bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acceptance and hesitancy of COVID-19 vaccination among Saudi pregnant women
Authors: Hawsawi Sereen , Orabi Abeer , Alnajjar Hend 
Published: January 2024

IntroductionSince the COVID-19 pandemic started, it has significantly impacted health systems and societies worldwide. Pregnancy increases the risk of severe illness when associated with COVID-19. Pregnant women are likely to experience COVID-19-related pregnancy complications however many of them were hesitant to receive the vaccine. This study aimed to assess the acceptance and hesitancy of COVID-19 vaccination among pregnant women in Jeddah.MethodsThe present study utilized a descriptive cross-sectional research design to include pregnant women through convenience sampling at the obstetrics and gynecology outpatient department and antenatal ward at King Abdul-Aziz Medical City, Jeddah. Data was collected from August to October 2022 using a structured questionnaire.ResultsApproximately one-third of the 264 participants (36.4%) strongly disagreed that they had developed immunity against COVID-19. More than half of them (61% and 66.3% respectively) had heard that the vaccine was unsafe for them and their babies during pregnancy, and it would contain the COVID-19 virus. However, half of them 50% agreed that vaccination would ease precautionary measures. A high acceptance score toward COVID-19 vaccination was observed among pregnant women working in the health sector. The most frequently reported reason for vaccination refusal was the belief that it was unsafe for the mother and her baby during pregnancy.DiscussionMost of the participants perceived their susceptibility to COVID-19 infection as low and were hesitant to take the vaccine because of their worry about its effectiveness. However, they indicated a willingness to take the vaccine if it was mandatory and if they received adequate information about it. These findings correspond with previous studies conducted in Saudi Arabia that explore the reluctance of pregnant and breastfeeding women to receive COVID-19 vaccination.
Increased circulating regulatory T cells and decreased follicular T helper cells are associated with colorectal carcinogenesis
Authors: Meng Qiao , Zhao Yang , Xu Miao , Wang Pingzhang , Li Jun , Cui Rongli , Fu Weiwei , Ding Shigang 
Published: January 2024

ObjectiveColorectal cancer (CRC) is the third most prevalent cancer worldwide and is associated with high morbidity and mortality rates. Colorectal carcinogenesis occurs via the conventional adenoma-to-carcinoma and serrated pathways. Conventional T helper (Th) and innate lymphoid cells (ILCs) play vital roles in maintaining intestinal homeostasis. However, the contribution of these two major lymphoid cell populations and their associated cytokines to CRC development is unclear. Therefore, we aimed to analyze peripheral lymphocyte profiles during colorectal carcinogenesis.MethodsWe collected 86 blood samples concurrently, and pathologists confirmed the presence of various pathological conditions (i.e., HPs, adenoma, and carcinoma) using hematoxylin and eosin staining. Ten healthy donors were recruited as healthy controls (HCs) from the physical examination center. We performed flow cytometry on peripheral blood mononuclear cells collected from patients with various pathological conditions and the HCs, and cytokines (interleukin-2, interleukin-4, interleukin-5, interleukin-13, interleukin-17A, interleukin-17F, interleukin-22, interferon-γ, and tumor necrosis factor-α) were quantified. We also analyzed the published single-cell RNA sequence data derived from tissue samples from different stages of colorectal carcinogenesis.ResultsThe cytokine response in peripheral CD4+ T cells was upregulated during the carcinoma process. The frequency of peripheral regulatory T cells (Tregs) increased in the adenoma and carcinoma stages. While the T follicular helper (Tfh) cell proportion was downregulated in the adenoma and carcinoma processes. Thus, Th cell subsets, especially Tregs and Tfh cells, were involved in colonic diseases. Moreover, the immunological profile characteristics in the HPs were clarified.ConclusionWe comprehensively analyzed circulating ILCs and adaptive T-cell lymphocyte subtypes in colorectal carcinoma progression. Our results show the immunological profile characteristics and support the involvement of Th subsets, especially Treg and Tfh cell populations, in colonic diseases. These findings significantly enhance our understanding of the immune mechanisms underlying CRC and its precancerous lesions. Further investigation of the Treg and Tfh cells’ function in colorectal disease development will provide potential therapeutic targets for monitoring and preventing CRC development.
Transcriptomic profiling of immune cells in murine polymicrobial sepsis
Authors: Murao Atsushi , Jha Alok , Aziz Monowar , Wang Ping 
Published: January 2024

