bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimating health state utilities in Duchenne muscular dystrophy using the health utilities index and EQ-5D-5L
Authors: Audhya Ivana F. , Szabo Shelagh M. , Bever Andrea , O’Sullivan Fiona , Malone Daniel C. , Feeny David , Neumann Peter , Iannaccone Susan T. , Jayasinghe P. , Gooch Katherine L. 
Published: December 2023

Abstract
Background
The progression of Duchenne muscular dystrophy (DMD) is characterized by loss of ambulation, respiratory insufficiency, cardiomyopathy, and early mortality. DMD profoundly impacts health-related quality-of-life (HRQoL). However, few health state utility data exist; published utilities tend to be derived from small samples for a limited number of health states and are often based on caregiver-reported patient health status. This study estimated utility values for varied clinical and functional health states in DMD, based on patient-reported health status.

Methods
Individuals with DMD in the US aged 12–40 years completed the EQ-5D (5-level) and Health Utilities Index (HUI) preference-based instruments. Based on responses to a clinical questionnaire, participants self-classified into functional health states according to level of lower and upper limb function, use of respiratory support, and presence of cardiomyopathy. Mean [standard deviation (SD)] utility and EQ-5D visual analogue scale (VAS) scores were estimated according to health state; and median (interquartile range) attribute levels calculated to understand which domains of health are most severely affected in DMD.

Results
Of 63 males with DMD, mean (SD) age was 19.8 (6.1) years and 11 (17.5%) were ambulatory. Mean (SD) utility values were 0.92 (0.08; HUI2), 0.84 (0.20; HUI3), and 0.84 (0.13; EQ-5D) for ambulatory patients without cardiomyopathy (n = 10). For non-ambulatory patients with moderately impaired upper limb function, night and daytime ventilation without cardiomyopathy, mean (SD) utilities were 0.49 (0.07) for the HUI2, 0.16 (0.15) for the HUI3 and 025 (0.14) for the EQ-5D. Mean (SD) VAS scores for the same health states were 91 (9) and 83 (21), respectively. In addition to impairments in mobility/ambulation, and self-care, attributes like usual activities and pain also showed notable effects of DMD.

Conclusions
In DMD, although a relationship between disease progression and HRQoL is observed, there is large variability in utility within functional health states, and across instruments. Utility values for less severe non-ambulatory health states described by level of upper limb function are novel. These utility values, derived based on direct patient feedback rather than from caregiver report, are relevant to individuals of varying functional statuses and augment scarce DMD-specific utility data.
Virtual, augmented, mixed, and extended reality interventions in healthcare: a systematic review of health economic evaluations and cost-effectiveness
Authors: Gómez Bergin Aislinn D. , Craven Michael P. 
Published: December 2023

Abstract
Introduction
Health economic evaluations are required to best understand the value of interventions to the health economy. As extended reality technologies (an umbrella term including virtual, augmented, and mixed reality) become cheaper and more accessible it is likely that they will be used more within healthcare.

Objective
The aim of this study was to systematically review common practices within health economic evaluations of extended reality interventions in healthcare and to discuss the methods, outcomes, and methodological quality to inform future HEEs.

Methods
MEDLINE, Embase, NHSEED, PubMed, and the ACM Digital Library were searched, and studies retrieved and screened. We extracted descriptions of the population, intervention, comparator, outcomes, context, costs, and economic evaluation data from studies that fit our criteria. We included studies that involved healthcare patients who were provided extended reality interventions versus standard care, other types of care, or another extended reality application within the same setting where the outcome included both health outcomes and health economic evaluations.

Results
The search identified 1,693 records in total, of which 1,271 were excluded after title and abstract screening. A total of 422 articles were retrieved and screened and the majority (n = 233) were excluded as they did not contain a health economic analysis or cost data. Fourteen articles were included in this review, all of which found that extended reality health interventions could provide cost savings. Our findings showed considerable heterogeneity between studies and a lack of clear descriptions of XR interventions, limiting their use within procurement.

Conclusion
Extended reality in healthcare has the potential to offer significant clinical benefits and research has shown it to be promising at delivering cost-savings. We make recommendations based on the findings of our review for future health economic analyses to help ensure that health economic analyses can support decision-makers in procuring these technologies.

