bluuebunny/crossref_metadata_2025_split huggingface dataset:
Area deprivation and demographic factors associated with diabetes technology use in adults with type 1 diabetes in Germany
Authors: Auzanneau Marie , Eckert Alexander J. , Meyhöfer Sebastian M. , Heni Martin , Gillessen Anton , Schwettmann Lars , Jehle Peter M. , Hummel Michael , Holl Reinhard W. 
Published: August 2023

IntroductionDiabetes technology improves glycemic control and quality of life for many people with type 1 diabetes (T1D). However, inequalities in access to diabetes technology exist in many countries. In Germany, disparities in technology use have been described in pediatric T1D, but no data for adults are available so far. We therefore aimed to analyze whether demographic factors and area deprivation are associated with technology use in a representative population of adults with T1D.Materials and methodsIn adults with T1D from the German prospective diabetes follow-up registry (DPV), we analyzed the use of continuous subcutaneous insulin infusion (CSII), continuous glucose monitoring (CGM), and sensor augmented pump therapy (SAP, with and without automated insulin delivery) in 2019-2021 by age group, gender, migration background, and area deprivation using multiple adjusted regression models. Area deprivation, defined as a relative lack of area-based resources, was measured by quintiles of the German index of Multiple Deprivation (GIMD 2015, from Q1, least deprived, to Q5, most deprived districts).ResultsAmong 13,351 adults with T1D, the use of technology decreased significantly with older age: CSII use fell from 56.1% in the 18−&lt;25-year age group to 3.1% in the ≥80-year age group, CGM use from 75.3% to 28.2%, and SAP use from 45.1% to 1.5% (all p for trend &lt;0.001). The use of technology was also significantly higher in women than in men (CSII: 39.2% vs. 27.6%; CGM: 61.9% vs. 58.0%; SAP: 28.7% vs. 19.6%, all p &lt;0.001), and in individuals without migration background than in those with migration background (CSII: 38.8% vs. 27.6%; CGM: 71.1% vs. 61.4%; SAP: 30.5% vs. 21.3%, all p &lt;0.001). Associations with area deprivation were not linear: the use of each technology decreased only from Q2 to Q4.DiscussionOur real-world data provide evidence that higher age, male gender, and migration background are currently associated with lower use of diabetes technology in adults with T1D in Germany. Associations with area deprivation are more complex, probably due to correlations with other factors, like the higher proportion of migrants in less deprived areas or the federal structure of the German health care system.
Evaluation of bone mineral density and bone turnover in children on anticoagulation
Authors: Thom Katharina , Patsch Janina Maria , Haufler Florentina , Pees Christiane , Albinni Sulaima , Weber Michael , Male Christoph , Raimann Adalbert 
Published: August 2023

BackgroundChildhood and adolescence are critical periods of bone mineral acquisition. Children on anticoagulation (AC) might have an increased risk for reduced bone mineral density (BMD). Risk factors for impaired bone accumulation include chronic diseases, immobility, and medication. Vitamin K (VK) deficiency reflected by undercarboxylated osteocalcin levels (ucOC) has been identified as a predictor of osteoporosis and fractures. Data on bone health in children under AC are sparse.AimsTo evaluate BMD in children on AC and characterize the risk factors of low BMD, including VK and Vitamin D (VD) status.MethodsSingle-center cross-sectional study of clinical, biochemical, and densitometric parameters. Assessment of VK surrogate parameters included ucOC and matrix gla protein (MGP).ResultsA total of 39 children (4–18 years; 12 females) receiving AC were included, 31 (79%) on VK antagonists and 8 (21%) on direct oral anticoagulants. Overall, BMD was decreased for both the lumbar spine (LS; −0.7SDS) and total body less head (TBLH; −1.32SDS) compared with pediatric reference data. Significant associations were found between early pubertal development and TBLH-BMD, and between BMI and LS-BMD. VK surrogate parameters were highly related to patients’ age and pubertal development. Neither serum parameters nor AC-related factors predicted BMD. VD was detected in 10/39 patients with lower values during puberty.ConclusionOur data indicate BMD reduction in pediatric patients on AC. Although AC-related factors did not predict reduced BMD, low BMI and pubertal stages represented important risk factors. Awareness of risk factors for low BMD and high prevalence of VD deficiency during puberty could contribute to the improvement of bone health in this vulnerable patient group.
Effect of 10.6 μm laser moxibustion on inflammation in diabetic peripheral neuropathy rats
Authors: Yin Yue , Wang Lina , Zhao Ling , Lin Lin , Shen Xueyong 
Published: August 2023

