bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apendicite aguda na gravidez: uma revisão integrativa
Authors: Zanuto Thiago Silva , Silva Laura Vilela Buiatte , Zanuto Bruno Silva , Gondin Milena Bavaresco , Daguer Julia Resende , Lobo Nayara Silva , Carpanezi Ana Luísa Tano Sanches 
Published: March 2023

Introdução: A Apendicite aguda na gravidez é a causa mais comum de doença abdominal não-obstétrica que determina a necessidade de cirurgia de urgência. Objetivo: Analisar os métodos utilizados para diagnosticar e tratar a apendicite aguda em pacientes gravidas, visando também diferenciar esses métodos quando realizados a pacientes não gravidas. O presente artigo trata-se de uma revisão integrativa de literatura. Foram utilizado os bancos de dados de artigos científicos para realizar as buscas:Us National Library Of Medicine (PUBMED) e Scientific Electronic Library Online (SCIELO). Foi utilizado os termos para ir de encontro à temática: “ Apendicite” AND “Gravidez” AND “Laparoscopia”. O recorte temporal engloba artigos publicados entre 1995 e 2022. A apendicite aguda na mulher gravida tem seu diagnostico dificultado devido as alterações anatomias e fisiológicas consequentes da gravidez, como por exemplo o deslocamento do apêndice devido ao crescimento do útero. Em caso de apendicite aguda na mulher a cirurgia por vídeo laparoscopia é o melhor método a ser empregado, uma vez que proporciona vantagens no pós-operatório que a cirurgia a céu aberto não proporciona. A apendicite aguda em gravidas mesmo apresentando baixa mortalidade nos dias atuais, precisa ter seu diagnóstico feito de forma rápida uma vez que a perfuração do apêndice pode elevar a mortalidade e colocar mãe e feto em risco.
Phylogenetic relationships of Mycobacterium tuberculosis isolates in Poland: The emergence of Beijing genotype among multidrug-resistant cases
Authors: Bakuła Zofia , Marczak Mateusz , Bluszcz Agata , Proboszcz Małgorzata , Kościuch Justyna , Krenke Rafał , Stakėnas Petras , Mokrousov Igor , Jagielski Tomasz 
Published: March 2023

IntroductionThe epidemiological situation of tuberculosis (TB) in Poland urges for its continuous and scrupulous monitoring. The objective of this study was to explore the genetic diversity of multidrug-resistant (MDR) and drug-susceptible (DS) Mycobacterium tuberculosis isolates from Poland with a combination of spoligotyping and high-resolution mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) analysis. The results were placed in the Northern and Eastern Europe context.MethodsThe study included 89 (39 MDR and 50 DS) M. tuberculosis isolates collected from as many patients between 2018 and 2021 in Poland. The analysis was done using spoligotyping, and MIRU-VNTR typing at 24 standard loci. The data were compared to those available on Poland and neighbors and global M. tuberculosis datasets.ResultsThe main identified families were Beijing (28.1%) and Haarlem (16.8%) while 34.8% of isolates were in the heterogeneous L4-unclassified group. Although the Beijing family was the most prevalent (61.5%) among MDR-TB cases, it accounted for only 2% of DS isolates. Among foreign-born patients, a higher ratio of MDR isolates were observed when compared with those who Poland-born (64.3% vs. 40%). Furthermore, all patients from the Former Soviet Union (FSU) countries were infected with MDR-TB.DiscussionWhereas DS M. tuberculosis population in Poland is dominated by L4 isolates, MDR isolates are mostly of the Beijing genotype. The rise in the prevalence of the Beijing isolates in Poland, coupled with high proportion of the Beijing genotype among foreign-born TB patients may reflect an ongoing transmission of this family, imported to Poland mainly from FSU countries.
What does the public think about artificial intelligence?—A criticality map to understand bias in the public perception of AI
Authors: Brauner Philipp , Hick Alexander , Philipsen Ralf , Ziefle Martina 
Published: March 2023

