bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prognostic study of mental stress-induced myocardial ischemia in coronary revascularization patients with depression/anxiety: rationale and design
Authors: Nan Nan , Feng Lei , Dong Wei , Gao Bingyu , Zuo Huijuan , Mi Hongzhi , Wang Gang , Song Xiantao , Zhang Hongjia 
Published: May 2023

Abstract
Background
Mental stress-induced myocardial ischemia (MSIMI) frequently occurs in patients with coronary artery disease (CAD), and is even more common in patients with co-occurring CAD and depression/anxiety. MSIMI appears to be a poor prognostic factor for CAD, but existing data on depression/anxiety patients are limited.

Methods
This cohort study will consecutively screen 2,647 CAD patients between 2023 and 2025. Included subjects will need to have received coronary revascularization and also have depression and/or anxiety at baseline. This study will enroll 360 subjects who meet the criteria. Two mental stress tests will be carried out in each patient at 1 month and 1 year timelines after coronary revascularization, using Stroop color word tests. MSIMI will be assessed by 99 m−Tc-sestamibi myocardial perfusion imaging. The endothelial function will be assessed by EndoPAT. Furthermore, we will dynamically monitor patients’ health and mental conditions every 3 months. The mean follow-up time will be 1 year. The primary endpoint is the major adverse cardiac events, a composite of all-cause death, cardiac death, myocardial infarction, stroke, or unplanned revascularization. Secondary endpoints will include overall health and mental conditions. The reproducibility of mental stress combined with myocardial perfusion for detecting MSIMI and comparisons between coronary stenosis and ischemic segments will also be included.

Conclusions
This cohort study will provide information on MSIMI outcomes in CAD patients who also have comorbid depression/anxiety after revascularization. In addition, understanding the long-term dynamics of MSIMI and the match between coronary stenosis and ischemia will provide insight into MSIMI mechanisms.

Trail Registration
ChiCTR2200055792, 2022.1.20, www.medresman.org.cn;
Handgrip strength is associated with risks of new-onset stroke and heart disease: results from 3 prospective cohorts
Authors: Li Guochen , Lu Yanqiang , Shao Liping , Wu Luying , Qiao Yanan , Ding Yi , Ke Chaofu 
Published: May 2023

Abstract
Background
Stroke and heart disease are two major contributors to the global disease burden. We aimed to evaluate and compare the roles of different handgrip strength (HGS) expressions in predicting stroke and heart disease in three nationally representative cohorts.

Methods
This longitudinal study used data from the Health and Retirement Study (HRS), the Survey of Health, Ageing, and Retirement in Europe (SHARE), and the China Health and Retirement Longitudinal Study (CHARLS). The Cox proportional hazard model was applied to analyze the relationship between HGS and stroke and heart disease, and Harrell’s C index was used to assess the predictive abilities of different HGS expressions.

Results
A total of 4,407 participants suffered from stroke and 9,509 from heart disease during follow-up. Compared with the highest quartile, participants in the lowest quartile of dominant HGS, absolute HGS and relative HGS possessed a significantly higher risk of new-onset stroke in Europe, America, and China (all P < 0.05). After adding HGS to office-based risk factors, there were minimal or no differences in the increases of Harrell’s C indexes among three HGS expressions. In contrast, the modest association between HGS and heart disease was only seen in SHARE and HRS, but not in CHARLS.

Conclusion
Our findings support that HGS can be used as an independent predictor of stroke in middle-aged and older European, American and Chinese populations, and the predictive ability of HGS may not depend on how it is expressed. The relationship between HGS and heart disease calls for further validation.
A case report of unilateral cerebral vasculitis in adults: keep in mind Lyme neuroborreliosis
Authors: Riescher Stanislas , Dos Santos Amélie , Lecomte Raphaël , Lenoble Cédric , Guillon Benoit 
Published: May 2023

Abstract
Background
Lyme neuroborreliosis (LNB), due to infection of the nervous system by the spirochete Borrelia burgdorferi, occurs in 15% of Lyme disease cases. However, neurovascular involvement is uncommon, especially recurrent stroke related to cerebral vasculitis in the absence of CSF pleocytosis.

Case presentation
We report the case of a 58-year-old man without any medical history who exhibited recurrent strokes in the same vascular territory (left internal carotid). Multiple biological screening, neuroimaging methods, and cardiovascular examinations failed to provide a diagnosis and treatment that could have prevented recurrences. Finally, B. burgdorferi sensu lato serology testing in blood and cerebrospinal fluid enabled diagnosis of LNB, in relation to a cerebral vasculitis. The patient experienced no further stroke after four weeks of doxycycline treatment.

