bluuebunny/crossref_metadata_2025_split huggingface dataset:
Glomerular filtration rate in patients with type 2 diabetes mellitus: is serum isthmin-1 level a possible link?
Authors: Xu Mingyue , Feng Ruiying , Feng Ruoqi , Yin Xiaofei , Zhang Lei , Wang Chuan , Liu Jinbo 
Published: August 2023

IntroductionIsthmin-1 (Ism-1) is a novel adipokine. However, little is known regarding the association between Ism-1 and type 2 diabetes mellitus (T2DM). This study aimed to investigate the relationship between serum Ism-1 levels and glomerular filtration rate (GFR) in patients with T2DM.Research design and methodsA total of 209 patients with T2DM were recruited into this retrospective study. Clinical data were collected. Fasting blood samples were collected for serum Ism-1 testing using ELISA kits. Based on the estimated glomerular filtration rate (eGFR), participants were divided into the normal eGFR group (n=167) and the decreased eGFR group (n=42). The relationship between Ism-1 and eGFR was assessed using linear and binary logistic regression analyses. Receiver operating characteristic (ROC) curve analysis was employed to examine the predictive efficacy of Ism-1 for distinguishing patients with eGFR <60 mL/min/1.73 m2.ResultsCompared with patients with normal eGFR, serum Ism-1 levels were increased in patients with decreased eGFR (p<0.001). Serum Ism-1 levels were negatively correlated with eGFR in patients with T2DM even after multiple adjustments (p<0.001). For each 0.1 ng/mL increment of Ism-1, the odds of having an eGFR <60 mL/min/1.73 m2increased by 54.5% (OR=1.545; p<0.001) in patients with T2DM. ROC analysis showed that higher serum Ism-1 levels (>1.297 ng/mL) had predictive efficacy in patients with eGFR <60 mL/min/1.73 m2, with an area under the curve of 0.908.ConclusionsSerum Ism-1 levels were inversely associated with eGFR, and high Ism-1 levels may be used as a potential biomarker for predicting kidney function impairment in patients with T2DM.
Implementation of flash glucose monitoring in four pediatric diabetes clinics: controlled before and after study to produce real-world evidence of patient benefit
Authors: Kandiyali Rebecca , Taylor Hazel , Thomas Elizabeth , Cullen Freyja , Hollingworth William , Ingram Jenny , Kenward Charlie , West Nicol , McGregor David , Smith Becky , Hamilton-Shield Julian 
Published: August 2023

AimsTo assess the real-world evidence for flash glucose monitoring (Abbott FreeStyle Libre) for children with type 1 diabetes in terms of glucose control, secondary healthcare resources and costs.Research design and methodsWe conducted a controlled before and after study (approximately 12 months before and after) using routinely collected health record data on children who start using flash monitors and a control population of children with self-monitoring of blood glucose (SMBG). Our population-based sample of eligible individuals using flash monitoring (n=114) and controls (n=80) aged between 4 and 18 years was drawn from four paediatric diabetes clinics (secondary care) in the South West England. Outcome measures included: glycated hemoglobin (HbA1c), frequency of BG tests; frequency of sensor scans; time in recommended glucose range; short-term complications (hypoglycemia, diabetic ketoacidosis and related illness resulting in investigation) and secondary care costs.ResultsAfter adjustment for age, time since diagnosis, deprivation and the test modality (point of care or laboratory), the mean HbA1c reading for controls was 61.2 (mmol/mol) for the period before and 63.9 after. For individuals using flash monitoring, the adjusted mean HbA1c reading was 64.6 for the period before implementation and 63.8 after. Rates of short-term complications were low across all groups in the study. Whereas the ‘after’ flash monitoring group had substantially higher incremental costs (+£703 vs the flash monitoring ‘before’ comparison and +£841 vs contemporaneous SMBG controls), these cost differences were driven by primary care prescribing (sensor costs).ConclusionsThere was some indication that flash monitoring might help young people improve the control of their diabetes but for our sample, the difference between finger-prick testing and flash monitoring was not clinically significant (HbA1c improvement <5 mmol/mol). Given the pace of technological change within diabetes, research efforts should now facilitate the real-time analysis of long-term routine data on flash and continuous glucose monitors.
Association between history of cholecystectomy and risk of gastric cancer: a meta-analysis of epidemiological studies
Authors: Sun Mei , Ma Tianyi , Yuan Huawei 
Published: August 2023