Trial registration
PROSPERO 2022 CRD42022342110.
Improvements in Survival and Clinical Benefit With Gemcitabine as First-Line Therapy for Patients With Advanced Pancreas Cancer: A Randomized Trial
Authors: Burris H A , Moore M J , Andersen J , Green M R , Rothenberg M L , Modiano M R , Cripps M C , Portenoy R K , Storniolo A M , Tarassoff P , Nelson R , Dorr F A , Stephens C D , Von Hoff D D 
Published: December 2023

PURPOSE Most patients with advanced pancreas cancer experience pain and must limit their daily activities because of tumor-related symptoms. To date, no treatment has had a significant impact on the disease. In early studies with gemcitabine, patients with pancreas cancer experienced an improvement in disease-related symptoms. Based on those findings, a definitive trial was performed to assess the effectiveness of gemcitabine in patients with newly diagnosed advanced pancreas cancer. PATIENTS AND METHODS One hundred twenty-six patients with advanced symptomatic pancreas cancer completed a lead-in period to characterize and stabilize pain and were randomized to receive either gemcitabine 1,000 mg/m2 weekly x 7 followed by 1 week of rest, then weekly x 3 every 4 weeks thereafter (63 patients), or to fluorouracil (5-FU) 600 mg/m2 once weekly (63 patients). The primary efficacy measure was clinical benefit response, which was a composite of measurements of pain (analgesic consumption and pain intensity), Karnofsky performance status, and weight. Clinical benefit required a sustained (> or = 4 weeks) improvement in at least one parameter without worsening in any others. Other measures of efficacy included response rate, time to progressive disease, and survival. RESULTS Clinical benefit response was experienced by 23.8% of gemcitabine-treated patients compared with 4.8% of 5-FU-treated patients (P = .0022). The median survival durations were 5.65 and 4.41 months for gemcitabine-treated and 5-FU-treated patients, respectively (P = .0025). The survival rate at 12 months was 18% for gemcitabine patients and 2% for 5-FU patients. Treatment was well tolerated. CONCLUSION This study demonstrates that gemcitabine is more effective than 5-FU in alleviation of some disease-related symptoms in patients with advanced, symptomatic pancreas cancer. Gemcitabine also confers a modest survival advantage over treatment with 5-FU.
OXPHOS capacity is diminished and the phosphorylation system inhibited during diapause in an extremophile, embryos of Artemia franciscana
Authors: Patil Yuvraj N. , Gnaiger Erich , Landry Alexander P. , Leno Zachary J. , Hand Steven C. 
Published: December 2023

ABSTRACT
Diapause exhibited by embryos of Artemia franciscana is accompanied by severe arrest of respiration. A large fraction of this depression is attributable to downregulation of trehalose catabolism that ultimately restricts fuel to mitochondria. This study now extends knowledge on the mechanism by revealing metabolic depression is heightened by inhibitions within mitochondria. Compared with that in embryo lysates during post-diapause, oxidative phosphorylation (OXPHOS) capacity P is depressed during diapause when either NADH-linked substrates (pyruvate and malate) for electron transfer (electron transfer capacity, E) through respiratory Complex I or the Complex II substrate succinate are used. When pyruvate, malate and succinate were combined, respiratory inhibition by the phosphorylation system in diapause lysates was discovered as judged by P/E flux control ratios (two-way ANOVA; F1,24=38.78; P&lt;0.0001). Inhibition was eliminated as the diapause extract was diluted (significant interaction term; F2,24=9.866; P=0.0007), consistent with the presence of a diffusible inhibitor. One candidate is long-chain acyl-CoA esters known to inhibit the adenine nucleotide translocator. Addition of oleoyl-CoA to post-diapause lysates markedly decreased the P/E ratio to 0.40±0.07 (mean±s.d.; P=0.002) compared with 0.79±0.11 without oleoyl-CoA. Oleoyl-CoA inhibits the phosphorylation system and may be responsible for the depressed P/E in lysates from diapause embryos. With isolated mitochondria, depression of P/E by oleoyl-CoA was fully reversed by addition of l-carnitine (control versus recovery with l-carnitine, P=0.338), which facilitates oleoyl-CoA transport into the matrix and elimination by β-oxidation. In conclusion, severe metabolic arrest during diapause promoted by restricting glycolytic carbon to mitochondria is reinforced by depression of OXPHOS capacity and the phosphorylation system.
Iron Absorption in Highly Trained Male Runners: Does it Matter When and Where You Eat Your Iron?
Authors: MCKAY ALANNAH K.A. , ANDERSON BRYCE , PEELING PETER , WHITFIELD JAMIE , TEE NICOLIN , ZEDER CHRISTOPHE , ZIMMERMANN MICHAEL B. , BURKE LOUISE M. , MORETTI DIEGO 
Published: December 2023

ABSTRACT

Purpose
We examined iron absorption and its regulation during two common scenarios experienced by endurance athletes. Our aims were to: (i) compare the effects of preexercise versus postexercise iron intake on iron absorption; and (ii) compare the impact of training at altitude (1800 m) on iron absorption preexercise.