IntroductionVarious immune cell types play critical roles in sepsis with numerous distinct subsets exhibiting unique phenotypes even within the same cell population. Single-cell RNA sequencing (scRNA-seq) enables comprehensive transcriptome profiling and unbiased cell classification. In this study, we have unveiled the transcriptomic landscape of immune cells in sepsis through scRNA-seq analysis.MethodsWe induced sepsis in mice by cecal ligation and puncture. 20 h after the surgery, the spleen and peritoneal lavage were collected. Single-cell suspensions were processed using a 10× Genomics pipeline and sequenced on an Illumina platform. Count matrices were generated using the Cell Ranger pipeline, which maps reads to the mouse reference transcriptome, GRCm38/mm10. Subsequent scRNA-seq analysis was performed using the R package Seurat.ResultsAfter quality control, we subjected the entire data set to unsupervised classification. Four major clusters were identified as neutrophils, macrophages, B cells, and T cells according to their putative markers. Based on the differentially expressed genes, we identified activated pathways in sepsis for each cell type. In neutrophils, pathways related to inflammatory signaling, such as NF-κB and responses to pathogen-associated molecular patterns (PAMPs), cytokines, and hypoxia were activated. In macrophages, activated pathways were the ones related to cell aging, inflammatory signaling, and responses to PAMPs. In B cells, pathways related to endoplasmic reticulum stress were activated. In T cells, activated pathways were the ones related to inflammatory signaling, responses to PAMPs, and acute lung injury. Next, we further classified each cell type into subsets. Neutrophils consisted of four clusters. Some subsets were activated in inflammatory signaling or cell metabolism, whereas others possessed immunoregulatory or aging properties. Macrophages consisted of four clusters, namely, the ones with enhanced aging, lymphocyte activation, extracellular matrix organization, or cytokine activity. B cells consisted of four clusters, including the ones possessing the phenotype of cell maturation or aging. T cells consisted of six clusters, whose phenotypes include molecular translocation or cell activation.ConclusionsTranscriptomic analysis by scRNA-seq has unveiled a comprehensive spectrum of immune cell responses and distinct subsets in the context of sepsis. These findings are poised to enhance our understanding of sepsis pathophysiology, offering avenues for targeting novel molecules, cells, and pathways to combat infectious diseases.
Global burden of stroke attributable to secondhand smoke in 204 countries and territories from 1990 to 2019: analysis of the global burden of disease study
Authors: Yang Xinyue , Sun Jiayi , Zhang Wenjuan 
Published: January 2024

BackgroundSecondhand smoke (SHS) continues a significant public health concern globally. This study aimed to assess the global burden of stroke attributable to SHS exposure during 1990–2019.MethodsThis analysis utilized data on stroke morbidity and mortality from the Global Burden of Disease (GBD) 2019 study covering 204 countries and territories. We estimated stroke burden indicators attributable to SHS exposure, including age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life-year rate (ASDR), stratified by age, sex, region, and stroke subtype.ResultsIn 2019, global SHS exposure accounted for 2.01 [95% uncertainty interval (UI): 1.49–2.58] million stroke mortality. The ASMR and ASDR were 2.5 (95% UI: 1.9–3.2) and 61.5 (95% UI: 46–78.8) per 100,000 population, respectively. The disease burden was higher among women than men and higher among the elderly than younger populations. Intracerebral hemorrhage and ischemic stroke had a more significant burden than subarachnoid hemorrhage. From 1990 to 2019, the ASMR and ASDR declined [estimated annual percentage change: −2.08 (95% CI: −2.21% to −1.95%) and −2.08% (95% CI: −2.19% to −1.97%) for each], but the absolute number of mortalities increased along with population growth. Substantial disparities existed across regions and sociodemographic groups.ConclusionDespite declining ASMR and ASDR over time, the absolute number of stroke deaths attributable to SHS continued to rise globally, imposing a considerable stroke burden worldwide. These findings can inform targeted interventions and policies aimed at SHS control.
Early and late basilar artery thrombectomy time window outcomes
Authors: Mierzwa Adam T. , Rao Rahul , Al Kasab Sami , Nelson Ashley , Ortega-Gutierrez Santiago , Vivanco-Suarez Juan , Farooqui Mudassir , Jadhav Ashutosh P. , Desai Shashvat , Toth Gabor , Alrohimi Anas , Nguyen Thanh N. , Klein Piers , Abdalkader Mohamad , Salahuddin Hisham , Pandey Aditya , Wilseck Zachary , Koduri Sravanthi , Vora Nirav , Aladamat Nameer , Gharaibeh Khaled , Afreen Ehad , Zaidi Syed , Jumaa Mouhammad 
Published: January 2024

