bluuebunny/crossref_metadata_2025_split huggingface dataset:
iCPET Calculator: A Web‐Based Application to Standardize the Calculation of Alpha Distensibility in Patients With Pulmonary Arterial Hypertension
Authors: Elliott Jordan , Menakuru Nainika , Martin Kellan Juliet , Rahaghi Farbod Nicholas , Rischard Franz P. , Vanderpool Rebecca R. 
Published: October 2023

Background
Pulmonary vascular distensibility associates with right ventricular function and clinical outcomes in patients with unexplained dyspnea and pulmonary hypertension. Alpha distensibility coefficient is determined from a nonlinear fit to multipoint pressure‐flow plots. Study aims were to (1) create and test a user‐friendly tool to standardize analysis of exercise hemodynamics including distensibility, and (2) investigate changes in distensibility following treatment in patients with pulmonary arterial hypertension.

Methods and Results

Participants with an exercise right heart catherization were retrospectively identified from the University of Arizona Pulmonary Hypertension (UA PH) registry and split into a pulmonary arterial hypertension group, a comparator group, and a control group. Right ventricular function was quantified using the coupling ratio and diastolic stiffness. Prototypes of the invasive cardiopulmonary exercise testing (iCPET) calculator were developed using Matlab, Python, and RShiny to analyze exercise hemodynamics and alpha distensibility coefficient, α (%/mm Hg) from multipoint pressure flow plots. Interclass correlation coefficients were calculated for interplatform and interobserver variability in alpha. No significant bias in the intraplatform (Matlab versus RShiny; intraclass correlation coefficient: 0.996) or interobserver (intraclass correlation coefficient: 0.982) comparison of alpha values. Afterload significantly decreased (
P
<0.05) with no change in alpha distensibility in the pulmonary arterial hypertension group at follow‐up. The comparator group had no change in pressure, resistance or alpha distensibility. There were no significant changes in RV diastolic stiffness at follow‐up.

Conclusions
The interactive user interface in the iCPET calculator allows exploration of alpha distensibility using standardized methods. No significant change in alpha distensibility at follow‐up suggests that alpha may be less modifiable in patients with long‐standing pulmonary arterial hypertension.
Paradoxical Effects of Prolonged Insufficient Sleep on Lipid Profile: A Pooled Analysis of 2 Randomized Trials
Authors: Barragán Rocío , Zuraikat Faris M. , Cheng Bin , Scaccia Samantha E. , Cochran Justin , Aggarwal Brooke , Jelic Sanja , St‐Onge Marie‐Pierre 
Published: October 2023

Background
Insufficient sleep is associated with increased cardiovascular disease risk, but causality is unclear. We investigated the impact of prolonged mild sleep restriction (SR) on lipid and inflammatory profiles.

Methods and Results

Seventy‐eight participants (56 women [12 postmenopausal]; age, 34.3±12.5 years; body mass index, 25.8±3.5 kg/m
2
) with habitual sleep duration 7 to 9 h/night (adequate sleep [AS]) underwent two 6‐week conditions in a randomized crossover design: AS versus SR (AS–1.5 h/night). Total cholesterol, low‐density lipoprotein cholesterol (LDL‐C), high‐density lipoprotein cholesterol, triglycerides, and inflammatory markers (CRP [C‐reactive protein], interleukin 6, and tumor necrosis factor‐α) were assessed. Linear models tested effects of SR on outcomes in the full sample and by sex+menopausal status (premenopausal versus postmenopausal women+men). In the full sample, SR increased high‐density lipoprotein cholesterol compared with AS (β=1.2±0.5 mg/dL;
P
=0.03). Sex+menopausal status influenced the effects of SR on change in total cholesterol (
P
‐interaction=0.04), LDL‐C (
P
‐interaction=0.03), and interleukin 6 (
P
‐interaction=0.07). Total cholesterol and LDL‐C decreased in SR versus AS in premenopausal women (total cholesterol: β=−4.2±1.9 mg/dL;
P
=0.03; LDL‐C: β=−6.3±2.0 mg/dL;
P
=0.002). Given paradoxical effects of SR on cholesterol concentrations, we explored associations between changes in inflammation and end point lipids under each condition. Increases in interleukin 6 and tumor necrosis factor‐α during SR tended to relate to lower LDL‐C in premenopausal women (interleukin 6: β=−5.3±2.6 mg/dL;
P
=0.051; tumor necrosis factor‐α: β=−32.8±14.2 mg/dL;
P
=0.027).