IntroductionArtificial Intelligence (AI) has become ubiquitous in medicine, business, manufacturing and transportation, and is entering our personal lives. Public perceptions of AI are often shaped either by admiration for its benefits and possibilities, or by uncertainties, potential threats and fears about this opaque and perceived as mysterious technology. Understanding the public perception of AI, as well as its requirements and attributions, is essential for responsible research and innovation and enables aligning the development and governance of future AI systems with individual and societal needs.MethodsTo contribute to this understanding, we asked 122 participants in Germany how they perceived 38 statements about artificial intelligence in different contexts (personal, economic, industrial, social, cultural, health). We assessed their personal evaluation and the perceived likelihood of these aspects becoming reality.ResultsWe visualized the responses in a criticality map that allows the identification of issues that require particular attention from research and policy-making. The results show that the perceived evaluation and the perceived expectations differ considerably between the domains. The aspect perceived as most critical is the fear of cybersecurity threats, which is seen as highly likely and least liked.DiscussionThe diversity of users influenced the evaluation: People with lower trust rated the impact of AI as more positive but less likely. Compared to people with higher trust, they consider certain features and consequences of AI to be more desirable, but they think the impact of AI will be smaller. We conclude that AI is still a “black box” for many. Neither the opportunities nor the risks can yet be adequately assessed, which can lead to biased and irrational control beliefs in the public perception of AI. The article concludes with guidelines for promoting AI literacy to facilitate informed decision-making.
Correlations between serum laminin level and severity of heart failure in patients with chronic heart failure
Authors: Xie Ling , Zhou Zhen , Chen Hai-Xiao , Yan Xiao-Yun , Ye Jia-Qi , Jiang Ying , Zhou Lei , Zhang Qing 
Published: March 2023

ObjectiveThis study aimed to investigate the correlation between serum laminin (LN) levels and clinical stages of heart failure in patients with chronic heart failure.MethodsA total of 277 patients with chronic heart failure were selected from September 2019 to June 2020 in the Department of Cardiology, Second Affiliated Hospital of Nantong University. Based on stages of heart failure, the patients were divided into four groups: stage A, stage B, stage C, and stage D, with 55, 54, 77, and 91 cases, respectively. At the same time, 70 healthy people in this period were selected as the control group. Baseline data were recorded and serum Laminin (LN) levels were measured. The research compared, the differences in baseline data among the four groups of HF and normal controls, and analyzed the correlation between N-terminal pro-brain natriuretic peptide (NT-proBNP) and left ventricular ejection fraction (LVEF). The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of LN in the C-D stage of heart failure. Logistic multivariate ordered analysis was applied to screen the independent related factors of clinical stages of heart failure.ResultsSerum LN levels in patients with chronic heart failure were significantly higher than those in healthy people, which were 33.2 (21.38, 101.9) ng/ml and 20.45 (15.53, 23.04) ng/ml, respectively. With the progression of clinical stages of HF, serum LN and NT-proBNP levels increased, while LVEF gradually decreased (P &lt; 0.05). Correlation analysis showed that LN was positively correlated with NT-proBNP (r = 0.744, P = 0.000) and negatively correlated with LVEF (r = −0.568, P = 0.000). The area under the ROC curve of LN for predicting C and D stages of heart failure was 0.913, 95% confidence interval was 0.882–0.945, P = 0.000, specificity 94.97%, and sensitivity 77.38%. Multivariate Logistic analysis showed that LN, Total bilirubin, NT-proBNP and HA were all independent correlates of heart failure staging.ConclusionSerum LN levels in patients with chronic heart failure are significantly increased and are independently correlated with the clinical stages of heart failure. It could potentially be an early warning index of the progression and severity of heart failure.
Age, sex and angiographic type-related phenotypic differences in inpatients with Takayasu arteritis: A 13-year retrospective study at a national referral center in China
Authors: Zhou Jingya , Li Jing , Wang Yi , Yang Yunjiao , Zhao Jiuliang , Li Mengtao , Pang Haiyu , Wang Tingyu , Chen Yuexin , Tian Xinping , Zeng Xiaofeng , Zheng Yuehong 
Published: March 2023