ImportanceStroke-to-recanalization time is a strong predictor of outcomes in anterior circulation large-vessel occlusion (LVO). The authors aimed to evaluate functional outcomes in early (&lt;6 h) vs. late (6–24 h) time windows for thrombectomy-treated basilar artery occlusions.MethodsPatients were derived from the Posterior Circulation Ischemic Stroke Evaluation: Analyzing Radiographic and Intra-procedural Predictors of Mechanical Thrombectomy (PC-SEARCH) Registry and retrospectively analyzed early and late basilar artery thrombectomy time windows cohorts. Patients were dichotomized based on the last known well and correlated to 90-day functional outcomes (mRS 0–3). A multiple logistic regression analysis was performed.ResultsA total of 405 patients were included in this study: 216 and 189 patients in the early and late time windows, respectively. Baseline demographic, stroke, radiographic, and intraprocedural characteristics were similar between the groups. A total of 99 (46%) and 79 (42%) patients in the early and late time windows, respectively, achieved favorable functional outcomes at 90 days (p = 0.41), and multiple logistic regression analysis did not reveal differences between cohorts (OR: 0.74; 95% CI: 0.46–1.19; p = 0.22). Symptomatic hemorrhage (7% vs. 5%; p = 0.69) and neurological complications (8% vs. 9%; p = 0.83) were similar between the groups; however, hospital complications were more common in the early time window cohort (22% vs. 13%; p = 0.01).ConclusionThe early and late thrombectomy time windows can achieve similar rates of 90-day favorable functional outcomes. However, timely thrombectomy influences the likelihood of achieving excellent functional outcomes (mRS ≤ 2) within the early time window.
Sodium intake and the risk of heart failure and hypertension: epidemiological and Mendelian randomization analysis
Authors: Yuan Miao , Yan Dingyi , Wang Yu , Qi Mengyao , Li Kexin , Lv Zhi , Gao Dengfeng , Ning Ning 
Published: January 2024

BackgroundThis study aimed to analysis the relationship between sodium intake and the risk of heart failure and hypertension through epidemiological studies and Mendelian randomization analysis.Methods and resultWe initially conducted an analysis using data from the National Health and Nutrition Examination Survey (NHANES) database to examine the relationship between sodium intake and heart failure, hypertension, systolic blood pressure, and diastolic blood pressure. After adjusting for confounding factors, we found a non-linear association between sodium intake and heart failure (p nonlinear = 0.0448). Subsequently, we utilized Mendelian randomization (MR) analysis by utilizing urinary sodium as a proxy for sodium intake to investigate the relationships between sodium and heart failure, hypertension, systolic blood pressure, and diastolic blood pressure. The results indicated that with increasing urinary sodium, there is an increase in systolic and diastolic blood pressure, as well as an elevated risk of heart failure and hypertension.ConclusionThe evidence provided by this study suggests that higher sodium intake is associated with an increased risk of heart failure and hypertension. However, excessively low sodium intake may not necessarily be beneficial, as there may be maximum benefits at a sodium intake level of around 3,000 mg/d.
Efficacy and safety of intercostal nerve anastomosis in immediate subpectoral prosthetic breast reconstruction after nipple–areola-sparing mastectomy: a randomized, controlled, open-label clinical study
Authors: Juan Zhang , Liang Yong-Ping , Shen Jiang-Lun , Dai Hao , Zhang Yang , Yao De-Shun , Jiang Run-Xue , Cai Hai-Feng 
Published: January 2024

