bluuebunny/crossref_metadata_2025_split huggingface dataset:
More recent insights into the breast cancer burden across BRICS-Plus: Health consequences in key nations with emerging economies using the global burden of disease study 2019
Authors: Mubarik Sumaira , Luo Lisha , Iqbal Mujahid , Nawsherwan  , Bai Jianjun , Yu Chuanhua 
Published: January 2023

BackgroundBrazil, Russia, India, China, South Africa, and 30 other Asian nations make up the BRICS-Plus, a group of developing countries that account for about half of the world’s population and contribute significantly to the global illness burden. This study aimed to analyzed the epidemiological burden of female breast cancer (BC) across the BRICS-Plus from 1990 to 2019 and studied the associations with age, period, birth cohort and countries’ sociodemographic index (SDI).MethodsThe BC mortality and incidence estimates came from the 2019 Global Burden of Disease Study. We estimated cohort and period effects in BC outcomes between 1990 and 2019 using age-period-cohort (APC) modeling. The maximum likelihood (ML) of the APC-model Poisson with log (Y) based on the natural-spline function was used to estimate the rate ratio (RR). We used annualized rate of change (AROC) to quantify change over the previous 30 years in BC across BRICS-Plus and compare it to the global.ResultsIn 2019, there were about 1.98 million female BC cases (age-standardized rate of 45.86 [95% UI: 41.91, 49.76]) and 0.69 million deaths (age-standardized rate of 15.88 [95% UI: 14.66, 17.07]) around the globe. Among them, 45.4% of incident cases and 51.3% of deaths were attributed to the BRICS-Plus. China (41.1% cases and 26.5% deaths) and India (16.1% cases and 23.1% deaths) had the largest proportion of incident cases and deaths among the BRICS-Plus nations in 2019. Pakistan came in third with 5.6% cases and 8.8% deaths. Over the past three decades, from 1990 to 2019, the BRICS-Plus region’s greatest AROC was seen in Lesotho (2.61%; 95%UI: 1.99-2.99). The birth cohort impacts on BC vary significantly among the BRICS-Plus nations. Overall, the risk of case-fatality rate tended to decline in all BRICS-Plus nations, notably in South Asian Association for Regional Cooperation (SAARC) and China-ASEAN Free Trade Area (China-ASEAN FTA) countries, and the drop in risk in the most recent cohort was lowest in China and the Maldives. Additionally, there was a substantial negative link between SDI and case fatality rate (r1990= -0.91, p&lt;0.001; r2019= -0.89, p&lt;0.001) in the BRICS-Plus in both 1990 and 2019, with the Eurasian Economic Union (EEU) nations having the highest case fatality rate.ConclusionsThe BC burden varies remarkably between different BRICS-Plus regions. Although the BRICS’ efforts to regulate BC succeeded, the overall improvements lagged behind those in high-income Asia-Pacific nations. Every BRICS-Plus country should strengthen specific public health approaches and policies directed at different priority groups, according to BRIC-Plus and other high-burden nations.
Evaluation of flattening-filter-free and flattening filter dosimetric and radiobiological criteria for lung SBRT: A volume-based analysis
Authors: Wu Junxiang , Song Hongchang , Li Jie , Tang Bin , Wu Fan 
Published: January 2023

IntroductionThe use of volumetric modulated arc therapy (VMAT) with flattening-filter-free (FFF) beams is becoming more prevalent in lung cancer stereotactic body radiotherapy (SBRT). The aim in this study was to assess the impact of dosimetric and radiobiological differences between FFF and flattening filter (FF) beams for lung SBRT based on the target volume.MethodsA total of 198 lung stereotactic body radiation therapy treatment plans with FFF beams and FF beams were retrospectively selected for this study. For all plans, the prescribed dose was 50 Gy/5 fractions, and the dose volume histogram (DVH) for the target and organs at risk (OAR) and the normal tissue complication probability (NTCP) of the lung were recorded and compared. Moreover, monitor units (MUs), the beam on-time and the treatment time were evaluated.ResultsThe study was performed following the Radiation Therapy Oncology Group (RTOG) 0813 and 0915 protocols. No significant differences in D90, coverage rate (CR) or conformity index (CI) of the target were observed between FFF beams and FF beams (p&gt;0.05). The D2, R50% and gradient index (GI) for the target improved with FFF beams compared with FF beams (p&lt;0.05). FFF beams also significantly reduced the dose for the lung, heart, spinal cord, esophagus and NTCP of the lung (p&lt;0.05), compared with FF beams. However, there was no significant difference in sparing of the trachea (p&gt;0.05). The mean MUs, beam on-time and treatment time were 1871 ± 278 MUs, 3.2 ± 0.2 min and 3.9 ± 0.3 min for FFF beams, and 1890 ± 260 MUs, 4.2 ± 0.3 min and 4.8 ± 0.4 min for FF beams, respectively.DiscussionThe FFF beam technique for lung SBRT with VMAT results in a better dose fall-off, better dose-sparing of OAR, lower NTCP of the lung and a shorter beam on-time compared with the FF beam technique. Additionally, the improvement in target and OAR-sparing for FFF beams was increased with increasing target volume.
Spatiotemporal clusters of Kawasaki disease in South Korea from 2008 to 2017: A municipal-level ecological study
Authors: Kim Jeehyun , Hong Kwan , Yoo Daesung , Chun Byung Chul 
Published: January 2023