PurposeEvidence from previous studies on the association between cholecystectomy and risk of gastric cancer are still inconsistent. We aimed at conducting a meta-analysis of epidemiological studies to evaluate this association.MethodsResearchers searched three databases (PubMed, Embase and Web of Science) through January 2021 for eligible studies. Relative risks (RRs) and 95% CIs in each included studies were pooled by random-effects models. Patients and the public were not involved in our study.ResultsEight studies were identified. Four studies reported significantly positive association between history of cholecystectomy and risk of gastric cancer, and the remaining studies reported null association. The pooled RR of these eight studies showed that a history of cholecystectomy was associated with a 11% higher risk of gastric cancer (pooled RR=1.11, 95% CI: 1.03 to 1.20). Moderate heterogeneity across the studies was detected (p=0.117, I2=37.8%). The pooled RRs were 1.12 (95% CI: 1.01 to 1.24) for five cohort studies and 0.95 (95% CI: 0.66 to 1.38) for three case–control studies. Compared with the risk in Europe and the USA, the pooled RR was higher for two studies conducted in Asia. Six studies were assessed as high-quality studies with the pooled RR of 1.12 (95% CI: 1.02 to 1.23). The pooled results were robust by sensitivity analyses, and no indication of publication bias was detected.ConclusionThis meta-analysis suggests that a history of cholecystectomy may be associated with an increased risk of gastric cancer.
Prevalence of type 2 diabetes and pre-diabetes in Sri Lanka: a systematic review and meta-analysis
Authors: Akhtar Sohail , Ali Aqsa , Asghar Mubeen , Hussain Ibrar , Sarwar Aqsa 
Published: August 2023

ObjectiveThe purpose of this research was to determine the prevalence of diabetes and pre-diabetes in Sri Lanka.DesignSystematic review and meta-analysis.Data sourcesMEDLINE (via PubMed), Web of Science, Sri Lankan Journals online and Google Scholar were searched for relevant articles published between January 1990 and June 2022 investigating the prevalence of pre-diabetes and diabetes in Sri Lanka.MethodsRandom effect meta-analyses were conducted to derive the pooled prevalence of pre-diabetes and diabetes and their 95% CIs. Heterogeneity was explored by subgroup and meta-regression analyses. Sensitivity analyses were used to evaluate the impact of any single study on the pooled estimates. Two authors screened articles, extracted data and evaluated the quality of selected studies.ResultsA total of 479 articles were reviewed, and 15 studies (n=30 137 participants) were selected in the final analysis. The overall pooled prevalence of diabetes was 12.07% (95% CI, 8.71% to 15.89%; prediction interval: 1.28–31.35). The pooled pre-diabetes prevalence was 15.57% (95% CI, 9.45% to 22.88%; prediction interval: 0.02–49.87). The pooled type 2 diabetes prevalence was the highest in the latest period of 2011–2021 (17.25%) than in the period of 2000s (11.84%) and 1990s (5.62%).ConclusionsThe growing trend of diabetes and pre-diabetes over the last 30 years is alarming in Sri Lanka. The government of Sri Lanka needs to take steps to improve diabetes education, screening, diagnosis and treatment.PROSPERO registration numberCRD42021288591.
Mediating role of learned helplessness’ components in the association between health literacy/social support and self-management among maintenance haemodialysis patients in Changsha, China: a cross-sectional study
Authors: Xie Chunyan , Li Li , Zhou Lin , Sun Cuifang , Zhang Yini , Li Yamin 
Published: August 2023

