bluuebunny/crossref_metadata_2025_split huggingface dataset:
Co-occurrence of behavioural risk factors for non-communicable diseases and mortality risk in Spain: a population-based cohort study
Authors: Ortiz Cristina , López-Cuadrado Teresa , Ayuso-Álvarez Ana , Rodríguez-Blázquez Carmen , Galán Iñaki 
Published: January 2025

ObjectivesThis study aims to estimate the impact of the co-occurrence of behavioural risk factors on mortality in the Spanish adult population.DesignPopulation-based cohort study based on data from the 2011–2012 Spanish National Health Survey and the 2014 European Health Survey (n=35 053 participants ≥15 years of age) both linked to mortality data as of December 2022. Risk factors included tobacco use, high-risk alcohol consumption, low adherence to the Mediterranean diet, leisure time sedentary lifestyle and body mass index outside the 18.5–24.9 kg/m2range. Deaths from any cause (n=2784), from diseases of the circulatory system (n=678) and from tumours (n=869) were identified. Standardised rate differences (SRD) and standardised rate ratios (SRR) were estimated using Poisson regression models adjusted for sociodemographic variables.ResultsCompared with those with no unhealthy behaviours, overall mortality risk increased gradually as the co-occurrence of risk behaviours increased. Individuals with two factors had an SRD of 3.0 deaths per 1000 person-years (95% CI 1.8; 4.3) and an SRR of 1.88 (95% CI 1.35; 2.62). A coexistence of five risk factors increased SRD and SRR to 11.5 (95% CI 7.2; 15.8) and 4.34 (95% CI 2.84; 6.63), respectively. The association was stronger among individuals under 65 years of age, whereas it did not vary by sex and educational level. Those reporting five risk factors had SRRs of 6.35 (95% CI 2.91; 13.83) and 2.57 (95% CI 1.11; 5.98) for tumour-related and cardiovascular disease mortality, respectively.ConclusionsThe co-occurrence of unhealthy behaviours increases the risk of overall and cause-specific mortality. Targeting multiple risk behaviours should be incorporated into the public health strategy.
Reduction in bacterial culture positivity rates at a human milk bank facility of a tertiary care hospital: a quality improvement initiative
Authors: Vadapalli Sailusha , Valvi Chhaya , Dawre Rahul M , Bhagat Vaishnavi , Chivale Sangeeta , Pawar Sameer , Kinikar Aarti A 
Published: January 2025

BackgroundHuman milk banks (HMBs) offer the best feed for neonates after mother’s own milk (MOM), especially when MOM is insufficient. Although HMBs are founded on standard protocols, contamination and wastage of milk due to positive milk cultures remain a problem. Present study was planned as a quality improvement (QI) initiative to reduce culture rates at the HMB.Aims statementThe aim is to reduce the milk-culture positivity rates at the HMB by 50% or more, over a span of 3 months.Materials and methodsA QI initiative was undertaken at the milk bank of a tertiary-care hospital in Western Maharashtra in 2020. All human milk cultures sent since January 2018 were recorded from the data at HMB registry. The milk-culture rates had increased from 105/4376 to 125/3823 between 2018 and 2019. A fishbone analysis identified sources of contamination of donor milk during 2018–2019. PDSA (Plan Do Study Act) cycles begun from 2020, interventions aimed at reducing milk-culture positivity rates were tried, namely improved hand-hygiene, sanitisation of milk donors before collection, steam sterilisers for breast-pump accessories and recruitment of staff nurses at all stages of milk handling.ResultsMilk-culture growths had increased from 105/4376 (2.37%) in 2018 to 125/3823 (3.27%) in 2019 and then declined to 23/2103 (1.09%) in 2020, 12/2345 (0.51%) in 2021, 9/2985 (0.30%) in 2022 and 1/1322 (0.08%) in June 2023. The unit achieved reduction of over 99% in milk wastage during this period. This improvement was sustained till 2023 with consistent increment in quality of consumable donor milk.ConclusionsThe QI initiative was successful and led to significant decrease in milk-culture rates, which has been well sustained. The measures that led to the improvement in the quality of milk at the HMB were improvement in hand hygiene, use of steam sterilisers and presence of committed individuals at all stages of milk handling. These methods are simple, easily replicated and sustainable with a promise of ensuring a steady supply of high-quality human milk.
Cardiovascular disease risk in cancer survivors: a population-based cohort study from the UK Biobank, and meta-analysis of cohort studies
Authors: Shu Chi , Mei Zubing , Yu Botao , Wang Xiran , Wu Hong , Li Changtao , Shen Yang , Liu Yiqiang , Li Hong , Zhao Jichun , Zhou Yanhong , Wang Ziqiang , He Yazhou , Xu Chuan 
Published: January 2025

