bluuebunny/crossref_metadata_2025_split huggingface dataset:
Simultaneously improving fracture toughness and impact resistance of the rapid-curing CFRP via insert with MAM/EP resin film
Authors: Liu Yuhang , Min Wei , Qi Liangliang , Muhuo Yu , Sun Zeyu 
Published: February 2023

In this research, a resin film of the MAM/EP blend curing system containing the triblock copolymer polymethyl methacrylate- b-poly-n-butyl acrylate- b-polymethyl methacrylate (MAM) was prepared. Such resin film was inserted into the interlaminar of rapid-curing composites to simultaneously improve both mode I, mode II fracture toughness and impact resistance. Both the Mode I and Mode II interlaminar fracture toughness of the composites were carefully investigated as a function of MAM content of the MAM/EP resin film (0, 20 and 40 phr@50 μm). A maximum improvement up to 109% and 70.2% on Mode I and Mode II fracture toughness, respectively was obtained with the introduction of the 40 phr@50 μm compared to the laminates with the introduction of the 0 phr@50 μm. Analysis of the fracture surfaces of the laminates elucidated that the distinctive improvement of the interlaminar fracture toughness could be attributed to the characteristic interlaminar structures of MAM in epoxy resin by self-assembly. The interleaved laminates also displayed an increase of 26.7% for the compression after impact (CAI) properties, and showed excellent impact resistance. The interlaminar shear strength (ILSS) of the composite was thereafter explored, which indicated slight enhancements to the strengths.
Co-Delivery of paclitaxel and doxorubicin in folate-Targeted pluronic/ploy (D,L-lactide-b-glycolide) polymersomes
Authors: Wu Tian Yi , Cao Wen Jie , Li Zi Ling , Gong Yan Chun , Xiong Xiang Yuan 
Published: February 2023

Drugs with different solubility can be selectively embedded into polymersomes with the hydrophilic core and hydrophobic bilayer. Novel folate-targeted Pluronic/poly (D,L-lactide- b-glycolide) polymersomes were constructed and used for the co-delivery of paclitaxel (PTX) and doxorubicin (DOX) to improve their inhibitory effect over cancer cells. The particle size of blank polymersomes was mainly distributed below 125 nm. The release of PTX and DOX from polymersomes showed an initial burst release followed by a sustained and slow release. The in vitro cytotoxicity data showed that the targeted co-loaded polymersomes (PTX&DOX FA-Ps) exhibited better inhibitory effect than single-loaded polymersomes and free drugs did. Furthermore, PTX&DOX FA-Ps showed the synergistic therapeutic effect over OVCAR-3 cancer cells. The cellular uptake results also showed that folate modified polymersomes had excellent targeting performance. Therefore, the folate-targeted Pluronic/poly (D,L-lactide- b-glycolide) polymersomes have potential application value as novel drug carriers to co-deliver PTX and DOX.
Dietary patterns and life-styles of patients with gastrointestinal involvement of systemic lupus erythematosus: Questionnaire survey from a tertiary center of China
Authors: Xu Haojie , Meng Xia , Wang Lu , Zhu Gaoqi , Fan Xiaoyun , Li Rongli , Fei Yunyun , Yang Huaxia , Zhao Lidan 
Published: February 2023