Conclusions
Among healthy adults, prolonged insufficient sleep does not increase atherogenic lipids. However, increased inflammation in SR tends to predict lower LDL‐C in premenopausal women, resembling the “lipid paradox” in which low cholesterol associates with increased cardiovascular disease risk in proinflammatory conditions.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT02835261, NCT02960776.
Haloed Hallucinations
Authors: Eklund Erik 
Published: October 2023

Abstract
Among the most popular hagiographies throughout Eastern and Coptic Christianity, Athanasius’ Life of Antony has exercised profound influence upon Western visual and literary art, not least Vladimir Nabokov’s Bend Sinister. Querying the alleged originality of Nabokov’s “symbol of the Divine power,” this article examines Nabokov’s engagement with the Antonian hagiographic tradition—represented by Athanasius’ Life, Hieronymus Bosch’s Triptych of the Temptation of St. Anthony, and Gustave Flaubert’s Le Tentation de saint Antoine—to reveal the religious ground of protagonist Adam Krug’s saint-like identity and the novel’s metaliterary mysticism in the Lord’s figural descent upon an inclined beam of light at the end of Antony’s temptations. Providing a transgressive theological terroir for Nabokov to probe the porous varieties of the real, the Antonian sources of Krug’s “haloed hallucination” invite further reconsideration of Nabokov’s self-styled “indifference” to the Christian imaginary.
History, the Mother of Truth
Authors: Plot Martín 
Published: October 2023

Abstract
In this paper I offer a new reading of some of the philosophical and political implications of Argentine writer Jorge Luis Borges’ work. The aim of this new reading is to show that Borges exhibited broad ethical sympathies for the pragmatist imagination. The first section offers a genealogy of Borges’ unusual and original first fictional pieces and a reading of “Pierre Menard, Author of the Quixote.” It is in this text that Borges first engaged William James. In the second section, the text presents a broad picture of pragmatism, from its origins in the work of Peirce to its recent revival in Rorty’s tour de force. In the final section I analyze Borges’ essays on James and suggest they are evidence that the former’s interest in James was related to something much more ethical and political than a mere attraction for the latter’s prose or his work’s overall aesthetic value.
Safety and efficacy of prostatic artery embolization in patients with hematuria due to benign prostate hyperplasia
Authors: Hijazi Bilal Ahmad , Shi Hai-Bin , Liu Sheng , Wei Tian , Alqurashi Turki Atia , Sabri Zakir Jamal , Singh Vinay , Hamdy Hayam 
Published: October 2023

Abstract
Background
Benign prostate hyperplasia (BPH) commonly affects aging men that can result in hematuria. For patients who are not suitable candidates for surgery, prostatic artery embolization (PAE) has emerged as a minimally invasive alternative. This study aimed to assess the safety and efficacy of PAE specifically for treating hematuria in BPH patients who cannot undergo surgery.

Methods
The study included n = 110 participants. PAE was performed, and outcomes of interest, including resolution of hematuria, improvement in lower urinary tract symptoms (LUTS), prostate volume (PV), and quality of life (QoL), were assessed. Adverse events were also analyzed.

Results
The study demonstrated a 100% clinical success rate in resolving hematuria at 3 months, with no recurrence observed during the 6-month follow-up. Mean hemoglobin levels increased, indicating successful resolution of bleeding. PAE also led to a significant reduction in LUTS severity, as measured by the International Prostate Symptom Score (IPSS). Improvement in the mean maximum urinary flow rate (Qmax) indicated enhanced urinary flow. Additionally, MRI measurements showed a reduction in prostate volume following PAE. These improvements contributed to enhanced QoL for the patients.