Diabetic peripheral neuropathy (DPN) is the main cause of disability in diabetes patients but the efficacy of available drugs is poor. Moxibustion is an adjunctive treatment for DPN that can reduce symptoms. The peak value of the far infrared wavelength of 10.6 μm laser moxibustion is close to the infrared radiation spectrum of traditional moxibustion. Its effect is similar to that of moxibustion and does not cause pain, infection or produce irritating smoke. Twenty-four male SD rats were divided into control (Con), DPN, laser moxibustion (LM), and pyrrolidine dithiocarbamate (PDTC) groups (n=6/group). The DPN, LM and PDTC group rats were intraperitoneally injected with 1% streptozotocin (STZ) to induce a model of DPN. LM group rats were irradiated with a laser at bilateral ST36 acupoints for 15 min, once every other day, for 14 days. PDTC group rats were intraperitoneally injected with PDTC once a day. Body weight, blood glucose, and paw withdrawal mechanical threshold (PWMT) were measured and laser speckle imaging (LSI) performed before and after modeling and at 1 and 2 weeks after intervention. Two weeks after intervention, changes in serum interleukin 1β (IL1β), interleukin 6 (IL6), tumor necrosis factor α (TNFα) and nerve growth factor (NGF) were analyzed, and the abundance of NF-κB and IκB-α proteins and levels of NF-κB and IκB-α mRNAs in the sciatic nerve were observed. The results showed that 10.6 μm laser moxibustion can relieve pain, improve microcirculation, and alleviate inflammation in DPN rats, possibly via the NF-κB inflammatory pathway.
The causal effect of inflammatory bowel disease on diffuse large B-cell lymphoma: two-sample Mendelian randomization study
Authors: Lu Chuanyang , Chen Qiuni , Tao Hong , Xu Lei , Li Jiaxin , Wang Chunling , Yu Liang 
Published: August 2023

BackgroundIt has been reported that inflammatory bowel disease (IBD) is associated with an increased risk of malignancies, including lymphoma. A number of large observational studies have been devoted to exploring the causal link between IBD and malignant lymphoma. However, no consensus exists on whether there is a causal relationship between IBD and malignant lymphoma.MethodsThe summary dataset of the IBD and lymphoma genome-wide association studies (GWAS) was obtained from the OPEN GWAS website. Single-nucleotide polymorphisms (SNPs) were selected as genetic instrumental variants (IVs) for fulling P &lt; 5 × 10-8 and linkage disequilibrium (LD) of r2 = 0.001 in the IBD GWAS. The proxy SNPs with LD of r2 &gt; 0.8 were identified. Palindromic SNPs and outlier SNPs were excluded. The assessments of sensitivity employed the Cochran’s Q test, Mendelian randomization (MR)-Egger intercept test, and leave-one-out analysis.ResultsThe MR analysis results proved the causality of IBD on diffuse large B-cell lymphoma (DLBCL). The risk of developing DLBCL is increased by 28.6% in patients with IBD [odds ratio (OR)IVW = 1.286, 95% confidence interval (CI) 1.066–1.552, P = 0.009]. The results of the subgroup analysis showed that Crohn’s disease (ORIVW = 1.218, 95% CI 1.030–1.441, P = 0.021) rather than ulcerative colitis (ORIVW = 1.206, 95% CI 0.984–1.478, P = 0.072) had a causal effect on DLBCL. No horizontal and directional pleiotropy was observed in the MR studies.ConclusionsThe above MR study concluded that IBD itself is causally responsible for DLBCL, especially Crohn’s disease. Further investigations are needed to elucidate the mechanism underlying this direct causal link.
Identification of ferroptosis-related genes as potential diagnostic biomarkers for diabetic nephropathy based on bioinformatics
Authors: Guo Binbin , Li Minhui , Wu Peipei , Chen Yan 
Published: August 2023