Objective To investigate the dietary patterns and lifestyles of patients with lupus gastrointestinal (GI) involvement and to reveal the possible role of organ-specific involvement of systemic lupus erythematosus (SLE) on daily diet. Methods Patients with SLE complicated with gastrointestinal involvement (SLE-GI) admitted to Peking Union Medical College Hospital (PUMCH) from January 2010 to September 2021 were enrolled. Age- and sex-matched SLE patients with lupus nephritis (SLE-LN) but free of other internal organs involvement who were admitted during the same period were enrolled as disease controls at the ratio of 1:1. In addition, a group of age- and sex-matched healthy people were also included as healthy controls (HCs). Questionnaires were distributed to these patients and HC to collect their dietary patterns and lifestyle information. Clinical features, dietary and lifestyle habits were compared between the two groups of patients and HC. Results The questionnaire survey showed that compared with HC, the SLE-GI group had higher proportions of vegetarians ( p = 0.014) and a lower proportion of omnivores ( p = 0.058). A higher percentage of SLE-GI patients reported a traditional Chinese medicine ( p = 0.018) taken history and surgical history ( p = 0.014). They also less likely to take fried/pickled food ( p = 0.042) and dietary supplements ( p = 0.024) than HC. Higher percentages of SLE-GI patients and SLE-LN patients preferred self-catering (87.5% and 94.3%) over take-out food than HC (70.8%) ( p = 0.127 and p = 0.016). No significant difference on drinking preference among the three groups, but it seemed more SLE-GI patients consumed yogurt than HC ( p = 0.097). The SLE-LN patients were also found to have lower frequencies of staying up late ( p = 0.005). The SLE-GI group also presented higher positivity rates for anti-SSA (69.6% vs . 45.7%, p = 0.020) and anti-SSB antibodies (32.6% vs . 10.9%, p = 0.011) but lower positivity rates for anti-dsDNA antibodies (30.4% vs . 82.6%, p < 0.001) compared with the SLE-LN group. Conclusion The dietary patterns, life-styles and autoantibody spectrum of SLE-GI patients differed greatly from those of SLE-LN patients and healthy people. These factors may reflect the influence of disease and organ involvement modes on patients’ daily life and may contribute partly to the systemic involvement in SLE.
Humoral COVID-19 vaccine response in patients with NMOSD/MOGAD during anti-IL-6 receptor therapy compared to other immunotherapies
Authors: Schwake Carolin , Pakeerathan Thivya , Kleiter Ingo , Ringelstein Marius , Aktas Orhan , Korporal-Kuhnke Mirjam , Wildemann Brigitte , Jarius Sven , Bayas Antonios , Pul Refik , Ceylan Ulas , Faissner Simon , Hellwig Kerstin , Ayroza Galvao Ribeiro Gomes Ana Beatriz , Lipps Patrick , Pröbstel Anne-Katrin , Kümpfel Tania , Oswald Eva , Then Bergh Florian , Gödel Clemens , Hümmert Martin W , Trebst Corinna , Gold Ralf , Ayzenberg Ilya 
Published: February 2023

Background: Data on the humoral vaccine response in patients on anti-interleukin-6 (IL-6) receptor therapy remain scarce. Objective: The main objective of our study was to investigate the humoral response after vaccination against SARS-CoV-2 in neuromyelitis optica spectrum disorder (NMOSD)/myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) patients treated with anti-IL-6 receptor therapy. Secondarily, we analyzed relapse activity timely associated with vaccination. Methods: In this retrospective cross-sectional multicenter study, we included 15 healthy controls and 48 adult NMOSD/MOGAD patients without previous COVID-19 infection. SARS-CoV-2 spike protein antibody titers during anti-IL-6 receptor therapy were compared to anti-CD20 antibody therapy, oral immunosuppressants, and to nonimmunosuppressed individuals. Results: We observed 100% seroconversion in the anti-IL-6 receptor treatment group. Titers of SARS-CoV-2 spike protein antibodies were lower compared to healthy controls (720 vs 2500 binding antibody units (BAU)/mL, p = 0.004), but higher than in the anti-CD20 (720 vs 0.4 BAU/mL, p < 0.001) and comparable to the oral immunosuppressant group (720 vs 795 BAU/mL, p = 1.0). We found no association between mRNA-based vaccines and relapse activity in patients with or without immunotherapy. Conclusions: Despite being lower than in healthy controls, the humoral vaccine response during anti-IL-6 receptor therapy was evident in all patients and substantially stronger compared to anti-CD20 treatment. No relevant disease activity occurred after mRNA vaccination against SARS-CoV-2.
The use of mediation analysis in evaluation of complex health interventions
Authors: DiLiberto Deborah D. , Opondo Charles , Staedke Sarah G. , Chandler Clare I. R. , Allen Elizabeth 
Published: February 2023

