group was higher than that in patients in the atherosclerosis-type group. (4) The PAPP-A levels in the group with elevated low-density lipoprotein are higher than those in the group with normal low-density lipoprotein. (5) Plasma PAPP-A level was not correlated with infarction location, infarction volume, or prognosis at the 90-day follow-up.Conclusion(1) The level of plasma PAPP-A could be the independent risk factor of ACI. It is positively correlated with triglyceride and cholesterol content. (2) PAPP-A level is positively correlated with low-density lipoprotein. (3) PAPP-A levels between different disease severities have a significant difference. (4) The level of plasma PAPP-A in the arteriolar occlusion-type group was higher than that in the atherosclerotic-type group.
Subclinical finding in the perception of tactile sensation involvement after SARS-CoV2 infection: comparison with healthy controls using Semmes–Weinstein monofilament testing
Authors: Tereshko Yan , Viotto Chiara , Lettieri Christian , Filon Francesca Larese , Belgrado Enrico , Merlino Giovanni , Bovenzi Massimo , Valente Mariarosaria , Gigli Gian Luigi , Dal Bello Simone , Negro Corrado , Ronchese Federico 
Published: November 2023

BackgroundPost-acute COVID-19 syndrome patients complain of sensory alterations, mainly positive symptoms such as paresthesia or neuropathic pain but also decreased tactile sensation. Using the Semmes–Weinstein monofilament test (SWMT), our study aims to confront recently infected SARS-CoV2 subjects with a control group.MethodsThis is a cross-sectional, single-centric study. We performed the SWMT (North Coast Medical Inc.) on 30 patients with previous SARS-CoV2 infection (COVID group) and 46 controls (control group). These patients did not present comorbidities or sensory impairment and did not take any medications. The control group tested negative for SARS-CoV2 infection since the COVID-19 pandemic; the COVID group was examined for this study after the resolution of the infection. We tested the threshold of tactile sensation of the tips of the thumb, index, and little finger of each hand, one hand at a time; the dorsum and the hypothenar regions were also tested.ResultsBoth groups presented the perception of tactile sensation within the reference value. Despite this result, subclinical changes suggestive of the involvement in peripheral sensory nerve function have been identified in the tested sites in the COVID group compared to the control group. The overall mean target force (grams) was higher in the COVID group than in the control group: 27 (7) vs. 19 (10) mg, p &lt; 0.001.ConclusionControls and the COVID group infection had normal tactile sensation thresholds. However, the COVID group presented a higher threshold than the control group, suggesting a possible subclinical perception of tactile sensation involvement of A-beta nerve fibers.
Lung-heart toxicity in a randomized clinical trial of hypofractionated image guided radiation therapy for breast cancer
Authors: Van Parijs Hilde , Cecilia-Joseph Elsa , Gorobets Olena , Storme Guy , Adriaenssens Nele , Heyndrickx Benedicte , Verschraegen Claire , Nguyen Nam P. , De Ridder Mark , Vinh-Hung Vincent 
Published: November 2023

BackgroundTomoBreast hypothesized that hypofractionated 15 fractions/3 weeks image-guided radiation therapy (H-IGRT) can reduce lung-heart toxicity, as compared with normofractionated 25-33 fractions/5-7 weeks conventional radiation therapy (CRT).MethodsIn a single center 123 women with stage I-II operated breast cancer were randomized to receive CRT (N=64) or H-IGRT (N=59). The primary endpoint used a composite four-items measure of the time to 10% alteration in any of patient-reported outcomes, physician clinical evaluation, echocardiography or lung function tests, analyzed by intention-to-treat.ResultsAt 12 years median follow-up, overall and disease-free survivals between randomized arms were comparable, while survival time free from alteration significantly improved with H-IGRT which showed a gain of restricted mean survival time of 1.46 years over CRT, P=0.041.DiscussionThe finding establishes TomoBreast as a proof-of-concept that hypofractionated image-guided radiation-therapy can improve the sparing of lung-heart function in breast cancer adjuvant therapy without loss in disease-free survival. Hypofractionation is advantageous, conditional on using an advanced radiation technique. Multicenter validation may be warranted.Trial registrationhttps://clinicaltrials.gov/ct2/show/NCT00459628. Registered 12 April 2007.
Disitamab Vedotin (RC48) for HER2-positive advanced breast cancer: a case report and literature review
Authors: Li Yang , Zhang Jingjiao , Cai Zhengang , Gao Xue , Zhang Lina , Lu Zhi , Wang Xiaojie , Yu Peiyao , Li Jia , Fang Fengqi 
Published: November 2023