Objective: This study investigated to probe ferroptosis-related diagnostic biomarkers and underlying molecular mechanisms in Diabetic nephropathy (DN).Methods: GSE30122 and GSE1009 from GEO database were used as training and verification sets, respectively, to screen differentially expressed ferroptosis-related genes (FRGs). These genes were further analyzed using GO, KEGG, and GSEA methods, and screened with PPI, LASSO, and SVM-RFE to identify ferroptosis-related diagnostic biomarkers for DN. A diagnostic model was established using the Glm function and verified with ROC curve. The relationship between these biomarkers and immune cell was analyzed, and qRT-PCR and Western blot were used to detect the expression of these biomarkers in kidney tissues and identify the effect of TP53 on DN development.Results: Fifty one differentially expressed FRGs were enriched in bioprocesses such as p53 signaling pathway, oxidative stress and chemical stress response, and mTOR signaling pathway. TP53, RB1, NF2, RRM2, PRDX1, and CDC25A were identified as ferroptosis-related diagnostic biomarkers for DN. TP53 showed the most differential expression. ROC analysis showed that AUC values of TP53, RB1, NF2, RRM2, PRDX1, and CDC25A were 0.751, 0.705, 0.725, 0.882, 0.691, and 0.675, respectively. The AUC value of DN diagnosis model was 0.939 in training set and 1.000 in verification set. qRT-PCR results confirmed significant differences in these six biomarkers between DN and normal kidney tissue (p &lt; 0.05), and correlation analysis showed that five biomarkers were significantly correlated with infiltrating immune cells (p &lt; 0.05). Furthermore, western blots showed that TP53 promotes apoptosis through PI3K-AKT signaling in DN.Conclusion:TP53, RB1, NF2, RRM2, PRDX1, and CDC25A have potential as diagnostic biomarkers for DN. The diagnostic model containing the above six biomarkers performs well in the diagnosis of DN. Five of the six biomarkers are strongly associated with several infiltrating immune cells. TP53 may play an essential role in the development of DN.
The effect of accompanying anxiety and depression on patients with different vestibular syndromes
Authors: Feng Shuai , Zang Jian 
Published: August 2023

ObjectiveThis study aims to investigate the situation of vertigo disorder combined with anxiety and depression in patients with different types of vestibular syndrome.MethodsA total of 330 patients with vertigo in otolaryngology outpatient department were selected, and clinical information such as age, gender, and scores of Dizziness handicap inventory (DHI), Generalized anxiety disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) were collected. Analyzed the differences among acute vestibular syndrome (AVS), episodic vestibular syndrome (EVS) and chronic vestibular syndrome (CVS) in terms of age, gender, comorbid anxiety and depression, and the multivariate ordered logistic regression analysis was used to evaluate the relationship between the above factors and the degree of vertigo disorder.ResultsThe three types of vestibular syndrome had no significant difference in age composition, sex composition, anxiety and depression. There was no significant difference in the probability of anxiety and depression among vertigo patients of different ages and genders. The total score of vertigo disorder and each sub-item score were higher in patients with anxiety and depression. Patients with anxiety mainly manifested in EVS and CVS, while patients with depression mainly manifested in EVS and AVS. The probability of increased vertigo in anxious patients was 4.65 times that of non-anxious patients, and the probability of increased vertigo in depressed patients was 3.49 times that of non-depressed patients. Age and gender had no statistically significant effect on the degree of vertigo. In patients with EVS, anxiety and depression had a significant effect on the degree of vertigo; in patients with CVS, anxiety had a significant effect on the degree of vertigo, but depression had no significant effect.ConclusionAge and gender do not significantly affect the degree of vertigo disorder and mental state in various vestibular syndromes. Instead, anxiety and depression are the risk factors for aggravating the degree of vertigo disorder, and manifest differently in each type of vestibular syndrome. Therefore, it is necessary to use a quick scale tool to conduct a standardized screening of the psychological status of patients with vertigo.
Salvianolic acid B attenuates inflammation and prevent pathologic fibrosis by inhibiting CD36-mediated activation of the PI3K-Akt signaling pathway in frozen shoulder
Authors: Yan Yan , Zhou Min , Meng Ke , Zhou Chuanhai , Jia Xiaoyu , Li Xinhao , Cui Dedong , Yu Menglei , Tang Yiyong , Li Ming , Zhang Jinming , Wang Zhuo , Hou Jingyi , Yang Rui 
Published: August 2023