IntroductionAs the etiology of Kawasaki disease (KD) remains unknown, identifying spatiotemporal clusters with proper stratification of KD could provide further evidence for investigating the triggers of KD. However, spatiotemporal distributions of KD with sex stratification have never been reported. Therefore, we aimed to analyze the spatiotemporal patterns of KD by sex in South Korea.MethodsWe extracted epidemiologic week (Epiweek)-based KD cases in patients &lt;5 years of age (ICD-10-CM code: M303) from 2008 to 2017 national health insurance service data at the 250 municipal level. To determine whether spatial autocorrelation and persistent municipal-level clusters exist, year- and sex-stratified global Moran's I statistics, Getis-Ord Gi* statistics, and emerging hotspot analysis on KD incidence were conducted.ResultsA total of 72,510 KD cases were reported between 2008 and 2017 (male-to-female ratio = 1.40:1). Incidence has increased since 2008, with the highest incidence in 2016 (396.8 per 100,000 population). KD had seasonality of winter and summer but different by sex. Positive spatial autocorrelation was consistently reported in every stratum, with the 2011–2014 period having the strongest index value (total sex I = 0.286, p &lt; 0.001; male I = 0.242, p &lt; 0.001; female I = 0.213, p &lt; 0.001). Hot spots were consistently detected in the northern parts, and cold spots were in the southern part for 9 years in both sexes. The emerging hot spot analysis showed new, consecutive, and sporadic hot spots on the northwestern and eastern coasts and new and sporadic cold spots in the southwestern part. However, the distribution and proportion of hot or cold spot types differed according to sex.DiscussionThe spatiotemporal features of KD had limits to concluding that only infectious triggers result in KD occurrence. Therefore, our findings support the notion that KD is a syndrome with multiple factors, including infectious, genetic, and environmental factors, that are associated with sex differences.
Displaced supracondylar femoral fractures: Clinical and radiographic outcomes in children aged 4–10 years treated with Kirschner wires and hip spica cast
Authors: Jing Yanhui , Ning Bo , Mo Yueqiang , Wang Dahui 
Published: January 2023

BackgroundSupracondylar femoral fractures (SFFs) are uncommon in children but can cause several abnormalities. Although several methods have been employed to treat these fractures, no accepted standard has been established.ObjectivesTo investigate the clinical and radiographic outcomes of displaced SFFs treated with Kirschner wires (K-wires) and hip spica casts in children aged 4–10 years.MethodsWe retrospectively reviewed 22 displaced SFFs (mean age, 6.7 years; range, 4–10 years) in patients who underwent surgical treatment with K-wires and hip spica casts. The patients were followed-up frequently, radiographically and clinically between January 2014 and February 2019. Postoperative healing and functional results were elevated according to the radiographic and clinical measures.ResultsFifteen boys and seven girls were included in this study. All patients except two (91%), underwent closed reduction and stabilization of the fractures. The mean follow-up duration was four years (range, 2–5 years). All fractures showed clinical and radiological evidence of union 4–8 weeks after surgery. At the most recent check-up, all patients reported being pain-free and had returned to normal activities. The mean Knee Society Score was 95.41 at the final follow-up. According to the radiologic criteria, 18 of the 22 patients (81.8%) obtained excellent results, 3 (13.6%) had good results, 1 (4.5%) had a fair result, and none had poor results.ConclusionSatisfactory clinical and radiological results can be expected in children aged 4–10 years using a combination of K-wires and hip spica cast fixation.
Effect of aerobic exercise and low-carbohydrate high-fat diet on glucose tolerance and android/gynoid fat in overweight/obese women: A randomized controlled trial
Authors: Valsdottir Thorhildur Ditta , Øvrebø Bente , Kornfeldt Thea Martine , Litleskare Sigbjørn , Johansen Egil Ivar , Henriksen Christine , Jensen Jørgen 
Published: January 2023