Background/aimHuman epidermal growth factor receptor 2 (HER2)-positive breast cancer is associated with a higher risk of metastasis and poorer overall survival (OS) due to HER2 gene overexpression/amplification. Although anti-HER2 targeted therapy has shown survival benefits in HER2-positive advanced breast cancer (ABC) patients, long-term treatment often leads to drug resistance, complicating further treatment options. RC48, an antibody-drug conjugate (ADC), combines the benefits of antibody targeting with the cytotoxic effects of a small molecule drug.Case reportWe present a case involving a female patient with HER2-positive ABC who developed drug resistance and disease progression following multi-line anti-HER2 targeted therapy. In this instance, RC48 exhibited anti-tumor activity in an ABC patient resistant to HER2-targeted therapy. After eight treatment cycles with 120 mg of RC48, the tumor size decreased and stabilized.ConclusionThis case report underscores the potential clinical value of RC48 as a promising treatment alternative for patients resistant to HER2 targeted therapies.
Comparing real-world outcomes of total neoadjuvant treatment and CRT at a tertiary medical center
Authors: Turfa Rim , Alawabdeh Tala , Naser Ayman , Alamro Yazan , Albliwi Moath , Almasri Sama , Al Qazakzeh Abdullah , Shattal Mohammad Abu , Dabous Ali , Amarin Rula 
Published: November 2023

IntroductionFor years, standard treatment for locally advanced rectal cancer (LARC) has included neoadjuvant chemoradiotherapy (CRT), followed by surgery and adjuvant chemotherapy. Although CRT has helped reduce local recurrence rates, it hasn’t consistently improved overall survival. Recent trials have unveiled a different approach called total neoadjuvant treatment (TNT), involving pre-surgery radiotherapy followed by chemotherapy (CAPOX/FOLFOX). TNT shows promise with improved treatment response and lower distant metastasis rates without compromising local control. Consequently, many healthcare institutions have adopted TNT as their preferred neoadjuvant treatment. This study, conducted at a tertiary center, compares the real-world outcomes of both CRT and TNT protocols.MethodsIn this retrospective study of 390 patients treated between 2015 and 2021, aged 18 or older with LARC and tumors within 12 cm of the anal verge, we compared treatment outcomes. We assessed factors like pathological complete remission (pCR), three-year event-free survival (EFS), and overall survival (OS) between the two treatment groups using the Chi-squared test.ResultsOut of the 390 eligible patients, 256 underwent CRT, while 84 received TNT. Surgery was performed on 215 (84%) patients in the CRT group, compared to 55 (65.5%) in the TNT group. Notably, 33 (12.8%) achieved pCR in the CRT group, whereas 23 (27.7%) achieved pCR in the TNT group (P &lt;.001). Regardless of whether surgery was performed or not, the TNT group exhibited lower recurrence rates (12.7% vs. 18.6% with surgery, 28.6% vs. 45% without surgery). The 3-year EFS rate was 80% in the CRT group and 90% in the TNT group (P = .05). Additionally, the 3-year OS rates favored the TNT group, standing at 96.4% compared to 84.4% in the CRT group (P = .005).ConclusionOur findings indicate that patients who underwent TNT demonstrated a higher likelihood of achieving pCR and experienced lower recurrence rates compared to those in the CRT group. Additionally, the TNT group exhibited superior 3-year EFS and OS. It is important to note, however, that a longer follow-up period is required to further validate these results.