This article presents an application of the causal inference approach to mediation analysis using the example of a complex intervention that aimed to improve the quality of care at health centres in Uganda. Mediation analysis is a statistical method that aims to isolate the causal mechanisms that make an intervention work in a given context. We combined data from a cluster randomized control trial and a mixed-methods process evaluation. We developed two causal models following our hypotheses of how the intervention was intended to work through mechanisms at health centres to improve health outcomes in the community. In adjusted analyses, there was evidence of an effect of the intervention on some health centre mechanisms; however, these did not lead to improvements in community health outcomes. We discuss the practical and epistemological challenges encountered when using mediation analysis to evaluate a complex intervention. These findings will inform future evaluations. Trial registration: The trial reported in this article is registered at: clinicaltrials.gov, NCT01024426. Registered 2 December 2009, https://clinicaltrials.gov/ct2/show/record/NCT01024426?term=NCT01024426&draw=2&rank=1
Color M-Mode Ultrasound to Assess Carotid Arteries: A Feasibility Study
Authors: Carlson Jessica , Adams Tyler , Lee Juhyun , Gao Jing 
Published: February 2023

Introduction: The gradual process of atherosclerosis involves both structural and functional changes that can accumulate over years and contribute to cardiovascular risk. We propose the use of color M-mode ultrasound to evaluate the distensibility of the carotid artery as a quantitative measurement of dynamic function that could evaluate age-related vascular change when considering atherosclerotic cardiovascular disease evaluation and risk. The aim of the study was to assess the feasibility of color M-mode ultrasound to evaluate age-related changes in the carotid arteries. Methods: Color M-mode ultrasound of the distal common carotid artery (CCA) with concurrent electrocardiogram tracing was performed on 62 adults (19 men and 43 women) in 3 age groups: young adult (20-44 years; n = 22), middle age (45-64 years; n = 20), and senior (≥65 years; n = 20). Color M-mode ultrasound images of the CCA were processed offline using ImageJ to quantify total, red, green, and blue (RGB) pixels in systole and diastole. The CCA distensibility was calculated by using the following equation: distensibility coefficient (DC) = (systolic − diastolic diameter)/(diastolic diameter × pulse pressure). The difference in ultrasound parameters among the 3 age groups was analyzed by one-way analysis of variance (ANOVA). Intraobserver and interobserver reliability of offline imaging processing was tested using intraclass correlation coefficient (ICC). Results: We observed a significant difference in CCA distensibility among the 3 age groups ( P < .05). The interobserver reproducibility and intraobserver repeatability in performing offline image processing were excellent (ICC >0.85). Conclusion: These findings suggest that color M-mode ultrasound is feasible in evaluating changes in CCA distensibility and systolic pixel values representing CCA blood flow significantly decreased in seniors.
Optimal use of antithrombotic agents in ischemic stroke with atrial fibrillation and large artery atherosclerosis
Authors: Kim Tae Jung , Lee Ji Sung , Yoon Jae Sun , Oh Mi Sun , Kim Ji-Woo , Park Soo-Hyun , Jung Keun-Hwa , Kim Hyun Young , Kwon Jee-Hyun , Choi Hye-Yeon , Kim Hahn Young , Eah Kyung Yoon , Han Sang Won , Oh Hyung-Geun , Kim Young-Jae , Shin Byoung-Soo , Kim Chang Hun , Kim Chi Kyung , Park Jong-Moo , Lee Kyung Bok , Park Tai Hwan , Lee Jun , Park Man-Seok , Choi Jay Chol , Kim Chulho , Shin Dong-Ick , Lee Soo Joo , Kim Dong-Eog , Cha Jae-Kwan , Kim Eung-Gyu , Yu Kyung-Ho , Hong Keun-Sik , Lee Young-Seok , Lee Ju-Hun , Sohn Sung Il , Bae Hee-Joon , Lee Young-Bae , Lee Jun Hong , Rha Joung-Ho , Lee Byung-Chul , Chang Dae-Il , Ko Sang-Bae , Yoon Byung-Woo 
Published: February 2023