The study was designed to compare the effects of weight loss induced by a low-carbohydrate-high-fat diet or a normal diet, with and without exercise, on glucose tolerance measured as area under the curve (AUC), and android (A) and gynoid (G) fat distribution. The study was registered at clinicaltrials.gov; NCT04100356. In total, 57 women classified as overweight or obese (age 40 ± 3.5 years, body mass index 31.1 ± 2.6 kg/m2) were randomly assigned and completed a 10-week intervention using a low-carbohydrate high-fat diet or a normal diet, with or without aerobic interval exercise. An equal deficit of 700 kcal/day was prescribed, either restricting the diet only, or moderately restricting diet and including three 50-min high-intensity bicycle sessions per week. There were thus four groups: normal diet (NORM); low-carbohydrate-high-fat diet (LCHF); normal diet with exercise (NORM-EX); and low-carbohydrate-high-fat diet with exercise (LCHF-EX). Linear mixed models was used to assess differences between groups. With all groups pooled, the intervention resulted in a weight loss of 6.7 ± 2.5% (p &lt; 0.001). The intervention did not result in differences between groups in AUC glucose, nor in fasting glucose or indicis for insulin resistance such as Homeostatic Model Assessment, Matsuda Insulin Sensitivity Index, insulinogenic index and disposition index. Post-intervention android fat was lower in LCHF than NORM (3,223 ± 727 vs. 2,533 ± 535 g, p = 0.041). LCHF reached a lower A/G ratio than NORM (0.94 ± 0.12 vs. 1.04 ± 0.09, p = 0.011) and LCHF-EX (0.94 ± 0.12 vs. 1.09 ± 0.09, p &lt; 0.001) after the intervention. LCHF resulted in lower android fat mass compared to NORM and the lowest A/G ratio compared to the other matched groups, but with no accompanying improvement in AUC glucose. In conclusion, although all groups achieved improvements in glucose tolerance, no superior effect was observed with the LCHF diet, neither with nor without exercise.
Tracking endothelium-dependent NO release in pressurized arteries
Authors: Wallis Lillian , Donovan Lucy , Johnston Aaron , Phillips Lauren C. , Lin Jinheng , Garland Christopher J. , Dora Kim A. 
Published: January 2023

Background: Endothelial cell (EC) dysfunction is an early hallmark of cardiovascular disease associated with the reduced bioavailability of nitric oxide (NO) resulting in over-constriction of arteries. Despite the clear need to assess NO availability, current techniques do not reliably allow this in intact arteries.Methods: Confocal fluorescence microscopy was used to compare two NO-sensitive fluorescent dyes (NO-dyes), Cu2FL2E and DAR-4M AM, in both cell-free chambers and isolated, intact arteries. Intact rat mesenteric arteries were studied using pressure myography or en face imaging to visualize vascular smooth muscle cells (SMCs) and endothelial cells (ECs) under physiological conditions. Both NO-dyes irreversibly bind NO, so the time course of accumulated fluorescence during basal, EC-agonist (ACh, 1 µM), and NO donor (SNAP, 10 µM) responses were assessed and compared in all experimental conditions. To avoid motion artefact, we introduced the additional step of labelling the arterial elastin with AF-633 hydrazide (AF) and calculated the fluorescence ratio (FR) of NO-dye/elastin over time to provide data as FR/FR0.Results: In cell-free chambers using either Cu2FL2E or DAR-4M AM, the addition of SNAP caused a time-dependent and significant increase in fluorescence compared to baseline. Next, using pressure myography we demonstrate that both Cu2FL2E and DAR-4M AM could be loaded into arterial cells, but found each also labelled the elastin. However, despite the use of different approaches and the clear observation of NO-dye in SMCs or ECs, we were unable to measure increases in fluorescence in response to either ACh or SNAP when cells were loaded with Cu2FL2E. We then turned our attention to DAR-4M AM and observed increases in FR/FR0 following stimulation with either ACh or SNAP. The addition of each agent evoked an accumulating, time-dependent, and statistically significant increase in fluorescence within 30 min compared to time controls. These experiments were repeated in the presence of L-NAME, an NO synthase inhibitor, which blocked the increase in fluorescence on addition of ACh but not to SNAP.Conclusion: These data advance our understanding of vascular function and in the future will potentially allow us to establish whether ECs continuously release NO, even under basal conditions.
Perception of effort and the allocation of physical resources: A generalization to upper-limb motor tasks
Authors: de la Garanderie Marie Payen , Courtay Aymeric , Féral-Basin Camille , Rainville Pierre , Gaveau Jérémie , Pageaux Benjamin 
Published: January 2023

