bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular disease risk in early rheumatoid arthritis: the impact of cartilage oligomeric matrix protein (COMP) and disease activity
Authors: Rydell Emil , Jacobsson Lennart TH , Saxne Tore , Turesson Carl 
Published: December 2023

Abstract
Background
To investigate whether baseline serum cartilage oligomeric matrix protein (COMP), patient characteristics, traditional cardiovascular disease (CVD) risk factors and disease activity over time predict CVD, in early rheumatoid arthritis (RA).

Methods
This study included patients with early RA (< 12 months disease duration) (n = 233) recruited 1995–2005. Potential predictors of CVD and coronary artery disease (CAD) were assessed using Cox regression.

Results
A first ever diagnosis of CVD occurred in 70 patients, and CAD in 52. Age, sex, hypertension and diabetes predicted CVD and CAD. COMP was associated with increased risk of CVD and CAD [crude hazard ratios (HRs) per SD 1.45; 95% CI 1.17–1.80 and 1.51; 95% CI 1.18–1.92, respectively]. When adjusted for age, sex, hypertension, diabetes and ESR, results where similar but did not reach significance [HRs 1.32, 95% CI 0.99–1.74 and 1.35, 95% CI 0.99–1.86]. Baseline disease activity did not independently predict CVD. High DAS28 (> 5.1) at two years was associated with increased risk of subsequent CVD [adjusted HR 2.58; 95% CI 1.10–6.04] and CAD. ESR and CRP at two years as well as cumulative disease activity over 2 years independently predicted CVD and CAD.

Conclusion
COMP may be a novel predictor of CVD and CAD in RA. Active disease two years after RA diagnosis, as well as cumulative disease activity, was associated with increased risk of CVD and CAD, independent of traditional CVD risk factors. Awareness of the particularly increased CVD risk among difficult to treat patients is important in order to further reduce CVD in RA.
Research on privacy information retrieval model based on hybrid homomorphic encryption
Authors: Song Wei-tao , Zeng Guang , Zhang Wen-zheng , Tang Dian-hua 
Published: December 2023

AbstractThe computational complexity of privacy information retrieval protocols is often linearly related to database size. When the database size is large, the efficiency of privacy information retrieval protocols is relatively low. This paper designs an effective privacy information retrieval model based on hybrid fully homomorphic encryption. The assignment method is cleverly used to replace a large number of homomorphic encryption operations. At the same time, the multiplicative homomorphic encryption scheme is first used to deal with the large-scale serialization in the search, and then the fully homomorphic encryption scheme is used to deal with the remaining simple operations. The depth of operations supported by the fully homomorphic scheme no longer depends on the size of the database, but only needs to support the single homomorphic encryption scheme to decrypt the circuit depth. Based on this hybrid homomorphic encryption retrieval model, the efficiency of homomorphic privacy information retrieval model can be greatly improved.
Immediate, short-term, and long-term effects of balloon mitral valvuloplasty on the left atrial global longitudinal strain and its correlation to the outcomes in patients with severe rheumatic mitral stenosis
Authors: Setouhi Amr , Boshra Hesham , Askalany Hany , Farrag Hazem M. A. 
Published: December 2023

Abstract
Background
Left atrial global longitudinal strain (LA GLS) has been used as a new assessment tool for left atrial function. This article aims to investigate the effect of balloon mitral valvuloplasty (BMV) in patients with severe rheumatic mitral stenosis on LA GLS and its relation to the mitral valve area achieved after the procedure. The study included 95 patients with severe mitral stenosis who fulfilled the criteria for BMV (case group) and 80 normal healthy subjects (control group). All included participants underwent complete echocardiographic examinations. For the case group, LA GLS was assessed by 2D speckle-tracking Echocardiography before valvuloplasty, immediately after, within 24 h, at 6 months, and at 12 months, and the results were compared.

Results
The impaired left-atrium strain in patients with severe mitral stenosis was improved immediately after BMV, and the improvement continued at 6 and 12 months post-BMV (23.1% ± 4.2 vs. 36.0% ± 4.9, 36.2% ± 4.5, and 40.1% ± 9.5, respectively p < 0.01). After BMV, there was a significant decrease in left atrial volume (76.3 ± 12.4 ml/m2 vs. 68.6 ± 10.4 ml/m2, p < 0.01) and a significant increase in the area occupied by the mitral valve (1.02 ± 0.18 cm2 vs. 1.60 ± 0.31 cm, p < 0.01). The immediate LA GLS and the mitral valve area were positively correlated (r = 0.64, p < 0.01). Furthermore, the immediate LA GLS was associated with significantly improved function class (p < 0.01).