Methods
Male runners (n = 18) completed three exercise trials over a 5-wk period, each preceded by 24 h of standardized low-iron diets. First, athletes completed two 60-min treadmill running trials at 65% V̇O2max at near sea-level (580 m). In a randomized order, preexercise and postexercise test meals labeled with 4 mg of 57Fe or 58Fe were consumed 30 min before or 30 min after exercise. Then, the same exercise trial was performed after living and training at altitude (~1800 m) for 7 d, with the labeled test meal consumed 30 min preexercise. We collected venous blood samples preexercise and postexercise for markers of iron status and regulation, and 14 d later to measure erythrocyte isotope incorporation.

Results
No differences in fractional iron absorption were evident when test meals were consumed preexercise (7.3% [4.4, 12.1]) or postexercise (6.2% [3.1, 12.5]) (n = 18; P = 0.058). Iron absorption preexercise was greater at altitude (18.4% [10.6, 32.0]) than at near sea-level (n = 17; P < 0.001) and hepcidin concentrations at altitude were lower at rest and 3 h postexercise compared with near sea level (P < 0.001).

Conclusions
In an acute setting, preexercise and postexercise iron absorption is comparable if consumed within 30 min of exercise. Preexercise iron absorption increases 2.6-fold at altitude compared with near sea-level, likely due to the homeostatic response to provide iron for enhanced erythropoiesis and maintain iron stores.
Large-vessel vasculitis and Q fever correlation
Authors: Ramos Joana C. , Santos Daniela , Dias Patrícia 
Published: December 2023

Q fever is a zoonotic infection caused by the pathogen Coxiella burnetii, and patients can present with a wide spectrum of clinical manifestations, depending on whether it is an acute or a chronic infection. We present the case of a 61-year-old male with fatigue, posterior thoracalgia, intermittent fever, night sweats and weight loss for a month. After an extensive workup, he was diagnosed with acute Q fever with large-vessel vasculitis. The FDG-PET/CT scan suggested an active vasculitis specifically in the thoracic aorta, proximal abdominal aorta, subclavian and carotid vessels, suggesting an immunologic response to acute Q fever infection, barely reported worldwide.
Emotional Psychoeducational Group for Psychiatric Inpatients. Findings from a Clinical Study
Authors: Lucattelli R. , Pecorari M. , Mentuccia V. , Biello C. , Riggio F. , Sagliano T. , Marino G. , Nicolò G. , Bernabei L. 
Published: December 2023

This research investigates the impact of psychoeducational interventions on emotional well-being within an acute psychiatric setting. Through a comprehensive study conducted in a psychiatric ward, we assess the effectiveness of targeted psychoeducational programs in managing and improving emotional states among individuals facing acute psychiatric conditions.
Results: Repeated measures ANOVA shows significant change in emotional regulation measured by DERS, although not significantly different between group.
Discussion: Preliminary findings suggest promising results, indicating that emotional psychoeducational interventions may play a crucial role in enhancing emotional stability and fostering a more supportive environment within acute psychiatric care. This research contributes valuable insights to the evolving field of mental health interventions, with potential implications for optimizing therapeutic approaches in similar clinical settings.
Should we recommend patellofemoral arthroplasties to patients?
Authors: Vella-Baldacchino Martinique , Webb Jeremy , Selvarajah Bhavana , Chatha Sukhjaad , Davies Andrew , Cobb Justin P. , Liddle Alexander D. 
Published: December 2023

