bluuebunny/crossref_metadata_2025_split huggingface dataset:
Herpes zoster associated with stroke incidence in people living with human immunodeficiency virus: a nested case–control study
Authors: Ku Han-Chang , Wu Yi-Lin , Yip Hei-Tung , Hsieh Cheng-Yang , Li Chung-Yi , Ou Huang-Tz , Chen Yen-Chin , Ko Nai-Ying 
Published: September 2023

Abstract
Background
The incidence of stroke is increasing among younger people with human immunodeficiency virus (HIV). The burden of stroke has shifted toward the young people living with HIV, particularly in low- and middle-income countries. People infected with herpes zoster (HZ) were more likely to suffer stroke than the general population. However, the association of HZ infection with the incidence of stroke among patients with HIV remains unclear.

Methods
A nested case–control study was conducted with patients with HIV registered in the Taiwan National Health Insurance Research Database in 2000–2017. A total of 509 stroke cases were 1:10 matched to 5090 non-stroke controls on age, sex, and date of first stroke diagnosis. Logistic regression models were used to estimate the odds ratio and 95% confidence intervals (CI) of stroke incidence.

Results
The odds ratio of stroke was significantly higher in the HIV-infected population with HZ (adjusted odds ratio [AOR]: 1.85, 95% CI: 1.42–2.41). A significantly increased AOR of stroke was associated with hypertension (AOR: 3.53, 95% CI: 2.86–4.34), heart disease (AOR: 2.32, 95% CI: 1.54–3.48), chronic kidney disease (AOR: 1.82, 95% CI: 1.16–2.85), hepatitis C virus infection (AOR: 1.49, 95% CI: 1.22–1.83), hyperlipidemia (OR: 1.41, 95% CI: 1.12–1.78), and treatment with protease inhibitors (AOR: 1.33, 95% CI: 1.05–1.69).

Conclusions
Our findings suggest that HZ concurrent with HIV may increase the risk of stroke. The incidence rates of stroke were independent of common risk factors, suggesting strategies for early prevention of HZ infection among people living with HIV.
Visit-to-visit HbA1c variability is associated with poor prognosis in peritoneal dialysis patients with type 2 diabetes mellitus
Authors: Zhang Fengping , Shi Taotao , Feng Xiaoran , Shi Yunying , Zhang Guilin , Liu Yu , Fu Ping 
Published: September 2023

Abstract
Background
The prognosis of diabetic peritoneal dialysis patients is poor. HbA1c serves as a crucial indicator for monitoring blood glucose control in patients with diabetes. Nevertheless, the relationship between visit-to-visit HbA1c variability and prognosis in peritoneal dialysis with diabetes remains unclear.

Methods
All participants were categorized into 3 groups based on the HbA1c variability score (HVS), which is the frequency of 0.5% (5.5 mmol/mol) alter in visit-to-visit HbA1c values. Then, the hazard ratio to HVS with all-cause mortality was analyzed using the Cox hazard model, followed by the Fine-Gray competing risk model for major adverse cardiovascular events. Subgroup and sensitivity analysis were conducted to ascertain the robustness of the findings.

Results
Eight hundred twenty patients with type 2 diabetes were finally enrolled in this study from 2,855 participants with a mean age of 56.9 ± 14.6 years and a median follow-up time of 44 months [IQR: 27–70], death occurred in 496 (60.2%) individuals. Compared with the lowest category (HVS < 1/3) after being adjusted by potential confounding factors, the hazard ratio for all-cause mortality was 4.59 (3.74–5.64) and the sub-distribution hazard ratio for major adverse cardiovascular events was 1.91 (1.46–2.51) of the highest category (HVS ≥ 2/3). Subgroup interaction and sensitivity analysis, including the adjustment for variables such as time-weighted average HbA1c, HbA1c measurement times and expansion, confirmed the reliability of the results.

Conclusion
The HVS is related to the risk of poor prognosis in peritoneal dialysis with type 2 diabetes mellitus, independently of clinical multiple variables, and is a novel indicator with clinical guidance.
Pulmonary vein perforation into the respiratory tract with systemic air embolism: a rare complication of left atrial appendage closure
Authors: Qiao Zhiqing , Zhao Liang , Xu Bin , Zou Zhiguo , Cheng Fuyu , Zhou Zien , Xie Yuquan , Pu Jun 
Published: September 2023

Abstract
Background
Pulmonary vein perforation is an uncommon complication during cardiac intervention. We present a rare case of pulmonary vein perforation into the respiratory tract with systemic air embolism during left atrial appendage closure (LAAC).