IntroductionIn addition to the well-recognised cardiotoxicity of cancer treatment, possible aetiological links between cancer diagnosis and cardiovascular disease (CVD) have gained growing research interests. We aimed to estimate the CVD burden among cancer survivors and illustrate population-level associations between these two conditions.MethodsWe first conducted a prospective cohort study in the UK Biobank and a meta-analysis of previous population-based cohorts. HRs were estimated in the cohort study to evaluate the effect of cancer diagnosis on the subsequent risk of CVD compared with that of non-cancer individuals. We then systematically searched Pubmed, Embase and Cochrane Library to retrieve previous cohorts. Random-effect meta-analysis was performed to pool relative risk estimates. A combination of multiple statistical metrics was employed to appraise the evidence.ResultsA total of 39 755 811 participants (5 898 597 cancer survivors vs 33 857 214 cancer-free controls) were identified in our study. In the cohort study, a 51% higher hazard of CVD risk was found among cancer survivors (95% CI 1.48 to 1.55, p<0.001). The hazard decreased to 29% after adjusting competing risk. The meta-analysis identified 104 published cohorts. We found a 1.34-fold increased CVD risk among patients with cancer (95% CI 1.22 to 1.47, p<0.001). The association remains significant among multiple cancer sites and multiple CVD subtypes. This association was consistent, irrespective of chemo or radiotherapy use. Evidence appraisal identified one convincing association between hematologic/lymphatic malignancies and ischaemic heart disease, along with 29 highly suggestive associations.ConclusionsOur study provided comprehensive estimates of CVD incidence in cancer survivors and identified a significantly elevated CVD risk among patients with cancer, regardless of chemotherapy or radiotherapy. These findings underscore the need for routine assessment of CVD risk factors at cancer diagnosis to enhance the well-being and survival of patients with cancer.PROSPERO registration numberCRD42022307056
Metabolic profiles of cutaneous lupus have abnormalities in the nicotinamide adenine dinucleotide pathway
Authors: Abbas Laila F , Barber Grant , Lu Grace , Chamseddin Bahir , Vu Hieu , Cai Ling , Srivastava Divya , Nijhawan Rajiv L , Wang Richard C , Chong Benjamin F 
Published: January 2025

ObjectiveMetabolic reprogramming plays a critical role in modulating the innate and adaptive immune response, but its role in cutaneous autoimmune diseases, such as cutaneous lupus erythematosus (CLE), is less well studied. An improved understanding of the metabolic pathways dysregulated in CLE may lead to novel treatment options, biomarkers and insights into disease pathogenesis. The objective was to compare metabolomic profiles in the skin and sera of CLE and control patients using liquid chromatography–mass spectrometry (LC-MS).MethodsThis was a cross-sectional pilot study comparing metabolomic sera and skin profiles of patients with CLE and normal controls. Patients were recruited from outpatient dermatology clinics at the University of Texas Southwestern and Parkland Health in Dallas, Texas, from January 2019 to October 2020. Skin and serum samples underwent LC-MS analysis. Disease sample metabolite levels were compared with controls, with significance levels adjusted for multiple hypothesis testing.Results17 serum samples (9 CLE, 8 control) and 11 skin samples (5 CLE, 6 control) were analysed using LC-MS, yielding 313 known unique metabolic structures from CLE samples. Patients with CLE were found to have 11 metabolites of differential abundance in the skin, but only 2 in the sera. CLE skin showed increased levels of citrulline (log2fold change (FC)=1.15, p=0.02) and uracil (log2FC=1.79, p=0.04), and downregulation of cyclic ADP ribose (cADPr) (log2FC=0.83, p=0.04), nicotinamide mononucleotide (NMN) (log2FC=0.75, p=0.016) and nicotinamide adenine dinucleotide (NAD+) (log2FC=0.86, p=0.016) versus control skin. CLE sera had increased arabinose (log2FC=1.17, p=0.02) and cystine (log2FC=1.04, p=0.03) compared with control sera.ConclusionsMetabolites associated with the NAD+pathway may be dysregulated in the skin of patients with CLE. Available treatments including nicotinamide supplementation and anti-CD38 biologics that can correct these abnormalities can be further investigated in patients with CLE.
Trends in work participation among patients with inflammatory rheumatic musculoskeletal diseases (iRMDs): Data from the German National Database (2010–2022)
Authors: Veltri Carlo , Albrecht Katinka , Kiltz Uta , Meyer-Olson Dirk , Späthling Susanna , Strangfeld Anja , Thiele Katja , Callhoff Johanna 
Published: January 2025