Conclusion
B. burgdorferi central nervous system infection must be considered in case of unexplained recurrent and/or multiple strokes, especially if cerebral vasculitis is suspected or demonstrated on neuroimaging.
Incidence of obstetric anal sphincter injuries following breech compared to cephalic vaginal births
Authors: Leborne Perrine , de Tayrac Renaud , Zemmache Zakarya , Serrand Chris , Fabbro-Peray Pascale , Allegre Lucie , Vintejoux Emmanuelle 
Published: May 2023

Abstract
Introduction
Obstetric anal sphincter injuries (OASIs) at the time of childbirth can lead to serious consequences including anal incontinence, dyspareunia, pain and rectovaginal fistula. These types of lesions and their incidence have been well studied after cephalic presentation deliveries, but no publications have specifically addressed this issue in the context of vaginal breech delivery. The goal of our study was to evaluate the incidence of OASIs following breech deliveries and compare it with cephalic presentation births.

Methods
This was a retrospective cohort study involving 670 women. Of these, 224 and 446 had a vaginal birth of a fetus in the breech (breech group) and cephalic (cephalic group) presentations respectively. Both groups were matched for birthweight (± 200 g), date of delivery (± 2 years) and vaginal parity. Main outcome of interest was to evaluate the incidence of OASIs following breech vaginal birth compared to cephalic vaginal births. Secondary endpoints were the incidence of intact perineum or first-degree tear, second-degree perineal tear and rates of episiotomies in each group.

Results
There was no statistically significant difference in OASIs incidence between the breech and cephalic groups (0.9% vs. 1.1%; RR 0.802 (0.157; 4.101); p = 0.31). There were more episiotomies in the breech group (12.5% vs. 5.4%, p = 0.0012) and the rate of intact or first-degree perineum was similar in both groups (74.1% vs. 75.3%, p = 0.7291). A sub-analysis excluding patients with episiotomy and history of OASIs did not show any statistically significant difference either.

Conclusion
We did not demonstrate a significant difference in the incidence of obstetric anal sphincter injuries between women who had a breech vaginal birth compared to cephalic.
Functional role and epithelial to mesenchymal transition of the miR-590-3p/MDM2 axis in hepatocellular carcinoma
Authors: Youssef Alaa Ibrahem , Khaled Gehad Mahmoud , Amleh Asma 
Published: May 2023

Abstract
Background
There is considerable evidence that microRNAs (miRNAs) regulate several key tumor-associated genes/pathways and may themselves have a dual regulatory function either as tumor suppressors or oncogenic miRNA, depending on the tumor type. MicroRNA-590-3p (miR-590-3p) is a small non-coding RNA involved in the initiation and progression of numerous tumors. However, its expression pattern and biological role in hepatocellular carcinoma (HCC) are controversial.

Results
In the current work, computational and RT-qPCR analysis revealed that HCC tissues and cell lines exhibited miR-590-3p downregulation. Forced expression of miR-590-3p attenuated HepG2 cells proliferation, migration, and repressed EMT-related gene expression. Bioinformatic, RT-qPCR, and luciferase assays revealed that MDM2 is a direct functional target of miR-590-3p. Moreover, the knockdown of MDM2 mimicked the inhibitory effect of miR-590-3p in HepG2 cells.

Conclusion
We have identified not only novel targets for miR-590-3p in HCC, but also novel target genes for miR590-3p/MDM2 pathway in HCC like SNAIL, SLUG, ZEB1, ZEB2, and N-cadherin. Furthermore, these findings demonstrate a crucial role for MDM2 in the regulatory mechanism of EMT in HCC.
Efficacy of aluminum chloride in severe regorafenib-associated hand-foot skin reactions: a single-arm trial
Authors: Nishizawa Aya , Shinozaki Eiji , Wakatsuki Takeru , Satoh Takahiro , Yamazaki Naoya , Oyamada Shunsuke , Ariyoshi Keisuke , Kihara Kota , Tsuboi Masahiro , Yamaguchi Kensei 
Published: May 2023

Abstract
Background
Regorafenib, a multikinase inhibitor, causes a high frequency of hand-foot skin reactions (HFSRs). The present study evaluated the efficacy of topical aluminum chloride, a perspiration suppressant, in reducing the severity of hand-foot skin reactions (HFSRs) caused by regorafenib.