BackgroundsWe aimed to investigate the demographic characteristics, vascular involvement, angiographic patterns, complications, and associations of these variables in a large sample of TAK patients at a national referral center in China.MethodsThe medical records of TAK patients discharged from 2008 to 2020 were retrieved from the hospital discharge database using ICD-10 codes. Demographic data, vascular lesions, Numano classifications and complications were collected and analyzed.ResultsThe median age at onset was 25 years in 852 TAK patients (670 female, 182 male). Compared with the females, the male patients were more likely to have type IV and were more likely to have iliac (24.7% vs. 10.0%) and renal artery (62.7% vs. 53.9%) involvement. They also had a higher prevalence of systemic hypertension (62.1% vs. 42.4%), renal dysfunction (12.6% vs. 7.8%) and aortic aneurysm (AA) (8.2% vs. 3.6%). The childhood-onset group was more likely to have involvement of the abdominal aorta (68.4% vs. 52.1%), renal artery (69.0% vs. 51.8%) and superior mesenteric artery (41.5% vs. 28.5%), and they were more likely to have type IV, V and hypertension than the adult-onset group. After adjusting for sex and age at onset, the patients with type II were associated with an increased risk of cardiac dysfunction (II vs. I: OR = 5.42; II vs. IV: OR = 2.63) and pulmonary hypertension (II vs. I: OR = 4.78; II vs. IV: OR = 3.95) compared with those with types I and IV. Valvular abnormalities (61.0%) were observed to be most prevalent in patients with type IIa. The patients with Type III were associated with a higher risk of aortic aneurysm (23.3%) than the patients with types IV (OR = 11.00) and V (OR = 5.98). The patients with types III and IV were more commonly complicated with systemic hypertension than the patients with types I, II and V. P &lt; 0.05 in all of the above comparisons.ConclusionSex, adult/childhood presentation and Numano angiographic type were significantly associated with differences in phenotypic manifestations, especially cardiopulmonary abnormalities, systemic hypertension, renal dysfunction and aortic aneurysm.
Comparing the effectiveness and safety of dual antiplatelet with ticagrelor or clopidogrel in elderly Asian patients with acute myocardial infraction
Authors: Yeh Jong-Shiuan , Chen Wan-Ting , Tomlinson Brian , Tam Weng-Chio , Chien Li-Nien 
Published: March 2023

BackgroundCurrent guidelines recommend potent P2Y12 inhibitors for patients after acute coronary syndrome. However, the data on the efficacy and safety of potent P2Y12 inhibitors in elderly Asian populations was limited. We aimed to investigate the major adverse cardiovascular events (MACE), bleeding events, and net adverse clinical events (NACE) with ticagrelor and clopidogrel in Taiwanese patients aged 65 and older after acute myocardial infarction (AMI).MethodsThis retrospective population-based cohort study was conducted using data from the National Health Insurance Research Database. The AMI patients aged ≥65 years who underwent percutaneous coronary intervention (PCI) and survived after 1 month were included. The patients were separated into 2 cohorts depending on the type of dual antiplatelet therapy (DAPT) they received: ticagrelor plus aspirin (T + A) or clopidogrel plus aspirin (C + A). We used inverse probability of treatment weighting to balance the difference between these 2 study groups. The outcome included all-cause mortality, MACE (cardiovascular death, nonfatal ischemic stroke, and nonfatal myocardial infarction), intracerebral hemorrhage, major bleeding, and NACE which is composed of cardiovascular death, ischemic and hemorrhagic events. The follow-up period was up to 12 months.ResultsFrom 2013 to 2017, a total of 14,715 patients who met the eligibility criteria were separated into 2 groups: 5,051 for T + A and 9,664 for C + A. Compared to patients with C + A, patients who received T + A had a lower risk of cardiovascular death and all-cause death, with an adjusted HR of 0.57 [95% confidence interval (CI), 0.38–0.85, p = 0.006] and 0.58 (95% CI 0.45–0.74, p &lt; 0.001), respectively. No differences were found in MACE, intracranial and major bleeding between the 2 groups. In addition, the patients with T + A had a lower risk of NACE with an adjusted HR of 0.86 (95% CI 0.74–1.00, p = 0.045)ConclusionAmong elderly AMI patients receiving DAPT after successful PCI, ticagrelor was a more favorable P2Y12 inhibitor than clopidogrel because of lowering the risk of death and NACE without increasing the risk of severe bleeding. Ticagrelor is an effective and safe P2Y12 inhibitor in Asian elderly survivors after PCI.
Quality and cost of healthcare services in patients with diabetes in Iran: Results of a nationwide short-term longitudinal survey
Authors: Abbasi-Kangevari Mohsen , Mohebi Farnam , Ghamari Seyyed-Hadi , Modirian Mitra , Shahbal Nazila , Ahmadi Naser , Farzi Yosef , Azmin Mehrdad , Roshani Shahin , Zokaei Hossein , Khezrian Maryam , Seyfi Shahedeh , Keykhaei Mohammad , Gorgani Fatemeh , Rahimi Saral , Rezaei Negar , Khatibzadeh Shahab , Shahraz Saeid 
Published: March 2023