AimsWith up to 40% of patients having patellofemoral joint osteoarthritis (PFJ OA), the two arthroplasty options are to replace solely the patellofemoral joint via patellofemoral arthroplasty (PFA), or the entire knee via total knee arthroplasty (TKA). The aim of this study was to assess postoperative success of second-generation PFAs compared to TKAs for patients treated for PFJ OA using patient-reported outcome measures (PROMs) and domains deemed important by patients following a patient and public involvement meeting.MethodsMEDLINE, EMBASE via OVID, CINAHL, and EBSCO were searched from inception to January 2022. Any study addressing surgical treatment of primary patellofemoral joint OA using second generation PFA and TKA in patients aged above 18 years with follow-up data of 30 days were included. Studies relating to OA secondary to trauma were excluded. ROB-2 and ROBINS-I bias tools were used.ResultsA total of nine studies were included, made up of four randomized controlled trials (domain 1) and five cohort studies (domain 2). PROMs and knee function specific scores developed for reporting TKA were unable to detect any difference between PFA and TKA. There was no significant difference in complications between PFA and TKA. PFAs were found to have a better postoperative range of motion.ConclusionTKA and PFA are both viable options for patients with primary PFJ OA. Over time, we have seen an emphasis on patient satisfaction and better quality of life. Recommending sacrificing healthy medial and lateral compartments to treat patellofemoral joint arthritis should be given further thought.Cite this article: Bone Jt Open 2023;4(12):948–956.
Construction of a recombinant vaccine expressing Nipah virus glycoprotein using the replicative and highly attenuated vaccinia virus strain LC16m8
Authors: Watanabe Shumpei , Yoshikawa Tomoki , Kaku Yoshihiro , Kurosu Takeshi , Fukushi Shuetsu , Sugimoto Satoko , Nishisaka Yuki , Fuji Hikaru , Marsh Glenn , Maeda Ken , Ebihara Hideki , Morikawa Shigeru , Shimojima Masayuki , Saijo Masayuki 
Published: December 2023

Nipah virus (NiV) is a highly pathogenic zoonotic virus that causes severe encephalitis and respiratory diseases and has a high mortality rate in humans (>40%). Epidemiological studies on various fruit bat species, which are natural reservoirs of the virus, have shown that NiV is widely distributed throughout Southeast Asia. Therefore, there is an urgent need to develop effective NiV vaccines. In this study, we generated recombinant vaccinia viruses expressing the NiV glycoprotein (G) or fusion (F) protein using the LC16m8 strain, and examined their antigenicity and ability to induce immunity. Neutralizing antibodies against NiV were successfully induced in hamsters inoculated with LC16m8 expressing NiV G or F, and the antibody titers were higher than those induced by other vaccinia virus vectors previously reported to prevent lethal NiV infection. These findings indicate that the LC16m8-based vaccine format has superior features as a proliferative vaccine compared with other poxvirus-based vaccines. Moreover, the data collected over the course of antibody elevation during three rounds of vaccination in hamsters provide an important basis for the clinical use of vaccinia virus-based vaccines against NiV disease.
Trial Registration: NCT05398796.
The complete mitochondrial genome of Echinolaelaps fukienensis provide insights into phylogeny and rearrangement in the superfamily Dermanyssoidea
Authors: He Gangxian , Li Wei , Yuan Bili , Dong Wenge 
Published: December 2023

BackgroundEchinolaelaps fukienensisis the dominant mite species parasitic on the body surface of the genusNiviventer. The mitochondrial genome (mitogenome) has its own independent genetic material and genetic system, and is now widely used in population genetics, genealogical biogeography, phylogeny and molecular evolution studies. Species diversity of the superfamily Dermanyssoidea is very rich, but its mitogenomes AT content is high, and it is difficult to amplify the complete mitogenome by routine PCR. To date, we have only obtained the mitogenomes of 6 species, scarcity on sequence data has greatly impeded the studies in the superfamily Dermanyssoidea.MethodsEchinolaelaps fukienensiswere collected in 2019 from the body surface ofNiviventer confucianus(Rodentia, Muridae) in Yunnan Province. TheE.fukienensismitogenome was determined and analyzed for the first time using the Illumina Novoseq 6000 platform. Phylogenetic analyses of the superfamily Dermanyssoidea were conducted based on the entire mitogenome sequences.ResultsTheE.fukienensismitogenome was 14,402 bp, which is known the smallest genome of the superfamily Dermanyssoidea, encoding a total of 37 genes, including 13 PCGs, 22 tRNAs, 2 rRNAs and 1 control region. Most protein-coding genes use ATN as the start codon and TAN as the stop codon. AT and GC skew ofatp8genes inE.fukienensiswere both 0. The average length of 22 tRNA genes ofE.fukienensiswas 64 bp, and secondary structures of tRNAs showed base mismatches and missing D-arms in many places. Compared with gene arrangement pattern of the hypothetical ancestor of arthropods, theE.fukienensismitogenome shows a novel arrangement pattern. Phylogenetic tree supported the monophyly of the superfamily Dermanyssoidea.Echinolaelaps fukienensisbeing the least genetic distant (0.2762) and most closely related toVarroa destructor.ConclusionsThis study analyzed comprehensive the structure and evolution of theE.fukienensismitogenome for the first time, enriches molecular data of the genusEchinolaelaps, which will contribute to further understand phylogeny and rearrangement patterns of the superfamily Dermanyssoidea.
Effect of influenza vaccination on resting metabolic rate and c-reactive protein concentrations in healthy young adults
Authors: Parker Claire Hagan , Sadhir Srishti , Swanson Zane , McGrosky Amanda , Hinz Elena , Urlacher Samuel S. , Pontzer Herman 
Published: December 2023

Objectives
Chronic immune activation and severe inflammatory states are positively associated with resting metabolic rate (RMR; kcal/day), but the impacts of mild immune stimuli on metabolism are poorly understood. This study investigates the within-individual association between the inflammatory response to influenza vaccination and RMR in young adults.