Case presentation
A 77-year-old man with persistent nonvalvular atrial fibrillation was referred for percutaneous LAAC under local anaesthesia (CHA2DS2-VASc score of 4, HAS-BLED score of 3, and prior ischaemic stroke). During the procedure, after delivering a super-stiff guidewire into the left superior pulmonary vein (LSPV), the patient suddenly developed a severe cough with haemoptysis upon advancement of a delivery sheath along the guidewire. Fluoroscopy showed signs of blood entering the left main bronchus, and fast transthoracic echocardiography revealed bubbles in the left heart without pericardial effusion. The procedure was terminated because of a major complication indicated by the repeated haemoptysis and headache, and haemostatic drugs were immediately administered. Subsequent chest computed tomography angiography (CTA) revealed a filling defect in the LSPV branches and bubbles in the aorta. The patient was transferred to the critical care unit for haemostasis and antibacterial treatment. Transthoracic echocardiography later that day showed no bubbles in the heart. The headache and haemoptysis significantly abated the following day. The bubbles in the aorta disappeared on chest CTA 7 days later.

Conclusions
Interventional cardiologists should pay attention to anatomical variations of the pulmonary vein, which are associated with a high risk of complications of pulmonary vein perforation during LAAC. Preoperative CTA examination and intraoperative transoesophageal echocardiography might be helpful to avoid this complication.
Pre-service healthcare professionals attitudes and self-efficacy towards individuals with intellectual disability in Ghana
Authors: Opoku Maxwell Peprah , Elhoweris Hala , Amponteng Michael , Nketsia William , Torgbenu Eric Lawer , Saah Reuben 
Published: September 2023

Abstract
Background
Intellectual disability (ID) involves impairment of general mental abilities, restricting the participation of individuals in conceptual, social and practical activities. Consequently, rehabilitation services are critical in efforts towards promoting the social and educational inclusion of persons with ID. However, the preparedness of health professionals in performing such a role depends on their perceptions of individuals with ID. Ajzen’s theory of planned behaviour was used as theoretical framework to understand the relationship between the perceived attitude and self-efficacy of healthcare students towards persons with ID.

Method
A cross-sectional survey was conducted among healthcare students (N = 328) in a Ghanaian university. The Community Living Attitude Scale for ID(CLAS-ID) and General Self-efficacy (GSE) Scale were employed to assess their attitudes and self-efficacy towards people with ID respectively. The data were analysed using SPSS and AMOS and were subjected to a t-test, ANOVA, correlation and regression.

Result
The healthcare students were ambivalent about both self-efficacy and attitudes towards persons with ID, and there was correlation between attitudes and self-efficacy. Attitudes and self-efficacy also varied across the demographic characteristics of the respondents including age, having a relative with ID, level of study, religion, and programme of study.

Conclusion
The study underscores the necessity for healthcare curriculum reform and provides corresponding recommendations. The study emphasizes the importance of enhancing healthcare students' understanding of ID, changing their attitudes, and bolstering their self-efficacy. This is crucial to foster positive attitudes, confidence in providing support to individuals with ID, and raising awareness within the broader community. To achieve this, health educators are encouraged to incorporate exposure to individuals with ID into healthcare students' training, along with more structured field experiences designed to increase their contact and interaction with individuals with ID. Such initiatives would enable students to better understand the uniqueness and requirements of individuals with ID.
Establishment and validation of an immune infiltration predictive model for ovarian cancer
Authors: Song Zhenxia , Zhang Jingwen , Sun Yue , Jiang Zhongmin , Liu Xiaoning 
Published: September 2023

Abstract
Background
The most prevalent mutation in ovarian cancer is the TP53 mutation, which impacts the development and prognosis of the disease. We looked at how the TP53 mutation associates the immunophenotype of ovarian cancer and the prognosis of the disease.

Methods
We investigated the state of TP53 mutations and expression profiles in culturally diverse groups and datasets and developed an immune infiltration predictive model relying on immune-associated genes differently expressed between TP53 WT and TP53 MUT ovarian cancer cases. We aimed to construct an immune infiltration predictive model (IPM) to enhance the prognosis of ovarian cancer and investigate the impact of the IPM on the immunological microenvironment.