PurposeThe perception of effort (PE) is widely used to prescribe and monitor exercise during locomotor and resistance tasks. The present study examines the validity of PE to prescribe and monitor exercise during upper-limb motor tasks under various loads and speed requirements.MethodsForty participants volunteered in two experiments. In experiment 1, we used four PE intensities to prescribe exercise on a modified version of the box and block test (BBT) and a pointing task. We investigated the possibility of monitoring the exercise intensity by tracking changes in PE rating in response to three different tempos or additional weights. Experiment 2 replicated the possibility of prescribing the exercise with the PE intensity during the BBT and explored the impact of additional weights on performance and PE during the standardized version of the BBT. Muscle activation, heart rate, and respiratory frequencies were recorded.ResultsIn experiment 1, increasing the PE intensity to prescribe exercise induced an increased performance between each intensity. Increasing task difficulty with faster movement tempo and adding weight on the forearm increased the rating of PE. Experiment 2 replicated the possibility to use PE intensity for exercise prescription during the BBT. When completing the BBT with an additional weight on the forearm, participants maintained performance at the cost of a higher PE. In both experiments, changes in PE were associated with changes in muscle activation.ConclusionOur results suggest that PE is a valid tool to prescribe and monitor exercise during upper-limb motor tasks.
A study on the correlation between family dynamic factors and depression in adolescents
Authors: Shi Jiali , Tao Yiran , Yan Caiying , Zhao Xudong , Wu Xueqing , Zhang Tingting , Zhong Cheng , Sun Jinhua , Hu Manji 
Published: January 2023

ObjectivesTo evaluate the relationship between systemic family dynamics and adolescent depression.MethodsAn offline survey was distributed to 4,109 students in grades 6–12, with the final analysis including 3,014 students (1,524 boys and 1,490 girls) aged 10–18 years. The questionnaire included the Self-Rating Scale of Systemic Family Dynamics (SSFD), the Self-Rating Depression Scale (SDS), and demographic characteristics.ResultsFamily dynamics were negatively correlated with depressive symptoms, with better family dynamics (high scores) associated with lower levels of depression based on the SDS score. After adjusting for sociodemographic characteristics, an ordinal multiclass logistic regression analysis identified family atmosphere (OR = 0.952, 95% CI: 0.948–0.956, p &lt; 0.001) as the most important protective family dynamic against depression, followed by individuality (OR = 0.964, 95% CI: 0.960–0.968, p &lt; 0.001). Latent class analysis (LCA) created the low family dynamic and high family dynamic groups. There were significant differences in the mean SDS scores between the two groups (45.52 ± 10.57 vs. 53.78 ± 11.88; p &lt; 0.001) that persisted after propensity matching. Family atmosphere and individuation had a favorable diagnostic value for depression, with AUCs of 0.778 (95% CI: 0.760–0.796) and 0.710 (95% CI: 0.690–0.730), respectively. The diagnostic models for depression performed well.ConclusionPoor family dynamics may be responsible for adolescent depression. A variety of early intervention strategies focused on the family may potentially avoid adolescent depression.
Unsociability and social adjustment of Chinese preschool migrant children: The moderating role of resilience
Authors: Zhu Jingjing , Zhang Zhenzhen , Xu Pin , Huang Kaiyu , Li Yan 
Published: January 2023