Conclusions
Prostatic artery embolization (PAE) was found to be a safe and effective treatment option for hematuria in BPH patients not suitable for surgery. PAE demonstrated a high success rate in resolving hematuria and resulted in significant improvements in LUTS, prostate volume, and QoL outcomes. These findings have important implications for clinical decision-making and improving patient care for BPH patients with hematuria. Further research and long-term follow-up studies are necessary to validate these findings and assess the durability of PAE outcomes in this patient population.
Methodology for the adolopment of recommendations for the treatment of rheumatoid arthritis in the Kingdom of Saudi Arabia
Authors: Khabsa Joanne , Yaacoub Sally , Omair Mohammed A. , Al Rayes Hanan , Akl Elie A. ,   the KSA 2021 ACR RA adolopment working group, Abdulaziz Sultana , Al Janobi Ghada A. , Al Khalaf Abdulaziz , Al Mehmadi Bader , Al Nassar Mahasin , AlBalawi Faisal , AlFurayj Abdullah S. , Al-Jedai Ahmed Hamdan , Almalag Haya Mohammed , Almudaiheem Hajer Yousef , AlRehaily Ali , Attar Mohammed A. , Kibbi Lina El , Fraenkel Liana , Halabi Hussein , Hasan Manal , Singh Jasvinder A. 
Published: October 2023

Abstract
Background
Currently, there are no guidelines for the treatment of rheumatoid arthritis (RA) tailored to the context of the Kingdom of Saudi Arabia (KSA). Adaptation of guidelines accounts for contextual factors and becomes more efficient than de novo guideline development when relevant, good quality, and up-to-date guidelines are available. The objective of this study is to describe the methodology used for the adolopment of the 2021 American College of Rheumatology (ACR) guidelines for the treatment of RA in the KSA.

Methods
We followed the ‘Grading of Recommendations Assessment, Development and Evaluation’ (GRADE)-ADOLOPMENT methodology. The adolopment KSA panel included relevant stakeholders and leading contributors to the original guidelines. We developed a list of five adaptation-relevant prioritization criteria that the panelists applied to the original recommendations. We updated the original evidence profiles with newly published studies identified by the panelists. We constructed Evidence to Decision (EtD) tables including contextual information from the KSA setting. We used the PanelVoice function of GRADEPro Guideline Development Tool (GDT) to obtain the panel’s judgments on the EtD criteria ahead of the panel meeting. Following the meeting, we used the PANELVIEW instrument to obtain the panel’s evaluation of the process.

Results
The KSA panel prioritized five recommendations, for which one evidence profile required updating. Out of five adoloped recommendations, two were modified in terms of direction, and one was modified in terms of certainty of the evidence. Criteria driving the modifications in direction were valuation of outcomes, balance of effects, cost, and acceptability. The mean score on the 7-point scale items of the PANELVIEW instrument had an average of 6.47 (SD = 0.18) across all items.

Conclusion
The GRADE-ADOLOPMENT methodology proved to be efficient. The panel assessed the process and outcome positively. Engagement of stakeholders proved to be important for the success of this project.
Female sex and overweight are associated with a lower quality of life in patients with myasthenia gravis: a single center cohort study
Authors: Wilcke Hannah , Glaubitz Stefanie , Kück Fabian , Anten Christoph , Liebetanz David , Schmidt Jens , Zschüntzsch Jana 
Published: October 2023

AbstractBackgroundMyasthenia gravis (MG) affects individuals as a chronic autoimmune disease for many years. Commonly, chronic diseases significantly reduce the patients’ quality of life. Aiming to improve the future quality of life in MG, this study assessed the factors impacting quality of life. As gender-specific medicine is becoming increasingly important, this study also focused on understanding gender differences in the outcome of MG.MethodsThe study is a combined monocentric, retrospective and prospective database analysis of patient records based on 2,370 presentations of 165 patients with clinically, serologically and/or electrophysiologically confirmed MG over an observation period of up to 47 years. The data collection included the following parameters: antibody status, disease severity, age, medication use, gender, and disease duration. In addition, a prospective survey was conducted on the quality of life using the Myasthenia gravis-specific 15-item Quality of Life scale (MG-QoL15) and on the activities of daily living using the MG-specific Activities of Daily Living scale (MG-ADL).ResultsOf the 165 patients, 85 were male (51.5%) and 80 were female (48.5%). The remaining baseline characteristics (e.g. age and antibody status) were consistent with other myasthenia gravis cohorts. A high body mass index (BMI) (p = 0.005) and a high disease severity (p < 0.001) were significantly associated with lower disease-specific quality of life. Additionally, the quality of life in women with MG was significantly reduced compared to male patients (19.7 vs. 13.0 points in the MG-QoL15, p = 0.024). Gender differences were also observable in terms of the period between initial manifestation and initial diagnosis and women were significantly more impaired in their activities of daily living (MG-ADL) than men (4.8 vs. 3.0 points, p = 0.032).ConclusionWomen with MG had significantly poorer disease specific quality of life compared to men as well as patients with a higher BMI. In order to improve the quality of life, gender-specific medicine and further investigation regarding a modification of the quality of life by lowering the BMI are essential and necessary.Trial registrationStudy approval by the Ethics Committee of the University Medical Center Göttingen was granted (number 6/5/18).
Comparison between continued inpatient treatment versus day patient treatment after short inpatient care in early onset anorexia nervosa (COTIDEA trial): a study protocol for a non-inferiority randomised controlled trial
Authors: Ayrolles A. , Bargiacchi A. , Clarke J. , Michel M. , Baillin F. , Trebossen V. , Kalifa H. Poncet , Guilmin-Crépon S. , Delorme R. , Godart N. , Stordeur C. 
Published: October 2023