Results
TP53 mutagenesis affected the expression of seventy-seven immune response-associated genes. An IPM was implemented and evaluated on ovarian cancer patients to distinguish individuals with low- and high-IPM subgroups of poor survival. For diagnostic and therapeutic use, a nomogram is thus created. According to pathway enrichment analysis, the pathways of the human immune response and immune function abnormalities were the most associated functions and pathways with the IPM genes. Furthermore, patients in the high-risk group showed low proportions of macrophages M1, activated NK cells, CD8+ T cells, and higher CTLA-4, PD-1, PD-L1, and TIM-3 than patients in the low-risk group.

Conclusions
The IPM model may identify high-risk patients and integrate other clinical parameters to predict their overall survival, suggesting it is a potential methodology for optimizing ovarian cancer prognosis.
Comparative cardiovascular safety of LABA/LAMA FDC versus LABA/ICS FDC in patients with chronic obstructive pulmonary disease: a population-based cohort study with a target trial emulation framework
Authors: Chen Chun-Yu , Pan Sheng-Wei , Hsu Chia-Chen , Liu Jason J. , Kumamaru Hiraku , Dong Yaa-Hui 
Published: September 2023

Abstract
Background
Use of combinations of long-acting β2 agonists/long-acting muscarinic antagonists (LABA/LAMA) in patients with chronic obstructive pulmonary disease (COPD) is increasing. Nevertheless, existing evidence on cardiovascular risk associated with LABA/LAMA versus another dual combination, LABA/inhaled corticosteroids (ICS), was limited and discrepant.

Aim
The present cohort study aimed to examine comparative cardiovascular safety of LABA/LAMA and LABA/ICS with a target trial emulation framework, focusing on dual fixed-dose combination (FDC) therapies.

Methods
We identified patients with COPD who initiated LABA/LAMA FDC or LABA/ICS FDC from a nationwide Taiwanese database during 2017–2020. The outcome of interest was a hospitalized composite cardiovascular events of acute myocardial infarction, unstable angina, heart failure, cardiac dysrhythmia, and ischemic stroke. Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for composite and individual cardiovascular events after matching up to five LABA/LAMA FDC initiators to one LABA/ICS FDC initiator using propensity scores (PS).

Results
Among 75,926 PS-matched patients, use of LABA/LAMA FDC did not show a higher cardiovascular risk compared to use of LABA/ICS FDC, with a HR of 0.89 (95% CI, 0.78–1.01) for the composite events, 0.80 (95% CI, 0.61–1.05) for acute myocardial infarction, 1.48 (95% CI, 0.68–3.25) for unstable angina, 1.00 (95% CI, 0.80–1.24) for congestive heart failure, 0.62 (95% CI, 0.37–1.05) for cardiac dysrhythmia, and 0.82 (95% CI, 0.66–1.02) for ischemic stroke. The results did not vary substantially in several pre-specified sensitivity and subgroup analyses.

Conclusion
Our findings provide important reassurance about comparative cardiovascular safety of LABA/LAMA FDC treatment among patients with COPD.
UAV-assisted NOMA secure communications: joint transmit power and trajectory optimization
Authors: Han Ruibo , Wang Yongjian , Zhang Yang 
Published: September 2023

AbstractWith the inherent advantages of exceptional maneuverability, flexible deployment options and cost-effectiveness, unmanned aerial vehicles (UAVs) present themselves as a viable solution for providing aerial communication services to Internet of Things devices in high-traffic or remote areas. Nevertheless, the openness of the air–ground channel poses significant security challenges to UAV-based wireless systems. In this paper, a UAV-assisted secure communication system model is established based on non-orthogonal multiple access (NOMA) from the perspective of physical layer security, aiming to conceal the transmission behavior between UAVs and legitimate users (LUs). Specifically, a mobile UAV assumes the role of an aerial base station, leveraging NOMA technique to transmit data to LUs while evading detection from mobile eavesdropper situated on the ground. To fortify the security performance of the system, a hovering UAV acts as a friendly jammer and transmits interference signals to mobile eavesdropper (referred to as Eve). The objective of this scheme is to maximize the minimum average secure rate of all LUs by meticulously optimizing the trajectory and power allocation of the mobile UAV, subject to secrecy performance constraints. The highly interdependent and non-convex nature of this optimization problem renders direct solutions infeasible. Hence, this paper designs an efficient iterative algorithm that decouples the original problem into two subproblems, enabling an alternating optimization process for the trajectory and power allocation of the mobile UAV until the convergence of the objective function is achieved. Simulation results demonstrate that the proposed algorithm effectively improves the minimum average secure rate of all LUs compared with the benchmark scheme.
Comparison of clinical characteristics between adult-onset and juvenile-onset non-radiographic axial spondyloarthritis in Chinese patients: results from the COCAS cohort
Authors: Huang Shu-Xin , Li Hao-Guang , Liang Hong-Jin , Wang Dan-Min , Peng Jian-Hua , Shen Feng-Cai , Li Wei-Ping , Lin Ling , Xiao Zheng-Yu , Hou Zhi-Duo 
Published: September 2023