PurposeThis aims to investigate the efficacy and safety of intercostal nerve anastomosis among breast cancer patients who undergo immediate subpectoral prosthetic breast reconstruction after nipple–areola-sparing mastectomy.MethodsFrom 2022 to 2023, female patients between the ages of 20 and 60 diagnosed with stage I–IIIA breast cancer, who required and were willing to undergo immediate subpectoral prosthetic breast reconstruction after nipple–areola-sparing mastectomy, were screened and assigned to take the operation with (treatment group) or without (control group) intercostal nerve anastomosis (the nerves with appropriate length and thickness were selected from the 2nd-4th intercostal nerves, which were then dissociated and anastomosed to the posterior areola tissue). A radial incision at the surface projection of the tumor location was used. The patients’ breast local sensation was assessed using Semmes–Weinstein monofilaments before the operation as well as at 10 days, 3 months, and 6 months postoperatively. Furthermore, the patients’ quality of life was evaluated 6 months postoperatively using the EORTC QLQ-C30 questionnaire. Adverse events, operation duration, drainage volume, and the duration of drainage tube carrying time were also monitored and recorded.ResultsCompared to the pre-operative period, a significant decrease in local sensation was observed 10 days after surgery in both groups. However, the control group showed a significant reduction in sensation at 3 and 6 months postoperatively, while the treatment group showed noticeable recovery. A statistically significant difference (P &lt; 0.001) in local sensation between the pre-operative and post-operative periods was observed at the final follow-up in the two groups. By the time of 3 and 6 months postoperatively, a significant difference was seen in the local sensation between the two groups. Intercostal nerve anastomosis was found to significantly improve the patients’ quality of life, including emotional (P = 0.01), physical (P = 0.04), and social functioning (P = 0.02) and pain (P = 0.04). There were no significant differences in general characteristics (such as age, BMI, and subtypes). Although intercostal nerve anastomosis increased the duration of operation by around 20 min (P &lt; 0.001), it did not affect the volume or duration of postoperative drainage tube usage between the two groups.ConclusionThis study indicated that intercostal nerve anastomosis improved the local sensation and quality of life of patients who underwent immediate subpectoral prosthetic breast reconstruction after nipple–areola-sparing mastectomy.Clinical Trial Registrationhttps://www.chictr.org.cn/showproj.html?proj=42487, identifier ChiCTR1900026340.
Ayurvedic protocols of chronic pain management: spatiotemporality as present moment awareness and embodied time
Authors: Agarwal Vinita 
Published: January 2024

BackgroundTemporality is understood as the subjective perception of the flow of chronological time and is a central component of contemporary and integrative medicine approaches. Although temporal dynamics are recognized as central to the processes associated with chronic pain (CP), the temporal management of CP is inadequately understood in pain research.Research questionHow is temporality conceptualized in Ayurvedic protocols of CP management?.MethodAyurvedic physicians (N = 10) from India were recruited through purposive and snowball sampling. A semi-structured interview protocol was employed to gather qualitative data focusing on the Ayurvedic protocol employed to treat CP patients. The interviews were audio-recorded, professionally transcribed, and thematically analyzed. Member validation, participant voice, and researcher self-awareness were employed to strengthen reliability and validity.FindingsAn ontologically grounded thematic exploration of Ayurvedic protocols illustrates that temporality is conceptualized in CP as spatiotemporal present moment awareness (PMA) and embodied time (ET). Spatiotemporality as PMA references an awareness of the relationality of cognitive temporal movement, dosha operations, and their pathophysiological expression in the body. Spatiotemporality as ET is conceptualized as awareness of the expression of time in embodied emotional and psychosocial processes as in the movement of the breath through the body, the movement of body sensations over time, and in their intersection with consciousness.DiscussionThe study findings present an experiential and relational framework situating spatiotemporality ontologically as an organizing principle in CP management. While temporality focuses on the representation of experiences and relations over time, spatiotemporality foregrounds a constructionist approach by centering the embodied spatial cognitive expression of time, consciousness, and subjective experience.
Validation of PleaseApp: a digital tool for the assessment of receptive pragmatic abilities in children with neurodevelopmental disorders
Authors: Andrés-Roqueta Clara , Flores-Buils Raquel , Igualada Alfonso 
Published: January 2024