ObjectivesThe present study examined the moderating effect of children’s resilience on the relations between unsociability and social adjustment (i.e., prosocial behaviors, peer exclusion, interpersonal skills, internalizing problems) in Chinese preschool migrant children.MethodsParticipants were N = 148 children (82 boys, Mage = 62.32 months, SD = 6.76) attending two public kindergartens in Shanghai, People’s Republic of China. Mothers provided ratings of children’s unsociability and resilience; teachers assessed children’s social adjustment outcomes, and children reported their receptive vocabulary.ResultsUnsociability was positively associated with peer exclusion and internalizing problems, and negatively associated with prosocial behaviors and interpersonal skills among Chinese preschool migrant children. Moreover, children’s resilience significantly moderated the relationship between unsociability and social adjustment. Specifically, among children with lower levels of resilience, unsociability was significantly and positively associated with peer exclusion and internalizing problems, while among children with higher levels of resilience, unsociability was not associated with social adjustment difficulties.ConclusionThe current findings inform us of the importance of improving children’s resilience to buffer the negative adjustment among Chinese migrant unsociable young children. The findings also highlight the importance of considering the meaning and implication of unsociability for preschool migrant children in Chinese culture.
The role of self-reported fear and disgust in the activation of behavioral harm avoidance related to medical settings
Authors: Birkás Béla , Kiss Botond , Coelho Carlos M. , Zsidó András N. 
Published: January 2023

IntroductionAlthough adaptive defense mechanisms are useful in helping us avoid getting injured, they are also triggered by medical interventions and procedures, when avoidance is harmful. A body of previous results showed that both fear and disgust play a pivotal role in medical avoidance. However, the underlying mechanisms are not fully understood. Thus, the aim of the current study was to examine the effects of experience, perceived control, and pain on medical avoidance with disgust and fear as mediating factors from an evolutionary perspective.MethodsWe assessed participants' knowledge of and experience with medical procedures, former negative medical experiences, and health-related information; their life history strategy variation; pain-related fear and anxiety of medical procedures; perceived control over emotional reactions and extreme threats; disgust sensitivity; blood-injury-injection phobia and medical treatment avoidance.ResultsWe found that more knowledge, experience, and a slower life strategy were linked to a greater level of perceived control and attenuated emotional reactions. Further, better ability to control affective and stress reactions to negative experiences was linked to reduced disgust and fear of pain, and thus might mitigate the level of perceived threat, and diminish fear and disgust reactions.DiscussionMore knowledge and experiences, better perceived control together with reduced disgust and fear of pain can decrease the probability of avoiding medical situations. Implications to treatment are discussed. Results support the importance of targeting these contextual factors in prevention to increase the likelihood of people attending regular screenings or seeking medical care when needed.
Feasibility of the virtual reality-based assessments in patients with panic disorder
Authors: Kim Byung-Hoon , Kim Jae-Jin , Oh Jooyoung , Kim Seung-Hyun , Han Changsu , Jeong Hyun-Ghang , Lee Moon-Soo , Kim Junhyung 
Published: January 2023

IntroductionRecurrences and diagnostic instability of panic disorder (PD) are common and have a negative effect on its long-term course. Developing a novel assessment tool for anxiety that can be used in a multimodal approach may improve these problems in panic disorder patients. This study assessed the feasibility of virtual reality-based assessment in panic disorder (VRA-PD).MethodsTwenty-five patients with PD (ANX group) and 28 healthy adults (CON group) participated in the study. VRA-PD consisted of four modules based on the key components of cognitive behavior therapy for an anxiety disorder: “Baseline evaluation module” (M0), “Daily environment exposure module” (M1), “Relaxation module” (M2), and “Interoceptive exposure module” (M3). Multiple evaluations, including self-rating anxiety scores (AS) and physiological responses [heart rate variability (HRV) index], were performed in three steps at M1, M2, and M3, and once at M0. Comparisons between patients with PD and healthy controls, factor analysis of variables in VRA-PD, changes in responses within modules, and correlation analysis between variables in VRA-PD and anxiety symptoms assessed by psychological scales were performed.ResultsAll participants completed the VRA-PD without discontinuation. The ANX group reported significantly higher AS for all steps and a smaller HRV index in M1 (steps 1 and 2) and M2 (step 1). Repeated-measures analysis of covariance (ANCOVA) revealed significant interaction effects for AS in M1 (F = 4.09, p = 0.02) and M2 (F = 4.20, p = 0.02), and HRV index in M2 (F = 16.22, p &lt; 0.001) and M3 (F = 21.22, p = 0.02). The HRV index only indicated a good model fit for the three-factor model, reflecting the construct of the VRA-PD. Both AS and HRV indexes were significantly correlated with anxiety and depression symptoms.DiscussionThe current study provides preliminary evidence that the VRA-PD could be a valid anxiety behavior assessment tool.