Abstract
Background
In children with early-onset anorexia nervosa (first symptoms before 13 years old, EO-AN), experts recommend initial outpatient treatment but in-patient treatment (IP) is frequently indicated due to acute medical instability or for those who have not improved with outpatient treatment. This IP can target either a partial weight restauration or a total weight normalization (return to the previous BMI growth trajectory). There are no evidence in the literature on which is the better therapeutic option in EOAN. But as long length of stay induce social isolation, with elevated costs, we wonder if a stepped-care model of daypatient treatment (DP) after short IP stabilisation may be a treatment option as effective as full-time IP to target weight normalization. We designed a two-arm randomised controlled trial testing the non-inferiority of a stepped-care model of DP after short IP stabilisation versus full-time IP.

Methods
Eighty-eight children aged 8 to 13 years suffering from EOAN with initial severe undernutrition will be randomly allocated to either IP treatment as usual or a stepped care DP model both targeting weight normalization. Assessments will be conducted at inclusion, somatic stabilization, weight normalization, 6 months and 12 months post randomisation. The primary outcome will be BMI at 12 months post-randomisation. Secondaries outcomes will included clinical (tanner stage), biological (prealbumin, leptin, total ghrelin and IGF1) and radiological (bone mineralization and maturation) outcomes, eating symptomatology and psychiatric assessments, motivation to change, treatment acceptability and quality of life assessments, cost-utility and cost-effectiveness analyses.

Discussion
COTIDEA will provide rigorous evaluation of treatment alternative to full-time inpatient treatment to allow a reduction of social iatrogenic link to hospital length of stay and associated costs.

Trial registration
Trial is registered on ClinicalTrials.gov (NCT04479683).
Sex-based influential factors for dental caries in patients with schizophrenia
Authors: Yang Mi , Xu Jingjing , Chen Xiaoqin , Liu Liju , Kong Di , Yang Yan , Chen Wei , Li Zezhi , Zhang Xiangyang 
Published: October 2023

Abstract
Background
Schizophrenia is a common mental disorder that seriously affects patients’ daily lives and brings heavy psychological and economic burdens to their families and society. The oral problems of patients with schizophrenia are gradually gaining attention, among which dental caries are among the most common oral diseases. Sex differences may be related not only to the various clinical symptoms of schizophrenia but also to different oral hygiene statuses; therefore, the main purpose of this paper is to investigate sex differences related to influencing factors for dental caries in patients with schizophrenia.

Method
Inpatients with schizophrenia over 18 years old were included in this study, and multidimensional indicators such as demographics, symptom and cognitive impairment assessments, medications, and the caries index of decayed, missing, and filled teeth (DMFT) were collected. An analysis of sex-based influential factors for dental caries in schizophrenia patients was performed.

Results
Four-hundred and ninety-six patients with schizophrenia were included, with a mean age of 46.73 ± 12.23 years, of which 142 were females and 354 were males. The mean DMFT was significantly higher in males (8.81 ± 8.50) than in females (5.63 ± 6.61, p < 0.001), and the odd ratio of caries in males to females was significantly higher as well (OR = 2.305, p < 0.001). The influential factors of caries in male patients were independently associated with age and smoking status, in which current smokers were at the highest risk for developing caries, and different smoking statuses had various influencing factors for caries. The influencing factors for caries in female patients were independently associated with age, antipsychotic dose, PANSS-positive symptoms, and MMSE levels.