Conclusions
LA GLS can indicate left atrial (mainly reservoir) function. The improvement observed in patients after BMV may indicate that LA GLS can be used to evaluate the progress after BMV.
Trial registration: The study was approved by the local ethics committee of the Faculty of Medicine in Minia University (Registration No. MUFMIRB 324-4-2022). Institutional Review Board, Faculty of Medicine, Minia University, Egypt. 324-4-2022, 24 18 April, 2022.
Cell therapies for autism spectrum disorder: a systematic review of clinical applications
Authors: Akat Ayberk , Karaöz Erdal 
Published: December 2023

Abstract
Purpose
Autism spectrum disorder (ASD) is a neurodevelopmental condition that affects patients’ ability to communicate, engage with others, and behave in certain ways. Despite the existence of several therapy possibilities, an effective treatment for ASD has not yet been identified. Cell therapies have been becoming increasingly recognized in recent years as a potential therapeutic approach for the management of ASD. Different types of cellular products are transplanted using different delivery methods as part of cell therapy, which has the ability to regulate the immune system, demonstrate paracrine, neuro-regenerative, anti-inflammatory, and anti-oxidative stress effects, as well as transfer healthy mitochondria. We have compared the results and findings of completed cell therapy clinical trials for the treatment of ASD in this systematic review.

Methods
A total of 547 studies were identified, in which 11 studies were found to be eligible to be included in this review as they were completed cell therapy clinical trials or clinical applications with quantitative results for the treatment of ASD patients.

Results
This systematic review provides an overview of clinical trials conducted with different types of cell therapy strategies for the treatment of ASD and their potential mechanisms of action. The limitations and future possibilities for this field of study, as well as the safety and efficacy of cell treatments in ASD, were reviewed.

Conclusion
Overall, the evidence suggests that various cell therapy methods may offer a novel and effective treatment option for individuals with ASD, although further research is needed to fully understand the optimal treatment strategy and therapeutic potential.
Inhibitory capacity of extracts and main constituents of hop flowers
Authors: do Nascimento Francisco Mateus Gomes , Marques Samuel Pedro Dantas , Trevisan Maria Teresa Salles , Owen Robert Wyn , Pereira Lucas Ramos , Lima Thales Caldas , de Sousa Anderson Freitas , Maia Carlos Eduardo Gonçalves 
Published: December 2023

Abstract
Background
Hops (Humulus lupulus Linn.) produce flowers that are used on an industrial scale to impart sensory properties to beer and have some pharmacologic properties already published in the literature. Gout, type 2 diabetes and Alzheimer’s are diseases the appearance/aggravation of which is related to the action of enzymes such as xanthine oxidase, α-glucosidase and acetylcholinesterase, respectively, which are associated with oxidative stress. Our hypothesis is that the extracts and chemical constituents isolated from the flowers of hops act as enzyme inhibitors and scavenge free radicals. Hexane and methanol extracts were obtained from flowers of different cultivars produced in Brazil and from commercial pellets, with the contents of bitter acids and xanthohumol determined by high-performance liquid chromatography (HPLC), after QuEChERS (Quick, Easy, Cheap, Effective, Rugged and Safe) extraction and were evaluated for their pharmacologic properties.

Results
The extracts and analytical standards showed a significant capacity against oxidative stress in all evaluated methods (DPPH·, ABTS·+, HO·). Xanthohumol and extracts with a high concentration of this compound demonstrated a strong capacity to inhibit the xanthine oxidase and significantly reduce the formation of uric acid. The results with the α-glucosidase revealed promising pharmacologic action for all samples, even more effective than the commercial drug (acarbose). The acetylcholinesterase inhibition assays were effective for hexane extracts and ICE-4, with values obtained close to the eserine.

Conclusion
It can be concluded with the results obtained that extracts and patterns of hop flowers showed promising potential to combat oxidative stress and complementary treatment of gout, type 2 diabetes and Alzheimer’s disease.
The effect of comprehensive rehabilitation on post-COVID-19 syndrome
Authors: Kesikburun Bilge , Ata Ayşe Merve , Borman Pınar , Özdemir Elif Esen , Becenen Elif , Metin Nurdan , Alemdaroğlu Ebru 
Published: December 2023

Abstract
Background
The present study aimed to investigate the efficacy of a comprehensive rehabilitation program on quality of life, anxiety, fatigue, and functional status in post-COVID-19 patients admitted to a specialized rehabilitation unit. The secondary objective of the study was to compare the differences between vaccinated and unvaccinated patients.