ObjectivesTo explore the multiple mediating roles of the learned helplessness’s core system in the relationship between health literacy/social support and self-management.DesignCross-sectional survey design.SettingChangsha, China.Participants239 Chinese maintenance haemodialysis (MHD) patients.MethodsTwo multiple mediator models were constructed based on the COM-B (Capacity, Opportunity, Motivation - Behaviour) model. A total of 239 Chinese MHD patients participated in a cross-sectional study, which included surveys on the Learned Helplessness Scale for MHD patients, Dialysis Knowledge Questionnaire, Social Support Scale and Self-Management Scale for Haemodialysis. The PROCESS macro in SPSS was used for mediated effects analysis.ResultsHelplessness and internality partially mediated the relationship between health literacy/social support and self-management ((β=−0.212, p<0.01; β=0.240, p<0.01)/(β=−0.331, p<0.001; β=0.376, p<0.001)). The mediation effect size was 0.780 (95% CI (0.373 to 1.218)) in the health literacy model, accounting for 45.29% of the total effect, and 0.286 (95% CI (0.207 to 0.377)) in the social support model, accounting for 57.88% of the total effect. The differences in effect sizes for helplessness and internality in the two models were −0.080 (95% CI (−0.374 to 0.216)) and −0.041 (95% CI (−0.127 to 0.043)), respectively.ConclusionHealth literacy/social support directly affects MHD patients’ self-management and indirectly affects it by changing learned helplessness, such as increasing internality while reducing helplessness.
Protocol for a systematic review of substance use and misuse prevalence and associated factors among transgender and non-binary youth living in the USA
Authors: Mammadli Tural , Whitfield Darren L , Betz Gail , Mack Linda-Jeanne M 
Published: August 2023

BackgroundTransgender and gender non-binary (TNB) youth living in the USA report elevated levels of substance use compared with their cisgender counterparts, with previous literature pointing to minority stressors as some of the factors that could facilitate such elevated levels. Yet, substance use and misuse prevalence and associated modifiable factors among TNB youth are not fully known. The current paper details the protocol for a systematic review aimed at (1) identifying substance use and misuse prevalence among TNB youth (ages <25) and related demographic disparities (based on racial, ethnic and gender identity, and sexual orientation), (2) examining factors associated with substance use and misuse among TNB youth and (3) examining protective factors against substance use and misuse among TNB youth.Methods and analysisSystematic searches will be conducted across four databases: PubMed, LGBTQ+ Source, CINAHL and PsycInfo to identify quantitative, qualitative and mixed-methods peer-reviewed research publications. An exhaustive list of keywords and corresponding MeSH (Medical Subject Headings) terms representing the concepts of ‘TNB’ (the population of interest) and ‘substance use and misuse’ (outcome) will be employed. Identified records will be initially screened via a review of titles and abstracts. Full text of the remaining records will be reviewed corresponding to the inclusion and exclusion criteria. Extracted data will be synthesised in table and narrative format. A meta-analysis will be considered contingent on the existence of sufficient data. Methodological quality and risk of bias of studies will be assessed.Ethics and disseminationThis review does not require approval from the Institutional Review Board as it involves no interactions with human subjects. We will disseminate our findings via peer-reviewed manuscripts and academic conference presentations.PROSPERO registration numberCRD42023394985.
Association of fruit and vegetable intake with predicted 10-year cardiovascular disease risk among hypertensive patients in Addis Ababa, Ethiopia: a cross-sectional study
Authors: Mekonene Mulugeta , Gebremedhin Samson , Bikila Demiraw , Ashebir Genet , Baye Kaleab 
Published: August 2023

ObjectiveIn low-income countries, such as Ethiopia, few studies have evaluated the risk of cardiovascular disease (CVD) among hypertensive patients. We assessed the 10-year CVD risk of hypertensive patients.DesignThis cross-sectional study was part of a larger survey conducted in Addis Ababa. The 10-year CVD risk was calculated using the Framingham Risk Score (FRS) algorithm based on seven sex-specific risk factors as well as a country-specific Globorisk score. Fruits and vegetables (FV) consumption, salt intake and stress levels were measured with 24-hour dietary recall, INTERSALT equation and Cohen’s Perceived Stress Scale, respectively. A multiple linear regression model was fitted to explore the association.SettingAddis Ababa, Ethiopia, 2021.ParticipantsA sample of 191 patients diagnosed with hypertension.Outcome measuresPredicted 10-year cardiovascular risk of hypertensive patients.ResultsA total of 42.4%, 27.7% and 29.8% of hypertensive patients were at low, moderate and high CVD risks, respectively. The majority (80.1%) of patients consumed inadequate FV, 95.7% consumed salt >5 g/day and 58.1% had moderate to high-stress levels. There was a substantial agreement between the FRS and Globorisk prediction models (weighted kappa 0.77). In the unadjusted model, FV consumption (>450 g/day) and total fruit intake in the highest tertile were associated with 14.2% and 6.7% lower CVD risk, respectively. After adjusting for lifestyle factors, increasing FV intake from 120 to 450 g/day was significantly related to 11.1%–15.2% lower CVD risk in a dose–response manner. Additionally, total fruit, but not total vegetable intake in the highest tertile, was significantly associated with decreased CVD risk.ConclusionWe found a high prevalence of CVD risk among hypertensive patients. High FV consumption was inversely associated with CVD risk. This suggests that patients should be advised to increase FV intake to minimise CVD risk.
Disease-specific therapy for the treatment of the cardiovascular manifestations of Fabry disease: a systematic review
Authors: Orsborne Christopher , Black Nicholas , Naish Josephine H , Woolfson Peter , Reid Anna B , Schmitt Matthias , Jovanovic Ana , Miller Christopher A 
Published: August 2023