Background: Optimal antithrombotic regimens to prevent recurrent stroke in patients with ischemic stroke due to atrial fibrillation (AF) and atherosclerotic large-vessel stenosis remain unknown. Aims: This study aimed to evaluate the effect of multiple antithrombotic therapies on outcomes at 1 year after ischemic stroke due to two or more causes. Methods: We identified 862 patients with ischemic stroke due to AF and large artery atherosclerosis from the linked data. These patients were categorized into three groups according to antithrombotic therapies at discharge: (1) antiplatelets, (2) oral anticoagulants (OAC), and (3) antiplatelets plus OAC. The study outcomes were recurrent ischemic stroke, composite outcomes for cardiovascular events, and major bleeding after 1 year. Inverse probability of treatment weighting (IPTW) was used to balance the three groups using propensity scores. Results: Among 862 patients, 169 (19.6%) were treated with antiplatelets, 405 (47.0%) were treated with OAC, and 288 (33.4%) were treated with antiplatelets and OAC. After applying IPTW, only OAC had a significant beneficial effect on the 1-year composite outcome (hazard ratio (HR): 0.37, 95% confidence interval (CI): 0.23–0.60, p < 0.001) and death (HR: 0.35, 95% CI: (0.19–0.63), p < 0.001). The combination of antiplatelet agents and OAC group had an increased risk of major bleeding complications (HR: 5.27, 95% CI: (1.31–21.16), p = 0.019). However, there was no significant difference in 1-year recurrent stroke events among the three groups. Conclusion: This study demonstrated that OAC monotherapy was associated with lower risks of composite outcome and death in patients at 1 year after ischemic stroke due to AF and atherosclerotic stenosis. In addition, the combination of an antiplatelet and OAC had a high risk of major bleeding.
Association between spontaneous internal carotid artery dissection and perivascular adipose tissue attenuation on computed tomography angiography
Authors: Cheng Kevin , Lin Andrew , Stecher Ximena , Bernstein Tomas , Zuñiga Paulo , Mazzon Enrico , Brunser Alejandro , Diaz Violeta , Martinez Gonzalo , Cameron William , Nicholls Stephen J , Patel Sanjay , Dey Damini , Wong Dennis TL , Muñoz Venturelli Paula 
Published: February 2023

Background: Spontaneous cervical artery dissection (sCAD) is a leading cause of ischemic stroke in young patients. Studies using high-resolution magnetic resonance imaging and positron emission tomography have suggested vessel wall inflammation to be a pathogenic factor in sCAD. Computed tomography (CT) attenuation of perivascular adipose tissue (PVAT) is an established non-invasive imaging biomarker of inflammation in coronary arteries, with higher attenuation values reflecting a greater degree of vascular inflammation. Objectives: We evaluate the CT attenuation of PVAT surrounding the internal carotid artery (PVATcarotid) with and without spontaneous dissection. Methods: Single-center prospective observational study of 56 consecutive patients with CT-verified spontaneous dissection of the internal carotid artery (ICA). Of these patients, six underwent follow-up computed tomography angiography (CTA). Twenty-two patients who underwent CTA for acute neurological symptoms but did not have dissection formed the control group. Using semi-automated research software, PVATcarotid was measured as the mean Hounsfield unit (HU) attenuation of adipose tissue within a defined volume of interest surrounding the ICA. Results: PVATcarotid was significantly higher around dissected ICA compared with non-dissected contralateral ICA in the same patients (−58.7 ± 10.2 vs −68.9 ± 8.1 HU, p < 0.0001) and ICA of patients without dissection (−58.7 ± 10.2 vs −69.3 ± 9.3 HU, p < 0.0001). After a median follow-up of 89 days, there was a significant reduction in PVATcarotid around dissected ICA (−57.5 ± 13.4 to −74.3 ± 10.5 HU, p < 0.05), while no change was observed around non-dissected contralateral ICA (−71.0 ± 4.4 to −74.1 ± 4.1 HU, p = 0.19). ICA dissection was an independent predictor of PVATcarotid following multivariable adjustment for age and the presence of ICA occlusion. Conclusion: PVATcarotid is elevated in the presence of sCAD and may decrease following the acute event.
Characteristics and outcomes of patients with psoriasis treated with apremilast in the real-world in Austria – results the APPRECIATE study
Authors: Jonak Constanze , Göttfried Isolde , Perl-Convalexius Sylvia , Gruber Barbara , Schütz-Bergmayr Martina , Vujic Igor , Weger Wolfgang , Schicher Nikolaus , Semlin Lydia , Hemetsberger Margit , Cordey Myriam , Sator Paul 
Published: February 2023