Frozen shoulder (FS) is characterized by pain and limited range of motion (ROM). Inflammation and fibrosis are accepted as main pathologic processes associated with the development of FS. However, the intrinsic mechanisms underlying pathologic fibrosis remain unclear. We aimed to elucidate the key molecules involved in pathologic fibrosis and explore new therapeutic targets for FS. Synovial fibroblasts isolated from patient biopsies were identified using immunofluorescence. Western blotting, RT-qPCR, cell adhesion tests, and would-healing assays were used to evaluate the fibrosis-related functions of synovial fibroblasts. Elevated cluster of differentiation 36 (CD36) expression was detected in FS using Western blotting and immunohistochemistry. Salvianolic acid b (SaB) inhibited CD36, blocking synovial fibroblast-induced inflammation and fibrosis. Our RNA-seq data showed that knocking down CD36 dramatically impaired the capacity of synovial fibroblasts for cell adhesion and that the PI3K-Akt signaling pathway may be crucial to the fibrotic process of FS. By up-regulating CD36 and inhibiting the phosphorylation of Akt, we demonstrated that CD36 promotes pathologic fibrosis by activating the PI3k-Akt pathway. Finally, rats treated with SaB had improved ROM and less collagen fiber deposition than the FS model group.Conclusion: SaB attenuates inflammation and inhibited the CD36-mediated activation of the PI3K-Akt signaling pathway to block pathologic fibrosis of FS in vitro and in vivo models.
Evaluating employability in contexts of change: validation of a scale
Authors: González-Navarro Pilar , Córdoba-Iñesta Ana Isabel , Casino-García Ana María , Llinares-Insa Lucía Inmaculada 
Published: August 2023

IntroductionEmployability is a crucial factor in managing to emerge and changing job demands. This study validates an expanded version of the Employability Appraisal Scale: EAS-60, as an instrument to identify and improve competencies for employability.MethodThe EAS-60 was tested in a cross-sectional study in a Spanish population. An exploratory study was carried out using a sample of 188 workers, and the scale’s structure was analyzed and confirmed in two Confirmatory Factor Analyses using a sample of 527 workers. Finally, reliability and validity were evaluated.ResultsExploratory and confirmatory analyses provide evidence supporting the multi-dimensional structure. The scale presents good psychometric properties and criteria for interpreting the scores.DiscussionThe EAS-60 is a reliable and valid instrument. It allows Human Resource Managers to offer career plans at work that include specific actions of job socialization, training, improvement of specific skills, etc. Furthermore, employees can increase their employability and develop their professional careers.
Adjunctive repetitive transcranial magnetic stimulation for adolescents with first-episode major depressive disorder: a meta-analysis
Authors: Sun Chen-Hui , Mai Jian-Xin , Shi Zhan-Ming , Zheng Wei , Jiang Wen-Long , Li Ze-Zhi , Huang Xing-Bing , Yang Xin-Hu , Zheng Wei 
Published: August 2023

ObjectiveThis meta-analysis of randomized clinical trials (RCTs) was conducted to explore the therapeutic effects, tolerability and safety of repetitive transcranial magnetic stimulation (rTMS) as an adjunct treatment in adolescents with first-episode major depressive disorder (FE-MDD).MethodsRCTs examining the efficacy, tolerability and safety of adjunctive rTMS for adolescents with FE-MDD were included. Data were extracted by three independent authors and synthesized using RevMan 5.3 software with a random effects model.ResultsA total of six RCTs involving 562 adolescents with FE-MDD were included. Adjunctive rTMS was superior in improving depressive symptoms over the control group [standardized mean difference (SMD) = −1.50, 95% confidence interval (CI): −2.16, −0.84; I2 = 89%, p &lt; 0.00001] in adolescents with FE-MDD. A sensitivity analysis and two subgroup analyses also confirmed the significant findings. Adolescents with FE-MDD treated with rTMS had significantly greater response [risk ratio (RR) = 1.35, 95% CI: 1.04, 1.76; I2 = 56%, p = 0.03] and remission (RR = 1.35, 95% CI: 1.03, 1.77; I2 = 0%, p = 0.03) over the control group. All-cause discontinuations were similar between the two groups (RR = 0.79, 95% CI: 0.32, 1.93; I2 = 0%, p = 0.60). No significant differences were found regarding adverse events, including headache, loss of appetite, dizziness and nausea (p = 0.14–0.82). Four out of six RCTs (66.7%), showed that adjunctive rTMS was more efficacious over the control group in improving neurocognitive function (all p &lt; 0.05).ConclusionAdjunctive rTMS appears to be a beneficial strategy in improving depressive symptoms and neurocognitive function in adolescents with FE-MDD. Higher quality RCTs with larger sample sizes and longer follow-up periods are warranted in the future.
Global associations of key populations with HIV-1 recombinants: a systematic review, global survey, and individual participant data meta-analysis
Authors: Nchinda Nkazi , Elangovan Ramyiadarsini , Yun Jason , Dickson-Tetteh Leslie , Kirtley Shona , Hemelaar Joris ,   WHO-UNAIDS Network for HIV Isolation and Characterisation
Published: August 2023