ObjectiveTo analyse work participation among patients with inflammatory rheumatic musculoskeletal diseases (iRMDs), namely rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc) and ANCA-associated vasculitis (AAV).MethodsA cross-sectional sample of 16 421 patients from the National Database of the German Collaborative Arthritis Centers, aged <65 years were analysed. For each diagnosis, yearly rates of absenteeism, employment and disability pensions were analysed from 2010 to 2022. Population data were used to calculate standardised employment ratios (SERs), adjusted for age, sex, federal state and vocational qualification. The analysis was additionally stratified by sex, adjusting for other factors.ResultsOver the observed time span, large employment increases were found across all diagnoses, namely in RA (54%–68%), PsA (58%–72%), SSc (47%–66%), AAV (43%–61%), SLE (48%–60%) and axSpA (65%–73%). SERs were for RA 0.88 (95% CI 0.86 to 0.90), axSpA (0.88 (0.84 to 0.91)), PsA (0.88 (0.85 to 0.91)), SSc (0.83 (0.75 to 0.91)), SLE (0.76 (0.72 to 0.80)) and AAV (0.73 (0.63 to 0.83)). In RA, axSpA, PsA and AAV, SERs were higher in men while in SLE and SSc men had lower SER. Median of yearly absenteeism due to the disease decreased by 5 (RA), 1 (axSpA), 6 (PsA), 11 (SLE), 4 (SSc) and 10 days (AAV) in the time span. Except for SSc, the proportion of disability pension receivers decreased for all diagnoses.ConclusionSince 2010, work participation has improved for patients with iRMDs, as reflected in higher employment, reduced absenteeism and less disability retirement. However, patients have not reached population employment rates.
Distinct clinical outcomes based on multiple serum cytokine and chemokine profiles rather than autoantibody profiles and ultrasound findings in rheumatoid arthritis: a prospective ultrasound cohort study
Authors: Fukui Shoichi , Michitsuji Tohru , Endo Yushiro , Nishino Ayako , Furukawa Kaori , Morimoto Shimpei , Shimizu Toshimasa , Umeda Masataka , Sumiyoshi Remi , Koga Tomohiro , Iwamoto Naoki , Tamai Mami , Origuchi Tomoki , van Schie Karin A J , Ueki Yukitaka , Eiraku Nobutaka , Yoshitama Tamami , Matsuoka Naoki , Suzuki Takahisa , Okada Akitomo , Hamada Hiroaki , Ayano Masahiro , Hidaka Toshihiko , Tsuru Tomomi , Maeda Takahiro , Huizinga Tom W J , Toes René E M , Kawakami Atsushi , Kawashiri Shin-Ya 
Published: January 2025

ObjectivesTo evaluate the potential of clinical factors, ultrasound findings, serum autoantibodies, and serum cytokine and chemokine profiles as predictors of clinical outcomes in rheumatoid arthritis (RA).Patients and methodsWe included 200 patients with RA treated with biological and targeted synthetic disease-modifying antirheumatic drugs in a prospective multicentre ultrasound cohort study. Their serum levels of multiple cytokines and chemokines, rheumatoid factors, and serum autoantibodies (anti-cyclic citrullinated peptide-2 (anti-CCP2) and anti-carbamylated protein antibodies) were measured at baseline, 3 months and 12 months.ResultsDimensionality reduction using 38 cytokines and chemokines demonstrated four distinct clusters that differed significantly regarding the frequencies of remission defined by clinical composite measures and ultrasound evaluations. Prominent differences in IL-1β, IL-5, IL-7, IL-10, IFNγ, GRO, IP-10, MCP-1 and MIP-1β characterised the between-cluster differences. Two distinct groups made of four clusters showed a significant difference in IgM-anti-CCP2 positivity. The least absolute shrinkage and selection operator regression of 38 cytokines and chemokines for Clinical Disease Activity Index (CDAI) remission at 12 months resulted in the selection of MIP-1β. Logistic regression using baseline levels of anti-citrullinated protein antibody, IgM-anti-CCP2 positivity, the CDAI, the total power Doppler score, the cluster by cytokines and chemokines, MIP-1β, methotrexate dose and mechanisms of action revealed that cluster by cytokines and chemokines was the sole significant factor for CDAI remission at 12 months.ConclusionsSpecific patterns of cytokines and chemokines—no other clinical factors and autoantibody profiles—were important to distinguish patients with RA achieving remission at 12 months.Trial registration numberUMIN000012524.
Efficacy of butylphthalide in preventing cognitive decline in ischaemic stroke survivors: a 12-month prospective following-up study
Authors: Han Qingqing , Zhao Xiyu , Shao Yingzhe , Tan Fengtao , Wen Haotian , Wang Di , Li Xiao , Wang Yunfan , Tu Jun , Wang Lifeng , Ning Xianjia , Wang Jinghua , Li Yan 
Published: January 2025