Background: Apremilast, an oral phosphodiesterase 4 inhibitor, is approved in the European Union for the treatment of moderate-to-severe chronic plaque psoriasis in adult patients refractory or contraindicated to or intolerant of other systemic therapies. Objectives: The APPRECIATE study assessed apremilast use in real-world practice and its clinical value to physicians and patients. APPRECIATE was a multinational, observational, retrospective, cross-sectional study. Methods: Apremilast effectiveness at 6 (±1) months was assessed on the basis of psoriasis severity and health-related quality-of-life scores and treatment satisfaction using physician/patient-reported outcomes, respectively. We report the Austrian cohort of 72 patients. Results: At 6 (±1) months, three-quarters of patients remained on apremilast, while physicians and patients reported treatment benefits across all psoriasis symptoms and manifestations. Of patients, the majority were satisfied with their treatment and achieved treatment goals considered most relevant. Patients’ and physicians’ perceptions of treatment effectiveness were aligned, and health-related quality-of-life scores indicated an improvement in the majority of patients. Apremilast tolerability was consistent with the known safety profile. Conclusions: Among psoriasis patients receiving apremilast in Austria, improvement in clinical outcomes were observed and satisfaction with apremilast treatment among patients and physicians was high. Registration: ClinicalTrials.gov NCT02740218
Antiresorptive Medications Prior to Stereotactic Body Radiotherapy for Spinal Metastasis are Associated with Reduced Incidence of Vertebral Body Compression Fracture
Authors: Patel Palak P. , Esposito Edward P. , Zhu Jiafeng , Chen Xuguang , Khan Majid , Kleinberg Lawrence , Lubelski Daniel , Theodore Nicholas , Lo Sheng-fu Larry , Hun Lee Sang , Kebaish Khaled , Bydon Ali , Redmond Kristin J. 
Published: February 2023