AimsTo investigate the journey of patients with diabetes in the healthcare system using nationally-representative patient-reported data.MethodsParticipants were recruited using a machine-learning-based sampling method based on healthcare structures and medical outcome data and were followed up for three months. We assessed the resource utilization, direct/indirect costs, and quality of healthcare services.ResultsOne hundred fifty-eight patients with diabetes participated. The most utilized services were medication purchases (276 times monthly) and outpatient visits (231 times monthly). During the previous year, 90% of respondents had a laboratory fasting blood glucose assessment; however, less than 70% reported a quarterly follow-up physician visit. Only 43% had been asked about any hypoglycemia episodes by their physician. Less than 45% of respondents had been trained for hypoglycemia self-management. The annual average health-related direct cost of a patient with diabetes was 769 USD. The average out-of-pocket share of direct costs was 601 USD (78.15%). Medication purchases, inpatient services, and outpatient services summed up 79.77% of direct costs with a mean of 613 USD.ConclusionHealthcare services focused solely on glycemic control and the continuity of services for diabetes control was insufficient. Medication purchases, and inpatient and outpatient services imposed the most out-of-pocket costs.
The association between maternal HbA1c and adverse outcomes in gestational diabetes
Authors: Muhuza Marie Parfaite Uwimana , Zhang Lixia , Wu Qi , Qi Lu , Chen Danqing , Liang Zhaoxia 
Published: March 2023

BackgroundThe role of HbA1c in women with gestational diabetes mellitus (GDM) is still unclear, particularly in the Asian population.AimTo investigate the association between HbA1c levels and adverse outcomes considering maternal age, pre-pregnancy body mass index (BMI), and gestational weight gain (GWG) in women with GDM.MethodA retrospective study included 2048 women with GDM and singleton live births. Using logistic regression, the associations between HbA1c and adverse pregnancy outcomes were assessed.ResultCompared to women with HbA1c ≤ 5.0%, HbA1c was significantly associated with macrosomia (aOR 2.63,95%CI1.61,4.31), pregnancy-induced hypertension (PIH, aOR 2.56,95%CI1.57,4.19), preterm birth (aOR 1.64,95%CI 1.05,2.55), and primary Cesarean section (primary C-section, aOR1.49,95%CI1.09,2.03) in GDM women with HbA1c ≥5.5% while significantly associated with PIH (aOR 1.91,95%CI1.24,2.94) in women with HbA1c 5.1-5.4%. The associations between HbA1c and adverse outcomes varied with maternal age, pre-pregnancy BMI, and GWG. In women aged ≤29 years, there’s significant association between HbA1c and primary C-section when HbA1c was 5.1-5.4% and ≥5.5%. In women aged 29-34 years and HbA1c ≥5.5%, HbA1c was significantly associated with macrosomia. In women aged ≥35 years, there’s significant association between HbA1c and preterm birth when HbA1c was 5.1-5.4% and macrosomia and PIH when HbA1c ≥5.5%. In pre-pregnant normal-weight women, HbA1c was significantly associated with macrosomia, preterm birth, primary C-section, and PIH when HbA1c ≥5.5% while HbA1c was significantly associated with PIH when HbA1c was 5.1-5.4% . In pre-pregnant underweight women with HbA1c 5.1-5.4%, HbA1c was significantly associated with primary C-section. HbA1c was significantly associated with macrosomia among women with inadequate GWG or excess GWG and HbA1c≥5.5%. In women with adequate GWG, there’s significant association between HbA1c and PIH when HbA1c was 5.1-5.4% and ≥5.5% .ConclusionConclusively, HbA1c at the time of diagnosis is significantly associated with macrosomia, preterm birth, PIH, and primary C-section in Chinese women with GDM.
Clinicopathological features and prognosis of idiopathic membranous nephropathy with thyroid dysfunction
Authors: Wang Peiheng , Wang Shulei , Huang Bo , Liu Yiming , Liu Yingchun , Chen Huiming , Zhang Junjun 
Published: March 2023

BackgroundThyroid dysfunction is common in patients with kidney disease. However, the relationship between thyroid dysfunction and idiopathic membranous nephropathy (IMN) remains unclear. This retrospective study aimed to investigate the clinicopathological characteristics and prognosis of patients with IMN and thyroid dysfunction compared to patients with IMN and without thyroid dysfunction.MethodsA total of 1052 patients with IMN diagnosed by renal biopsy were enrolled in this study, including 736 (70%) with normal thyroid function and 316 (30%) with abnormal thyroid function. We analyzed the clinicopathological features and prognostic data between the two groups, using propensity score matching (PSM) to reduce the bias. Logistic regression analysis was performed to investigate the risk factors for IMN combined with thyroid dysfunction. Kaplan-Meier curves and Cox regression analysis were used to evaluate the association between thyroid dysfunction and IMN.ResultsPatients with IMN and thyroid dysfunction exhibited more severe clinical features. Female sex, lower albumin level, higher D-dimer level, severe proteinuria, and decreased estimated glomerular filtration rate were predictors of thyroid dysfunction in patients with IMN. After PSM, 282 pairs were successfully matched. Results from the Kaplan-Meier curves indicated that the thyroid dysfunction group had a lower complete remission rate (P = 0.044), higher relapse rate (P &lt; 0.001), and lower renal survival rate (P = 0.004). The multivariate Cox regression analysis revealed that thyroid dysfunction was an independent risk factor for complete remission [hazard ratio (HR) = 0.810, P = 0.045], relapse (HR = 1.721, P = 0.001), and composite endpoint event (HR = 2.113, P = 0.014) in IMN.ConclusionsThyroid dysfunction is relatively common in patients with IMN, and the clinical indicators are more severe in these patients. Thyroid dysfunction is an independent risk factor for poor prognosis in patients with IMN. More attention should be paid to thyroid function in patients with IMN.
EpiCRISPR targeted methylation of Arx gene initiates transient switch of mouse pancreatic alpha to insulin-producing cells
Authors: Đorđević Marija , Stepper Peter , Feuerstein-Akgoz Clarissa , Gerhauser Clarissa , Paunović Verica , Tolić Anja , Rajić Jovana , Dinić Svetlana , Uskoković Aleksandra , Grdović Nevena , Mihailović Mirjana , Jurkowska Renata Z. , Jurkowski Tomasz P. , Jovanović Jelena Arambašić , Vidaković Melita 
Published: March 2023