Results
The single-center prospective study was conducted. Demographics, comorbidities, vaccination, clinical signs and symptoms, and oxygen saturation were assessed. The rehabilitative protocol was created considering the condition of patients, age, the direct impact of COVID-19 on the systems, sequelae, severity of disease, and comorbidities. The comprehensive rehabilitation program through a multidisciplinary team is applied in a stepwise graded manner. The Nottingham Health Profile (NHP), Fatigue Severity Scale (FSS) The Functional Ambulation Categories (FAC), the modified Medical Research Council (mMRC), the Modified Borg Scale, post-COVID-19 Functional Status (PCFS) scale, Hospital Anxiety and Depression Scale (HADS), and the Barthel Index (BI) were used. In total, 39 patients (61.5% men, age 59.7.0 ± 15.6 years) participated in the study. They were discharged home after 37.5 ± 17.6 days stay in the hospital. The most frequently reported persistent symptoms were dyspnea (76.9%), fatigue (69.2%), and myalgia (64.1%). There was a statistically significant improvement in baseline outcomes including BI, HADS, PCFS, FSS, MMRC, Modified Borg Scale, FAC, O2 support, and NHP after the comprehensive rehabilitation program (p < 0.001). The vaccinated patients had older age, high BMI, and shorter duration of rehabilitation (p = 0.003, p = 0.040, p = 0.022, respectively), while unvaccinated patients had higher BI, FSS, PCFS, and FAC.

Conclusion
The comprehensive rehabilitation program improves quality of life, reduces fatigue, anxiety, and depression, and regains function in patients with post-COVID-19 syndrome. In addition, vaccinated patients had older ages and shorter duration of rehabilitation, while unvaccinated patients achieved higher functional status and had significantly higher levels of fatigue at discharge.
High versus standard blood pressure target in hypertensive high-risk patients undergoing elective major abdominal surgery: a study protocol for the HISTAP randomized clinical trial
Authors: Messina Antonio , Cortegiani Andrea , Romagnoli Stefano , Sotgiu Giovanni , Piccioni Federico , Donadello Katia , Girardis Massimo , Noto Alberto , Maggiore Salvatore Maurizio , Antonelli Massimo , Cecconi Maurizio 
Published: December 2023

Abstract
Background
The intraoperative period is often characterized by hemodynamic instability, and intraoperative hypotension is a common complication. The optimal mean arterial pressure (MAP) target in hypertensive patients is still not clear. We hereby describe the protocol and detailed statistical analysis plan for the high versus standard blood pressure target in hypertensive high-risk patients undergoing elective major abdominal surgery: the HISTAP randomized clinical trial. The HISTAP trial aims at addressing whether the use of a higher intraoperative MAP target in high-risk hypertensive surgical patients scheduled for elective abdominal surgery would improve postoperative outcomes, as compared to the standard and recommended perioperative MAP, by using a composite outcome including a 30-day mortality from surgical intervention and at least one major organ dysfunction or new onset of sepsis and septic shock occurring 7 days after surgery.

Methods
The HISTAP trial is an investigator-initiated, pragmatic, parallel-grouped, randomized, stratified, analyst-blinded trial with adequate allocation sequence generation, and allocation concealment. We will allocate 636 patients to a MAP target ≥ 80 mmHg (treatment group) or to a MAP target ≥65 mmHg (control group). The primary outcome is a composite outcome including a 30-day mortality from the operation and major organ complications. Secondary outcomes are mortality at 30 days, intensive care unit (ICU) length of stay, ICU readmission, Sequential Organ Failure Assessment (SOFA) scores recorded up to postoperative day 7, overall intraoperative fluid balance, vasopressors use, and the need for reoperation. An unadjusted χ2 test will be used for the primary outcome analysis. A Cox proportional hazards model will be used to adjust the association between the primary outcome and baseline covariates.