Study Design Retrospective Cohort Objective Antiresorptive drugs are often given to minimize fracture risk for bone metastases, but data regarding optimal time or ability to reduce stereotactic body radiotherapy (SBRT)-induced fracture risk is limited. This study examines the association between antiresorptive use surrounding spinal SBRT and vertebral compression fracture (VCF) incidence to provide information regarding effectiveness and optimal timing of use. Methods Patients treated with SBRT for spinal metastases at a single institution between 2009-2020 were included. Kaplan-Meier analysis was used to compare cumulative incidence of VCF for those taking antiresorptive drugs pre-SBRT, post-SBRT only, and none at all. Cox proportional hazards and Fine-Gray competing risk models were used to identify additional factors associated with VCF. Results Of the 234 patients (410 vertebrae) analyzed, 49 (20.9%) were taking bisphosphonates alone, 42 (17.9%) were taking denosumab alone, and 25 (10.7%) were taking both. Kaplan-Meier analysis revealed a statistically significant lower VCF incidence for patients initiating antiresorptive drugs before SBRT compared to those taking none at all (4% vs 12% at 1 year post-SBRT, P = .045; and 4% vs 23% at 2 years, P = .008). On multivariate analysis, denosumab duration (HR: .87, P = .378) or dose (HR: 1.00, P = .644) as well as bisphosphonate duration (HR: .98, P= .739) or dose (HR: .99, P= .741) did not have statistical significance on VCF incidence. Conclusion Initiating antiresorptive agents before SBRT may reduce the risk of treatment-induced VCF. Antiresorptive drugs are underutilized in patients with spine metastases and may represent a useful intervention to minimize toxicity and improve long-term outcomes.
Pectoralis Major Transfer for Medial Scapular Winging
Authors: Ottofaro Trevor , Singh Suvleen K. , Welsh Megan E. , Friedman Richard J. , Eichinger Josef K. 
Published: February 2023

Background: Scapular winging is a rare and often misdiagnosed disorder, which can be painful and functionally limited. Medial scapular winging is often due to serratus anterior dysfunction in the setting of a long thoracic nerve palsy. While nonoperative management can be successful, transfer of the pectoralis major with autograft hamstring augmentation to the inferior scapula is an effective operative means of relieving pain and restoring shoulder function in those who fail conservative management. Indications: The patient is a 16-year-old woman with symptomatic medial scapular winging who had a complete workup and 6-month course of conservative treatment, including physical therapy. Thus, we elected to proceed with a 2-incision transfer of the sternal head of pectoralis major transfer with autograft hamstring augmentation to the inferior scapular angle. Technique Description: A 2-incision transfer of the sternal head of pectoralis major with autograft hamstring to the inferior scapular angle is a strong and reliable method of operatively treating medial scapular winging. In addition, performing this operation in the lateral position allows for ease of access to both the anterior and posterior incisions. Results: At 1-year follow-up, the patient had full, painless range of motion of the shoulder with 5/5 strength in all tested planes. She also had returned to all activities, including softball, without restrictions. Discussion/Conclusions: A 2-incision transfer of the sternal head of the pectoralis major with autograft hamstring augmentation to the inferior scapular angle is an effective means of operatively treating medial scapular winging. Multiple studies have shown that this operation improves motion, pain, and function for those who have failed an appropriate course of conservative treatment. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Profile of liver cholestatic biomarkers following prolonged ketamine administration in patients with COVID-19
Authors: Henrie Julie , Gerard Ludovic , Declerfayt Caroline , Lejeune Adrienne , Baldin Pamela , Robert Arnaud , Laterre Pierre-François , Hantson Philippe 
Published: February 2023

Abstract
Background
To investigate the possible influence of prolonged ketamine (K) or esketamine (ESK) infusion on the profile of liver cholestatic biomarkers in patients with COVID-19 infection.

Methods
A retrospective analysis was performed on 135 patients with COVID-19 related ARDS who received prolonged K or ESK infusion. They were compared to 15 COVID-19 ICU patients who did not receive K/ESK while being mechanically ventilated and 108 COVID-19 patients who did not receive mechanical ventilation nor K/ESK. The profile of the liver function tests was analysed in the groups.

Results
Peak values of ALP, GGT and bilirubin were higher in the K/ESK group, but not for AST and ALT. Peak values of ALP were significantly higher among patients who underwent mechanical ventilation and who received K/ESK, compared with mechanically ventilated patients who did not receive K/ESK. There was a correlation between these peak values and the cumulative dose and duration of K/ESK therapy.

Conclusions
Based on the observations of biliary anomalies in chronic ketamine abusers, prolonged exposure to ketamine sedation during mechanical ventilation may also be involved, in addition to viral infection causing secondary sclerosing cholangitis. The safety of prolonged ketamine sedation on the biliary tract requires further investigations.