Methods
We evaluated RMRs through indirect calorimetry and circulating c-reactive protein (CRP) concentrations (mg/L)—a direct measure of inflammation—via high-sensitivity immunoassays of dried blood spots (n = 17) at baseline and two- and seven-days post-vaccine. Wilcoxon matched-pairs signed-rank tests were used to evaluate the magnitude of the CRP and RMR responses. Type II Wald chi-square tests of linear mixed-effect models assessed whether those responses were correlated.

Results
Baseline CRP was 1.39 ± 1.26 mg/L. On day two post-vaccine, CRP increased by 1.47 ± 1.37 mg/L (p < 0.0001), representing a 106% increase above baseline values. CRP remained higher on day seven post-vaccine, 1.32 ± 2.47 mg/L (p = 0.05) above baseline values. There were no statistically significant changes in RMR from baseline to day two (p = 0.98) or day seven (p = 0.21). Change in CRP from baseline did not predict RMR variation across days (p = 0.46).

Conclusions
We find no evidence that adult influenza vaccination results in a corresponding increase in RMR. These results suggest that the energetic cost of an influenza vaccine’s mild inflammatory stimulus is either too small to detect or is largely compensated by a temporary downregulation of energy allocated to other metabolic tasks.
A phase I study of intra-anal artesunate (suppositories) to treat anal high-grade squamous intraepithelial lesions
Authors: Fang Sandy Hwang , Plesa Mihaela , Carchman Evie H. , Cowell Nicole A. , Staudt Emily , Twaroski Kyleigh Ann , Buchwald Ulrike K. , Trimble Cornelia L. 
Published: December 2023

Background
Ablation or surgical excision is the typical treatment of anal high-grade squamous intraepithelial lesions (HSIL). Recurrences are common due to the persistence of underlying human papillomavirus (HPV) infection. Additional well-tolerated and effective non-surgical options for HPV-associated anal disease are needed.

Methods
This 3+3 dose escalation Phase I clinical trial evaluated the safety and tolerability of artesunate suppositories in the treatment of patients with biopsy-proven HSIL.

Results
The maximal tolerated dose was 400 mg, administered in 3 cycles. All adverse events associated with the use 200- and 400-mg artesunate suppositories were Grade 1. At the 600-mg dose, patients experienced clinically significant nausea.

Conclusion
Artesunate suppositories are a safe treatment option for anal HSIL.
O Brasil como potência emergente no Sul Global no novo cenário internacional: ameaças e possibilidades diante da mudança hegemônica
Authors: Filipe Fernandes Ivan 
Published: December 2023

O objetivo deste estudo é discutir as opções na política externa brasileira face às transformações do sistema internacional. Diante de um ambiente mais tenso e a posição periférica, questiona-se: deve o país escolher lados ou manter sua autonomia? Argumentamos que a ação brasileira deve retomar as heranças da sua atuação estratégica frente a contestações hegemônicas anteriores. A situação atual reduz o espaço para a ação hegemônica e abre possibilidades de rupturas, colocando o Brasil diante de uma encruzilhada. O Brasil é um membro ativo dos BRICS, portanto, parte da zona de contestação da ordem liberal; faz também parte da zona de influência americana no Hemisfério Ocidental e possui um regime democrático vigoroso, colocando-o como parte da frente Ocidental. Damos especial atenção os riscos e oportunidades nas principais parcerias do Sul Global, que contrasta com a parceria secular do Brasil com os EUA e Europa. O BRICS permite uma aproximação institucionalizada e em temas fora do campo da segurança com as potências não ocidentais, sem colocar em risco a aproximação do Brasil com o Ocidente. O nosso estudo basear-se-á numa abordagem da histórica do tempo presente das relações do Brasil com as grandes potências e nas recentes transformações do sistema internacional.
Palavras-chave: Política Externa Brasileira, Equidistância Pragmática, China, Estados Unidos, Autonomia.