Conclusions
The HISTAP trial results will provide important evidence to guide clinicians’ choice regarding the intraoperative MAP target in high-risk hypertensive patients scheduled for elective abdominal surgery.
Health promotion, the social determinants of health, and urban health: what does a critical discourse analysis of World Health Organization texts reveal about health equity?
Authors: Amri Michelle , Enright Theresa , O’Campo Patricia , Di Ruggiero Erica , Siddiqi Arjumand , Bump Jesse Boardman 
Published: December 2023

Abstract
Background
The World Health Organization (WHO) has focused on health equity as part of its mandate and broader agenda—consider for example, the “health for all” slogan. However, a recent scoping review determined that there are no studies that investigate the WHO’s approach to health equity. Therefore, this study is the first such empirical analysis examining discourses of health equity in WHO texts concerning health promotion, the social determinants of health, and urban health.

Methods
We undertook a critical discourse analysis of select texts that concern health promotion, the social determinants of health, and urban health.

Results
The findings of this study suggest that (i) underpinning values are consistent in WHO texts’ approach to health equity; (ii) WHO texts reiterate that health inequities are socially constructed and mitigatable but leave the ‘causes of causes’ vague; (iii) despite distinguishing between health “inequities” and “inequalities,” there are several instances where these terms are used interchangeably across texts; (iv) WHO texts approach health equity broadly (covering a variety of areas); (v) health equity may be viewed as applicable either throughout the life-course or intergenerationally, which depends on the specific WHO text at hand; and (vi) WHO texts at times use vague or unclear language around how to improve health equity.

Conclusions
This study does not present one definition of health equity and action to be taken. Instead, this study uncovers discourses embedded in WHO texts to spur discussion and deliberate decision-making. This work can also pave the way for further inquiry on other complex key terms or those with embedded values.
Neuropsychiatric Adverse Effects of Synthetic Glucocorticoids: A Systematic Review and Meta-Analysis
Authors: Koning Anne-Sophie C A M , van der Meulen Merel , Schaap Daphne , Satoer Djaina D , Vinkers Christiaan H , van Rossum Elisabeth F C , van Furth Wouter R , Pereira Alberto M , Meijer Onno C , Dekkers Olaf M 
Published: December 2023

Abstract

Context
Synthetic glucocorticoids are widely used to treat patients with a broad range of diseases. While efficacious, glucocorticoids can be accompanied by neuropsychiatric adverse effects.

Objective
This systematic review and meta-analysis assesses and quantifies the proportion of different neuropsychiatric adverse effects in patients using synthetic glucocorticoids.

Methods
Six electronic databases were searched to identify potentially relevant studies. Randomized controlled trials, cohort studies, and cross-sectional studies assessing psychiatric side effects of glucocorticoids measured with validated questionnaires were eligible. Risk of bias was assessed with RoB 2, ROBINS-I, and AXIS appraisal tool. For proportions of neuropsychiatric outcomes, we pooled proportions, and when possible, differences in questionnaire scores between glucocorticoid users and nonusers were expressed as standardized mean differences (SMD). Data were pooled in a random-effects logistic regression model.

Results
We included 49 studies with heterogeneity in study populations, type, dose, and duration of glucocorticoids. For glucocorticoid users, meta-analysis showed a proportion of 22% for depression (95% CI, 14%-33%), 11% for mania (2%-46%), 8% for anxiety (2%-25%), 16% for delirium (6%-36%), and 52% for behavioral changes (42%-61%). Questionnaire scores for depression (SMD of 0.80 [95% CI 0.35-1.26]), and mania (0.78 [0.14-1.42]) were higher than in controls, indicating more depressive and manic symptoms following glucocorticoid use.

Conclusion
The heterogeneity of glucocorticoid use is reflected in the available studies. Despite this heterogeneity, the proportion of neuropsychiatric adverse effects in glucocorticoid users is high. The most substantial associations with glucocorticoid use were found for depression and mania. Upon starting glucocorticoid treatment, awareness of possible psychiatric side effects is essential. More structured studies on incidence and potential pathways of neuropsychiatric side effects of prescribed glucocorticoids are clearly needed.
Fahr Syndrome Secondary to Pseudohypoparathyroidism
Authors: Shu Sharon W , Sharma Sakshi , Iqbal Qasim Z , Romo Karina G 
Published: December 2023