Abstract
Background
Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease predominantly affecting the axial skeleton. We aimed to describe the clinical characteristics of patients with non-radiographic axSpA (nr-axSpA) in China and compare the differences between adult- and juvenile-onset cases.

Methods
A cross-sectional study was conducted using data from 776 patients with nr-axSpA in the Clinical Characteristic and Outcome in Chinese Axial Spondyloarthritis (COCAS) study cohort. Patients were divided into two groups including the adult-onset group (n = 662) and the juvenile-onset group (n = 114) according to age at disease onset. Baseline demographics and clinical characteristics were compared between patients with adult-onset and juvenile-onset nr-axSpA.

Results
Overall, the male-to-female ratio was 1.26:1, the prevalence of HLA-B27 positivity was 72.2%, and the median age at disease onset of nr-axSpA was 22 years. Nearly 75% of nr-axSpA patients had peripheral arthritis in the disease course, and the prevalence of extra-articular manifestations was 10.4%. The juvenile-onset group contained a higher proportion of men (66.7% vs. 53.9%, P = 0.011) and a longer baseline disease duration (4.0 [4.0] vs. 1.6 [3.5], P < 0.001) than the adult-onset group. A family history of spondyloarthritis was more frequent in the juvenile-onset group than in the adult-onset group (23.7% vs. 15.4%, P = 0.028), but no significant difference in the prevalence of HLA-B27 positivity was observed between the two groups (P = 0.537). Regarding initial symptoms, peripheral arthritis occurred more often in patients with juvenile-onset nr-axSpA, whereas patients with adult-onset nr-axSpA presented more frequently with axial involvement. The prevalence of inflammatory back pain (IBP) was higher in the adult-onset group than in the juvenile-onset group (85.0% vs. 75.4%, P = 0.010), whereas the juvenile-onset group showed a higher prevalence of peripheral arthritis and enthesitis than the adult-onset group (67.5% vs. 48.5%, P < 0.001; 35.1% vs. 23.3%, P = 0.007, respectively).

Conclusions
Compared with adult-onset nr-axSpA, juvenile-onset nr-axSpA was more common in men and those with a family history of spondyloarthritis. Juvenile-onset nr-axSpA presents with a “peripheral predominant” mode at disease onset and a higher frequency of peripheral arthritis and enthesitis during the disease course.
Dissecting tumor antigens and immune subtypes for mRNA vaccine development in breast cancer
Authors: Li Lang , He Lvyuan , Zhu Ying 
Published: September 2023

Abstract
Purposes
Cancer mRNA vaccines are a promising strategy and a hot topic in cancer immunotherapy. However, mRNA vaccines for breast cancer (BRCA) remain undeveloped. This study aimed to identify potential tumor antigens for mRNA vaccine development and a population with BRCA suitable for vaccination.

Methods
Gene expression profiles and the clinical information of the TCGA-BRCA (the Cancer Genome Atlas Breast Cancer) and METABRIC (Molecular Taxonomy of Breast Cancer International Consortium) cohorts were downloaded from the TCGA and cBioPortal databases, respectively. cBioPortal was used to identify mutant genes. DEG (differentially expressed gene) identification and survival analysis were performed with the GEPIA2 tool. ssGSEA (single-sample gene set enrichment analysis) was applied to estimate abundances of 28 immune cells for each sample. An unsupervised consensus clustering algorithm was used to identify ISs (immune subtypes). A graph learning-based dimensionality reduction analysis algorithm was utilized to construct an immune landscape. WGCNA (weighted correlation network analysis) was performed to identify immune gene modules.