ObjectiveThe cardiovascular manifestations of Fabry disease are common and represent the leading cause of death. Disease-specific therapy, including enzyme replacement therapy (ERT) and chaperone therapy (migalastat), is recommended for patients exhibiting cardiovascular involvement, but its efficacy for modulating cardiovascular disease expression and optimal timing of initiation remains to be fully established. We therefore aimed to systematically review and evaluate the effectiveness of disease-specific therapy compared with placebo, and to no intervention, for the cardiovascular manifestations of Fabry disease.MethodsEight databases were searched from inception using a combination of relevant medical subject headings and keywords. Randomised, non-randomised studies with a comparator group and non-randomised studies without a comparator group were included. Studies were screened for eligibility and assessed for bias by two independent authors. The primary outcome comprised clinical cardiovascular events. Secondary outcomes included myocardial histology and measurements of cardiovascular structure, function and tissue characteristics.Results72 studies were included, comprising 7 randomised studies of intervention, 16 non-randomised studies of intervention with a comparator group and 49 non-randomised studies of intervention without a comparator group. Randomised studies were not at serious risk of bias, but the others were at serious risk. Studies were highly heterogeneous in their design, outcome measurements and findings, which made assessment of disease-specific therapy effectiveness difficult.ConclusionIt remains unclear whether disease-specific therapy sufficiently impacts the cardiovascular manifestations of Fabry disease. Further work, ideally in larger cohorts, with more standardised clinical and phenotypic outcomes, the latter measured using contemporary techniques, are required to fully elucidate the cardiovascular impact of disease-specific therapy.PROSPERO registration numberCRD42022295989.
Automated external defibrillator location and socioeconomic deprivation in Great Britain
Authors: Burgoine Thomas , Austin David , Wu Jianhua , Quinn Tom , Shurmer Pam , Gale Chris P , Wilkinson Chris 
Published: August 2023

ObjectiveThe early use of automated external defibrillators (AEDs) improves outcomes in out-of-hospital cardiac arrest (OHCA). We investigated AED access across Great Britain (GB) according to socioeconomic deprivation.MethodsCross-sectional observational study using AED location data from The Circuit: the national defibrillator network led by the British Heart Foundation in partnership with the Association of Ambulance Chief Executives, Resuscitation Council UK and St John Ambulance. We calculated street network distances between all 1 677 466 postcodes in GB and the nearest AED and used a multilevel linear mixed regression model to investigate associations between the distances from each postcode to the nearest AED and Index of Multiple Deprivation, stratified by country and according to 24 hours 7 days a week (24/7) access.Results78 425 AED locations were included. Across GB, the median distance from the centre of a postcode to an AED was 726 m (England: 739 m, Scotland: 743 m, Wales: 512 m). For 24/7 access AEDs, the median distances were further (991 m, 994 m, 570 m). In Wales, the average distance to the nearest AED and 24/7 AED was shorter for the most deprived communities. In England, the average distance to the nearest AED was also shorter in the most deprived areas. There was no association between deprivation and average distance to the nearest AED in Scotland. However, the distance to the nearest 24/7 AED was greater with increased deprivation in England and Scotland. On average, a 24/7 AED was in England and Scotland, respectively, 99.2 m and 317.1 m further away in the most deprived than least deprived communities.ConclusionIn England and Scotland, there are differences in distances to the nearest 24/7 accessible AED between the most and least deprived communities. Equitable access to ‘out-of-hours’ accessible AEDs may improve outcomes for people with OHCA.
Individualised evaluation based on pathophysiology for moyamoya vasculopathy: application in surgical revascularisation
Authors: Zhang Xin , Lei Yu , Su Jiabin , Gao Chao , Li Yanjiang , Feng Rui , Xia Ding , Gao Peng , Gu Yuxiang , Mao Ying 
Published: August 2023