IntroductionGlobal HIV infections due to HIV-1 recombinants are increasing and impede prevention and treatment efforts. Key populations suffer most new HIV infections, but their role in the spread of HIV-1 recombinants is unknown. We conducted a global analysis of the associations between key populations and HIV-1 recombinants.MethodsWe searched PubMed, EMBASE, CINAHL, and Global Health for HIV-1 subtyping studies published from 1/1/1990 to 31/12/2015. Unpublished data was collected through a global survey. We included studies with HIV-1 subtyping data of key populations collected during 1990-2015. Key populations assessed were heterosexual people (HET), men who have sex with men (MSM), people who inject drugs (PWID), vertical transmissions (VERT), commercial sex workers (CSW), and transfusion-associated infections (BLOOD). Logistic regression was used to determine associations of key populations with HIV-1 recombinants. Subgroup analyses were performed for circulating recombinant forms (CRFs), unique recombinant forms (URFs), regions, and time periods.ResultsEight hundred and eighty five datasets including 77,284 participants from 83 countries were included. Globally, PWID were associated with the greatest odds of recombinants and CRFs (OR 2.6 [95% CI 2.46–2.74] and 2.99 [2.83–3.16]), compared to HET. CSW were associated with increased odds of recombinants and URFs (1.59 [1.44–1.75] and 3.61 [3.15–4.13]). VERT and BLOOD were associated with decreased odds of recombinants (0.58 [0.54–0.63] and 0.43 [0.33–0.56]). MSM were associated with increased odds of recombinants in 2010–2015 (1.43 [1.35–1.51]). Subgroup analyses supported our main findings.DiscussionAs PWID, CSW, and MSM are associated with HIV-1 recombinants, increased preventative measures and HIV-1 molecular surveillance are crucial within these key populations.Systematic review registrationPROSPERO [CRD42017067164].
Change in grip strength, hang time, and knot tying speed after 24 hours of endurance rock climbing
Authors: Yu Elaine , Lowe Jacques , Millon Jasmin , Tran Kristi , Coffey Christanne 
Published: August 2023

BackgroundNon-professional climbers are increasingly attempting long routes in a single day. Many suffer injury or rely on search and rescue teams when they become too fatigued to finish. Predicting fatigue is difficult, and existing studies have only studied climbers over durations less than an hour, while many outdoor multipitch climbs require more than an hour of climbing.ObjectivesTo determine how strength, endurance, and dexterity reflect fatigue after 24 h of continuous climbing.MethodsVolunteer competitors completed measurements of grip strength, static hang time to failure, and time to tie a figure-eight follow-through knot. Measurements were taken during the registration period before the competition and again within an hour after the competition ended. Measurements were compared using the pairedt-test. Subgroup analysis was applied to competitors by division. Linear regression was applied to determine the relationship between vertical feet climbed and the number of routes climbed during the competition on each metric.ResultsThirty-six total climbers (average age 29.4 years old) completed pre- and post-competition measurements. After 24 h of climbing (n = 36), mean grip strength decreased by 14.3–15 lbs or 14.7%–15.1% (p &lt; 0.001) and static hang time decreased by 54.2 s or 71.2% (p &lt; 0.001). There was no significant change in time to tie a figure-eight-follow-through knot. Grip strength and hang time decreases were significant in climbers with outdoor redpoints of 5.10a and above. Hang time decreased by 5.4 s per 1,000 vertical feet climbed (p = 0.044).ConclusionClimbers can expect to experience a 14.7%–15.1% decrease in grip strength and 71.2% decrease in static hang time after 24 h of continuous climbing. These changes may make it difficult to climb consistently over a long objective, and climbers can use these measures at home to train for longer climbing routes. Future studies on shorter climbing intervals can help determine rates of decline in performance measures.