Abstract
Fahr syndrome is a rare neurologic disorder, usually affecting young and middle-aged adults, that can present with symptoms ranging from extrapyramidal to neuropsychiatric abnormalities. Pseudohypoparathyroidism (PHP), characterized by parathyroid hormone (PTH)-resistance or PTH-unresponsiveness at target organs, is associated with Fahr syndrome and typically presents with hypocalcemia. The following case presents a 39-year-old-woman with PHP complicated by symptomatic hypocalcemia, hypokalemia, and movement disturbances, who had computed tomography imaging showing basal ganglia calcifications consistent with Fahr syndrome. She initially presented with headache and was hospitalized for hypertensive emergency and severe hypocalcemia. Examination, including the neurologic examination, was unrevealing aside from hypertension and central adiposity. Laboratory tests were consistent with PHP, showing hypocalcemia with elevated PTH, and negative for hyperaldosteronism. Management of hypocalcemia consisted of intravenous calcium infusion, oral calcium carbonate, oral vitamin D3, and oral calcitriol. Patients with severe hypocalcemia and elevated PTH who present with new neurological symptoms despite normal general neurologic examination may warrant consideration for brain imaging to evaluate for Fahr syndrome. Further investigations are necessary to determine the prevalence of Fahr syndrome and hypokalemia in patients with PHP, explore if these findings are significantly associated with PHP-1b subtype, and ultimately inform potential new screening pathways for these patients.
An Object In Between
Authors: Ma Xiaolu 
Published: December 2023

AbstractBy interrogating how the original composition and textual reincarnations of Lu Xun's “Diary of a Madman” manifest his idea of an “object in between,” this article celebrates an intertextual event in world literature. It traces how Lu Xun's “Diary of a Madman” came into being in conversation with preexisting literary creations and how the intertextual recasting of Lu Xun's story both within and beyond the Sinophone world incorporates postcolonial contexts and recent cyberculture. The intertextuality not only calls for a dynamic negotiation with Lu Xun's “Diary of a Madman” but also involves unexpected engagement with the literary antecedents to Lu Xun's work. By examining the transculturation of cannibalism and insanity in the works of Lu Xun, Liang Wern Fook, Ōe Kenzaburō, and Leonid Andreev, among others, this article reveals how “Diary of a Madman” as an object in between projects a vision of a future that resists the pressures of historical impasse.
Treatment of Acute Traumatic Central Cord Syndrome: A Study of North American Trauma Centers
Authors: Badhiwala Jetan H. , Witiw Christopher D. , Wilson Jefferson R. , da Costa Leodante B. , Nathens Avery B. , Fehlings Michael G. 
Published: December 2023

BACKGROUND AND OBJECTIVES:
Central cord syndrome (CCS) is expected to become the most common traumatic spinal cord injury, yet its optimal management remains unclear. This study aimed to evaluate variability in nonoperative vs operative treatment for CCS between trauma centers in the American College of Surgeons Trauma Quality Improvement Program, identify patient- and hospital-level factors associated with treatment, and determine the association of treatment with outcomes.

METHODS:
Adults with CCS were identified from the Trauma Quality Improvement Program database (2014-2016). Mixed-effects modeling with a random intercept for trauma centers was used to examine the adjusted association of patient- and hospital-level variables with nonoperative treatment. The random-effects output of the model assessed the risk-adjusted variability in nonoperative treatment across centers. Outlier hospitals were identified, and the median odds ratio was calculated. The adjusted effect of nonoperative treatment on mortality, morbidity, and hospital length of stay (LOS) was examined at the patient and hospital level by mixed-effects regression.

RESULTS:
Three thousand, nine hundred twenty-eight patients across 255 centers were eligible; of these, 1523 (38.8%) were treated nonoperatively. Older age, noncommercial insurance (odds ratio [OR] 1.26, 95% CI 1.08-1.48, P = .004), absence of fracture (OR 0.58, 95% CI 0.49-0.68, P < .001), severe head injury (OR 1.41, 95% CI 1.09-1.82, P = .008), and comatose presentation (1.82, 95% CI 1.15-2.89, P = .011) were associated with nonoperative treatment. Twenty-eight hospitals were outliers, and the median odds ratio was 2.02. Patients receiving nonoperative treatment had shorter LOS (mean difference −4.65 days). Nonoperative treatment was associated with lesser in-hospital morbidity (OR 0.49, 95% CI 0.37-0.63, P < .001) at the patient level. There was no difference in mortality.

CONCLUSION:
Operative decision-making for CCS is influenced by patient factors. There remains substantial variability between trauma centers not explained by case-mix differences. Nonoperative treatment was associated with shorter hospital LOS and lesser inpatient morbidity.