Background
Although bypass surgery is an effective treatment for moyamoya vasculopathy (MMV), the incidence of postoperative complications is still high. This study aims to introduce a novel evaluating system based on individualised pathophysiology of MMV, and to assess its clinical significance.

Methods
This multicentre, prospective study enrolled adult patients with MMV from Huashan Hospital, Fudan University and National Center for Neurological Disorders, China between March 2021 and February 2022. Multimodal neuroimages containing structural and functional information were used to evaluate personalised disease severity and fused to localise the surgical field, avoid invalid regions and propose alternative recipient arteries. The recipient artery was further selected intraoperatively by assessing regional haemodynamic and electrophysiological information. The preanastomosis and postanastomosis data were compared with assist with the postoperative management. Patients who received such tailored revascularisations were included in the novel group and the others were included in the traditional group. The 30-day surgical outcomes and intermediate long-term follow-up were compared.

Results
Totally 375 patients (145 patients in the novel group and 230 patients in the traditional group) were included. The overall complication rate was significantly lower in the novel group (p˂0.001). In detail, both the rates of postoperative infarction (p=0.009) and hyperperfusion syndrome (p=0.010) were significantly lower. The functional outcomes trended to be more favourable in the novel group, though not significantly (p=0.260). Notably, the proportion of good functional status was higher in the novel group (p=0.009). Interestingly, the preoperative statuses of perfusion and metabolism around the bypass area were significantly correlated with the occurrence of postoperative complications (P˂0.0001).

Conclusions
This novel evaluating system helps to identify appropriate surgical field and recipient arteries during bypass surgery for MMV to achieve better haemodynamic remodelling and pathophysiological improvement, which results in more favourable clinical outcomes.
Synthesis, structures and alkane oxygenation reactivity of bioinspired fluoroalkyl iron phthalocyanines
Authors: Zhort Mufeda , Lee Hyun-Jin , Gorun Sergiu M. 
Published: August 2023

We report the synthesis, structural characterization and reactivity of perfluoroalkyl (R[Formula: see text] substituted perfluoro phthalocyanines, [F[Formula: see text]PcFe(II)L2], L = axial H2O, methanol or pyridine, and [F[Formula: see text]PcFe(III)L], L = methoxy and cyanide anions. X-ray structures of the Fe(II) complexes reveal that axial H2O and methanol are nested in the hydrophobic R[Formula: see text] pocket of the macrocycle. The aqua complexes exhibit columnar stacking with a central linear chain of H-bonded H2O-Fe-H2O groups that form a hydrophilic, linear “core“embedded in surrounding R[Formula: see text] groups. The electron-deficient fluoroalkyl fluoro ([Formula: see text]-C3F[Formula: see text]F8PcFe(II)L2 complexes are all low-spin, diamagnetic, unlike the F[Formula: see text]PcFe complex, L = H2O, which is paramagnetic. The P450-related PcFe(II) complexes, which exhibit no macrocyclic C-H bonds, catalyze cyclohexane (C[Formula: see text] oxygenations using both t-butyl hydroperoxide (TBHP) and air, without noticeable catalyst decomposition, to produce C6-alcohol and C6-ketone in ~1:1 ratio (KA-oil). Relatively high TOFs, 180 and 85/hr, are observed for TBHP and O2-based oxygenations, respectively. No catalyst decomposition is observed for at least 8 hours, even up to 100[Formula: see text]C, when O2 is the oxidant, in the absence of a co-reductant. Fluoroalkylated phthalocyanine iron catalysts lacking C-H bonds could be suitable for other aerobic oxidations and oxygenations.