Results
Four potential tumor antigens, i.e., SLC7A5, CHPF, CCNE1, and CENPW, associated with poor prognosis and APCs (antigen-presenting cells) among overexpressed and mutated genes were identified in BRCA. Two ISs (IS1-2) characterized by distinct clinical, immune cell infiltration, and molecular features were observed in both the TCGA-BRCA and METABRIC cohorts. BRCA patients with IS2 tumors related to poor prognosis had an immune "hot" phenotype, while those patients with IS1 tumors related to superior prognosis had an immune "cold" phenotype. Distinct IS tumors were observed in different ICD (immunogenic cell death modulator) and ICP (immune checkpoint) expression profiles. The immune landscape showed an immune distribution in BRCA patients. Additionally, we identified 2 immune gene modules with different biological functions.

Conclusions
SLC7A5, CHPF, CCNE1, and CENPW are the potential tumor antigens for mRNA vaccine development with BRCA. Patients with IS2 tumors are a suitable population for mRNA vaccination. This study provides a new insight into mRNA vaccine development, population selection for vaccination, and prognosis prediction.
Role of fluid on seismicity of an intra-plate earthquake zone in Western India: an electrical fingerprint from magnetotelluric study
Authors: Borah Ujjal K. , Patro Prasanta K. , Raju Khasi , Reddy K. Chinna , Babu Narendra , Rao P. Rama , Rao N. Purnachandra 
Published: September 2023

AbstractThe magnetotelluric (MT) investigation carried out in Koyna Seismogenic Zone (KSZ), an intra-plate earthquake region in Western India, along an E–W profile brings out moderately conductive (~ 700–1000 Ωm) near vertical features within the very high resistive (> 20,000 Ωm) granite/granite-gneiss basement. Occurrences of these anomalous moderate conductors are corroborated with sensitivity analysis. The alignment of earthquake hypocenters along the resistive–conductive boundary signifies the moderate conductor as basement fault. The conversion of resistivity values to the ratio of seismic P- to S-wave velocity (vp/vs) suggests that the moderate conductivity of the fault zone (as compared to the surrounding basement) appears due to the presence of fluid in the fault zone. Geophysical evidences reveal ~ 2.5–3.6 vol% fluid in the fault zone with ~ 1.8–2.6% interconnected porosity, which migrates along the structural boundary and invades the mechanically strong basement to nucleate the brittle failure within it. The present study proposes two mechanisms for the seismicity in the Koyna region. First: the meteoric water circulation due to the loading–unloading of nearby Koyna reservoir acts as potential fluid source for this triggered seismicity, which has also been suggested by previous studies. Second: the fluid circulation due to a deep-seated source. The present MT study brings out a conductive feature below 20 km depth which is thought to be emerged due to the dehydration of amphibole bearing rocks. The fluid generated from dehydration might act as a probable source to the triggered seismicity; since the conductive feature has a linkage to the upper crust.
Graphical Abstract
Functional performance recovery after individualized nutrition therapy combined with a patient-tailored physical rehabilitation program versus standard physiotherapy in patients with long COVID: a pilot study
Authors: Roggeman Stijn , Jimenez Garcia Berenice Gabriela , Leemans Lynn , Demol Joy , Geers Janne , De Smedt Ann , Putman Koen , Schiltz Marc , Beckwée David , De Waele Elisabeth 
Published: September 2023

Abstract
Background
Long COVID is suggested to be present in 14 to 43% of COVID 19-survivors. Literature on this new condition states a need for a multidisciplinary approach including physical exercise and nutrition. The aim of the current pilot study is to investigate the feasibility of the proposed protocol to prepare for a randomized controlled study that addresses the effectiveness of a personalized multimodal treatment compared to standard physiotherapy.

Methods
This is a protocol of the UNLOCK (Nutrition and LOComotoric rehabilitation in long COVID) study, a pragmatic, single center, randomized controlled pilot trial with two groups. Patients with persisting symptoms related to a SARS-CoV-2 infection will receive either standard physiotherapy or a personalized multimodal treatment for a period of 12 weeks, consisting of individualized physical exercise program combined with individualized nutritional therapy. They will be followed-up at 6, 12, and 18 weeks after randomization.

Discussion
A multidisciplinary approach for dealing with long COVID is needed. Because of the lack of clear data and the fact that this is a very heterogenic group, we aim to prepare and optimize a randomized controlled study that addresses the effectiveness of a personalized multimodal treatment.

Trial registration
ClinicalTrials.gov Identifier: NCT05254301 (since February 24, 2022).