IntroductionBeta cell dysfunction by loss of beta cell identity, dedifferentiation, and the presence of polyhormonal cells are main characteristics of diabetes. The straightforward strategy for curing diabetes implies reestablishment of pancreatic beta cell function by beta cell replacement therapy. Aristaless-related homeobox (Arx) gene encodes protein which plays an important role in the development of pancreatic alpha cells and is a main target for changing alpha cell identity.ResultsIn this study we used CRISPR/dCas9-based epigenetic tools for targeted hypermethylation of Arx gene promoter and its subsequent suppression in mouse pancreatic αTC1-6 cell line. Bisulfite sequencing and methylation profiling revealed that the dCas9-Dnmt3a3L-KRAB single chain fusion constructs (EpiCRISPR) was the most efficient. Epigenetic silencing of Arx expression was accompanied by an increase in transcription of the insulin gene (Ins2) mRNA on 5th and 7th post-transfection day, quantified by both RT-qPCR and RNA-seq. Insulin production and secretion was determined by immunocytochemistry and ELISA assay, respectively. Eventually, we were able to induce switch of approximately 1% of transiently transfected cells which were able to produce 35% more insulin than Mock transfected alpha cells.ConclusionIn conclusion, we successfully triggered a direct, transient switch of pancreatic alpha to insulin-producing cells opening a future research on promising therapeutic avenue for diabetes management.
Serum creatinine levels, traditional cardiovascular risk factors and 10-year cardiovascular risk in Chinese patients with hypertension
Authors: Chen Xin , Jin Hang , Wang Dan , Liu Jiali , Qin Yu , Zhang Yongqing , Zhang Yuqing , Xiang Quanyong 
Published: March 2023

BackgroundSerum creatinine is associated with cardiovascular risk and cardiovascular events, however, the relationship between serum creatinine levels and cardiovascular risk is not well established in hypertensive population in Jiangsu Province. We aimed to evaluate the association of serum creatinine levels with traditional cardiovascular risk factors and 10-year cardiovascular risk in a Chinese hypertensive population.MethodsParticipants were patients with hypertension registered and enrolled in health service centers in 5 counties or districts from January 2019 to May 2020 in Jiangsu Province of China followed strict inclusion and exclusion criteria, demographics as well as clinical indicators and disease history and lifestyle were collected. Participants were divided into four groups according to quartiles of serum creatinine levels, then the China-PAR model was used to calculate 10-year cardiovascular risk for each individual.ResultsA total of 9978 participants were enrolled in this study, 4173(41.82%) were males. The blood pressure level and prevalence of dyslipidemia, elderly, current smokers and drinking as well as obesity were higher in the Q4 group than the Q1 group (all P &lt; 0.05). Multivariable logistic regression showed that serum creatinine in the Q4 group compared with that in the Q1 group was positively associated with overweight and obesity (OR=1.432, 95% CI 1.237-1.658, P&lt;0.001), while negatively associated with physical activity (OR=0.189, 95%CI 0.165-0.217, P&lt;0.001), and so on. Multiple linear regression showed 10-year cardiovascular risk is positively associated with serum creatinine levels after adjusting for multiple risk factors (β=0.432, P&lt; 0.001).ConclusionSerum creatinine was associated with several traditional cardiovascular risk factors and the 10-year cardiovascular risk in hypertensive patients. Creatinine-reduction and kidney-sparing therapy are essential for patients with hypertension to optimize control of cardiovascular risk.