BackgroundPragmatic skills allow children to use language for social purposes, that is, to communicate and interact with people. Most children with neurodevelopmental disorders (NDDs) face pragmatic difficulties during development. Nevertheless, pragmatic skills are often only partially assessed because the existing instruments usually focus on specific aspects of pragmatics and are not always adapted to children with communication difficulties. In this sense, digital tools (e.g., apps) are an optimal method to compensate for some difficulties. Moreover, there is a lack of pragmatic tools measuring the receptive domain. Therefore, the present study aims to validate PleaseApp as a digital instrument that measures eight pragmatic skills by presenting the design of the assessment tool and its psychometric properties.MethodsPleaseApp was designed based on previous empirical studies of developmental pragmatics in children with and without NDD. PleaseApp assesses eight receptive pragmatic skills: figurative language, narrative, reference, indirect speech acts, visual and verbal humor, gesture-speech integration, politeness, and complex intentionality. The study involved 150 typically developing children between 5 and 12 years of age.ResultsA confirmatory factor analysis proposes an eight-factor model with no underlying factor structure. The eight tests that compose PleaseApp have obtained a model with a good fit and with adequate reliability and validity indices.DiscussionPleaseApp is an objective, valid, and reliable tool for assessing pragmatic skills in children with NDD. In this sense, it helps to assess whether a child has acquired pragmatic skills correctly according to his/her age and clarify the specific problems a child has in eight different components to plan personal and personalized interventions.
The effect of urban–rural resident basic medical insurance on physical health of the rural older adult in China
Authors: Pu Xiaohong , He Sichang , Lin Xi 
Published: January 2024

IntroductionUrban–Rural Resident Basic Medical Insurance (URRBMI) is an important system for effectively transferring disease risks to the rural older adult. As China experiences rapid aging, maintaining the physical health of the rural older adult is key to achieving the goal of healthy aging.MethodsThe study explores the impact of URRBMI on physical health of the rural older adult in China using the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2018. Ordinary least square models were used to analyze the relationship between URRBMI and physical health of the rural older adult, and we used instrumental variable method to address the potential endogenous problem.ResultsWe find that URRBMI greatly improves physical health of the rural older adult. The heterogeneity analysis indicates that URRBMI contributes more significantly to the rural older adult in eastern areas and the advanced rural older adult. The results also suggested that URRBMI improves physical health of the rural older adult through increasing life satisfaction and enhancing the timeliness of medical services.RecommendationsThis study implies that we need to further improve the participation rate, increase the actual reimbursement ratio and increase financial subsidies for URRBMI in central and western areas, and further integrate the distribution of medical resources to promote physical health of the rural older adult.
Examining the moderating effect of perceived risk from particulate matter on outdoor sports participants: a theory of planned behavior perspective
Authors: Kim Do Hun , Jeong Yunduk 
Published: January 2024

PurposeThis study, drawing from the theoretical framework of the Theory of Planned Behavior (TPB), examines the structural relationship among attitudes, subjective norms, perceived behavioral control (PBC), and behavioral intention. The study focuses on investigating how the perceived risk associated with particulate matter moderates the relationships between “attitudes and behavioral intention,” “subjective norms and behavioral intention,” and “PBC and behavioral intention” within the context of individuals engaged in outdoor sports.Design/methodology/approachThe data were collected from outdoor sports gatherings facilitated through a popular South Korean sports meetup application. Confirmatory factor analysis was employed to establish the construct validity of the measurement scale, assess factor loadings, averaged variance extracted (AVE), and construct reliability (CR). We also ensured the reliability of the measurement scale through Cronbach’s α analysis. To achieve our research objectives, we utilized structural equation modeling with maximum likelihood estimation to examine the positive relationships under investigation. Additionally, we performed moderation analysis using the statistical software Jamovi.FindingsThe findings demonstrate the significant impacts of attitudes, subjective norms, and PBC on behavioral intention and reveal that perceived risk acts as a moderator, influencing the relationship between PBC and behavioral intention.