BackgroundCognitive decline is a significant concern for stroke survivors, affecting their quality of life and increasing their burden on the healthcare system. DL-3-n-butylphthalide (butylphthalide) has shown efficacy in the short-term treatment of various cognitive impairments. This study evaluated the efficacy of butylphthalide in preventing cognitive decline over a 12-month period in patients with ischaemic stroke.MethodsThis prospective following-up study involved patients newly diagnosed with ischaemic stroke between 1 month and 6 months after stroke onset and not in the acute phase. Patients were assigned to either the butylphthalide or control group. Cognitive function was assessed using the mini-mental state examination (MMSE) at baseline and at the 12-month follow-up. Statistical analyses included t-tests, χ2tests and multivariate regression analyses.ResultsButylphthalide was negatively associated with the MMSE D-value (β=−0.122; 95% CI −1.932 to −0.298; p=0.003) and the MMSE D-value percentage (β=−0.117; 95% CI −0.057 to −0.011; p=0.004). A multivariate analysis indicated that butylphthalide treatment was negatively associated with both changes in orientation and language score. Additionally, the incidence of cognitive decline was significantly lower in the butylphthalide group (OR, 0.612; p=0.020) than the control group. An age of ≥60 years and lower educational level were identified as risk factors for lower cognitive score and cognitive decline.ConclusionThis study demonstrated that butylphthalide is effective in preventing cognitive decline in patients with ischaemic stroke. These findings have significant implications for clinical practice, suggesting that butylphthalide could be incorporated into standard post-stroke care regimens to improve patient outcomes and reduce the healthcare burden. Additional multicentre double-blind trials are recommended to confirm these results in diverse populations.
Dynamical system analysis for extended f(P) gravity coupled with scalar field
Authors: Mandal Ratul , Debnath Ujjal , Pradhan Anirudh 
Published: January 2025

Abstract
In the present article, we have explored the physical characteristics of extended f(P) gravity through the dynamical system analysis. We choose the function f(P) in the form of a polynomial of second order, i.e.

$$f(P)=\alpha P +\beta P^2$$

f

(
P
)

=
α
P
+
β

P
2

, where

$$\alpha $$

α

and

$$\beta $$

β

are constant parameters. As an additional dark energy component, we take a canonical scalar field

$$\phi $$

ϕ

, and several types of interaction between the dark components are considered. After presenting the field equation for the corresponding cosmological setup, we introduce some dimensionless variables and formulate a nonlinear autonomous system. For the different interaction scenarios, we have investigated the phase space and their physical characteristics and the dynamics of the cosmological solution associated with each critical point. For the first interaction model, the results we obtained by the analysis of phase space reveals that the cosmological solution associated with critical points exhibits two different cosmological epochs, namely the de-sitter epoch and quintessence epoch. For the second interaction model, the solutions represent the quintessence era. We have also studied the dynamical stability properties of each critical point by linear stability theory and determined possible physical constraints to the parameters. The cosmological solutions support cosmic acceleration. Moreover, an analysis of statefinder parameter {r,s} in terms of the dynamical system variable is presented. Based on the mathematical prospects, the modified theory of gravitation based on the extension of f(P) cubic gravity has the potential to manifest an accelerated expansion during late-time evolution.
Quando a criança reproduz o incesto sofrido com outras crianças na escola: estudo de caso
Authors: Ávila Luiza Abadia de , Tachibana Miriam 
Published: January 2025