Conclusion
Our findings suggest sex differences exist among influential factors for caries in patients with schizophrenia. These risk factors may even be associated with and affect the treatment and prognosis of psychiatric symptoms in patients. Therefore, oral hygiene management of patients with schizophrenia should be enhanced. These differential factors provide new visions and ideas for formulating individual interventions, treatments, and care priorities.
Evaluating the effect of an adapted mental health literacy intervention on mental health related stigma among secondary students in Germany: results of a pre-post evaluation study
Authors: Kirchhoff Sandra , Fretian Alexandra M. , Okan Orkan , Bauer Ullrich 
Published: October 2023

Abstract
Background
Most mental health problems develop during youth, with about three quarter emerging before age 25. In adolescence, stigmatizing attitudes related to mental illness become more nuanced and consolidate into one’s belief system. As the stigma of mental illness is still one of the leading barriers to help-seeking, intervention measures should explicitly address it before it becomes entrenched over time. Preventive measures, for example, based on promoting mental health literacy (MHL), can be used to address and tackle stigmatizing attitudes. The Canadian MHL-based intervention “the Guide” was translated and adapted for the use in German schools. The present study evaluates the effect of the German version of the Guide on attitudes towards mental illness among students in Germany.

Methods
The first-time application of the Guide (German version) was evaluated with a pre-post-evaluation study with an intervention and a control group. The evaluation data of 188 students (intervention group n = 106, control group n = 82) were statistically analyzed focusing on the outcomes social stigma, social distance, and self-stigma.

Results
The analysis showed that participants do not tend to hold stigmatizing attitudes even before the intervention. Nevertheless, the intervention was effective in reducing social stigma, but not in reducing social distance and self-stigma. Neither gender, pre-existing experience with mental illness, nor the delivery modality of the contact element within the intervention (speaker vs. video) seemed to influence the outcomes.

Conclusions
The German version of the MHL-based intervention, the Guide, seems to be a suitable intervention to improve attitudes towards mental illness among students in Germany. More extensive research is necessary to confirm the findings and further explore factors that influence the program’s effects on attitudes short- and long-term.
Biomechanical improvement of anterior talofibular ligament by augmentation repair of ligament advance reinforcement system: a cadaver study
Authors: Xiang Dulei , Jin Wenming , Li Han , Zhao Gen , Li Bao , Du Shuyuan , Liu Xinwei 
Published: October 2023

Abstract
Background
Ankle sprain are one of the most frequent sports injuries. Some individuals will develop chronic lateral ankle instability (CLAI) after ankle sprain and suffer from recurrent ankle sprain. Current surgical treatment of CAI with anterior talofibular ligament (ATFL) rupture fails to restore the stability of the native ATFL. Ligament Advance Reinforcement System (LARS) augmentation repair of ATFL was developed to improve its primary stability after repaired.

Methods
This study was performed to evaluate whether LARS augmentation repair of ATFL had similar stability as the modified Broström repair and the intact ATFL to maintain ankle construct stability. Standardized surgical techniques were performed on eighteen fresh frozen cadaver ankle specimens. The intact ATFL group has just undergone an ATFL exploratory surgery. The modified Broström procedure is based on anatomical repair of the ATFL with a 2.9 mm suture anchor, and the LARS procedure is an augmentation procedure of the ATFL using LARS ligaments based on the modified Broström procedure. A dynamic tensile test machine was used to assess load-to-failure testing in the three groups. The ultimate failure load and stiffness were calculated and reported from the load-displacement curve. A one-way analysis of variance was used to detect significant differences (p < 0.05) between the LARS augmentation repair, the modified Broström repair and the intact ATFL, followed by least significant difference (LSD) post-hoc tests.

Results
The LARS augmentation repair group showed an increased in ultimate failure to load and stiffness compared to the other two groups. There were no significant differences in ultimate failure to load and stiffness between the modified Broström and the intact ATFL, the LARS ligament for ATFL augmentation allows for improved primary stability after repair and reduced stress on the repaired ATFL, which facilitates healing of the remnant ligament.

Conclusions
The LARS augmentation repair of ATFL represents a stable technique that may allow for the ankle stability to be restored in patients with CAI after surgery.