The school has been linked to the phenomenon of sexual violence against children as a place of prevention and identification of cases. Given the scarcity of studies dealing with the school as a place of reproduction of intrafamilial sexual violence, we aim to provide clinical and theoretical reflections on the victimized child who repeatedly directs hyper-sexualized behaviour towards his peers at school. A case study was carried out in an outpatient clinic specializing in victims of sexual assault. From the material analysis, we confirmed the risk of an institutional violence perpetrated against the child by the school, which tends to adopt exclusionary movements, possibly due to the disarticulation of the Protection Network. We see the need for more studies on this specific target group, in order to guarantee inclusive movements.
Ressignificação do patrimônio cultural de Vassouras/RJ: a valorização de grupos sociais invisibilizados
Authors: Fogaça Isabela de Fátima , Caldas Tânia Maria de Araújo 
Published: January 2025

Vassouras is a municipality in the Paraíba Valley that was the result of the economic heyday of the coffee cycle. Its historic center has imposing buildings in neoclassical architecture, such as: a building built in 1845, which in 2018 was revitalized to become the Cazuza Cultural Center; the building that housed the Santa Casa de Misericórdia is being restored to become the Vila de Vassouras Museum; the Casa do Barão de Vassouras is being restored; it was the stage for the exhibition that valued the cultural traditions of Vassouras. Thus, the aim of this article is to discuss the stories of invisible social groups that built this rich heritage, told on the basis of the new uses of this heritage. As a methodology, bibliographic and documentary research existed in historical collections, newspaper reports and digital media. As a result, it is clear that looking at cultural heritage sheds light on traditions in social relationships that until then were invisible.
Memória de longa duração: um estudo sobre a consolidação das trajetórias de imigrantes norte-americanos no contexto de 1859 a 1870 nas cidades do Rio de Janeiro e São Paulo
Authors: Silveira Isabel Orestes 
Published: January 2025

Some North American characters contributed to significant social and educational changes in the cities of Rio de Janeiro in 1859 and São Paulo in 1870. This article is interested in pointing out the relationships between some Presbyterian missionaries who came to Brazil, such as Ashbel Green Simonton (1833-1867) and George W. Chamberlain (1839-1902), as well as important educators: Mary A. Annesley Chamberlain, Mary Parker Dascomb, Phebe R. Thomas, and Marcia P. Brown. The "long-term memory", which refers to the emphasis given by the Annales to historical processes or long periods, which surpass the history of events, evokes the problematization that arises: how has the acquisition, consolidation and evocation of the memory of such protagonists been over time? The bibliographic methodology is based on historical sources such as Garcez (1969), Motta (1970), Matos (2004), Braudel (1950), among others. It is hoped that history will be revisited, memory evoked and the relationships between subjects will highlight past facts and point to the gains of the present, in addition to highlighting the permanence of the legacy left by such agents.
‘She Is Like Your Favourite Aunt’
Authors: Debele Serawit B. 
Published: January 2025

Abstract
This article draws on accounts of how Ethiopian Orthodox Christian queer women relate to Saint Mary to foreground an aspect of intimacy that goes beyond the object of sexual desire. By studying relationships with nonhuman agents such as saints, the article demonstrates how queer subjects cultivate intimacies that go beyond and outside the dominant way of relating to the deities. In queer women’s praxis, intimacy’s formations and manifestations expose the lurking shades and shadows of intimacy and complicate what seems to be an accepted norm that dictates how to be close to Saint Mary. Further, by highlighting the spiritual life of queer women, this article joins the scholarship that problematises the assumption that religious and sexual identities are (or should be) mutually exclusive.
Possible Actions by Coastal States to Protect Their Marine Environment from Oil Tankers in the Dark Fleet
Authors: Beckman Robert , Nguyen Trung , Ong Joel 
Published: January 2025

Abstract
An unintended consequence of the sanctions on the Russian Federation, Iran, and Venezuela is the creation of a ‘dark fleet’ of oil tankers that do not comply with the International Maritime Organization (IMO) regulations on the safety of navigation and protection of the marine environment. These tankers are environmental disasters waiting to happen and present a serious threat to the marine environment of coastal States. In this article, we examine these issues and explore the options that coastal States can take under the 1982 United Nations Convention on the Law of the Sea (LOSC) to protect their marine and coastal environment from the tankers in the dark fleet.