Methods
The present single-arm study included patients with metastatic colorectal cancer receiving regorafenib. Aluminum chloride ointment was applied topically one week prior to the start of regorafenib treatment, and the observation period was 12 weeks. The primary endpoint was the incidence of regorafenib-related grade 3 HFSR. Secondary endpoints were the incidence of all grades of HFSR, time to any grade of HFSR, time to improvement from grade 2 or higher to grade 1 or lower, treatment discontinuation rate, treatment interruption rate or dosage reduction due to HFSR, and incidence of adverse effects of aluminum chloride.

Results
In total 28 patients were enrolled, and 27 patients were analyzed. The incidence of grade 3 HFSR was 7.4%, meeting the primary endpoint. The incidence of all grades of HFSR was 66.7%, and the median time to the occurrence of any grade of HFSR was 15 days. No patients discontinued or reduced the regorafenib dosage because of HFSR. The most common reason for the interruption of regorafenib therapy was liver dysfunction in nine patients (33%) and HFSR in three patients (11%). No serious adverse events related to aluminum chloride were observed.

Conclusions
Aluminum chloride ointment, a drug commonly used in routine practice to treat hyperhidrosis, is safe to use, has no serious side effects, and may be effective in reducing the occurrence of severe, regorafenib-related HFSR.

Trail registration
ClinicalTrials.gov. identifier: jRCTs031180096, Registered on 25/01/2019.
PTEN-negative endometrial cancer cells protect their genome through enhanced DDB2 expression associated with augmented nucleotide excision repair
Authors: Hameed J S Fathima , Devarajan Anjali , M S Devu Priya , Bhattacharyya Ahel , Shirude Mayur Balkrishna , Dutta Debasree , Karmakar Parimal , Mukherjee Ananda 
Published: May 2023

AbstractBackgroundEndometrial cancer (EC) arises from uterine endometrium tissue and is the most prevalent cancer of the female reproductive tract in developed countries. It has been predicted that the global prevalence of EC will increase in part because of its positive association with economic growth and lifestyle. The majority of EC presented with endometrioid histology and mutations in the tumor suppressor gene PTEN, resulting in its loss of function. PTEN negatively regulates the PI3K/Akt/mTOR axis of cell proliferation and thus serves as a tumorigenesis gatekeeper. Through its chromatin functions, PTEN is also implicated in genome maintenance procedures. However, our comprehension of how DNA repair occurs in the absence of PTEN function in EC is inadequate.MethodsWe utilized The Cancer Genome Atlas (TCGA) data analysis to establish a correlation between PTEN and DNA damage response genes in EC, followed by a series of cellular and biochemical assays to elucidate a molecular mechanism utilizing the AN3CA cell line model for EC.ResultsThe TCGA analyses demonstrated an inverse correlation between the expression of the damage sensor protein of nucleotide excision repair (NER), DDB2, and PTEN in EC. The transcriptional activation of DDB2 is mediated by the recruitment of active RNA polymerase II to the DDB2 promoter in the PTEN-null EC cells, revealing a correlation between increased DDB2 expression and augmented NER activity in the absence of PTEN.ConclusionOur study indicated a causal relationship between NER and EC that may be exploited in disease management.
The sustained psychological impact of coronavirus disease 2019 pandemic on hospital workers 2 years after the outbreak: a repeated cross-sectional study in Kobe
Authors: Fukushima Haruko , Imai Hissei , Miyakoshi Chisato , Naito Atsumi , Otani Kyohei , Matsuishi Kunitaka 
Published: May 2023

Abstract
Background
Healthcare workers who are exposed to coronavirus disease 2019 are psychologically distressed. This study aimed to evaluate the mental health outcomes of hospital workers 2 years after the outbreak of coronavirus disease 2019 and to identify changes in the stress of hospital workers and predicted risk factors.

Methods
This survey was conducted 2 years after the initial evaluation performed under the first emergency declaration of the coronavirus disease 2019 pandemic among hospital workers at the same hospital in an ordinance-designated city in Japan from June to July 2022. Sociodemographic data, 19 stress-related question responses, the Impact of Event Scale-Revised, and the Maslach burnout inventory-general survey were collected. Multiple regression models were used to identify factors associated with each of the mental health outcomes 2 years after the coronavirus disease 2019 outbreak.

Results
We received 719 valid responses. Between 2020 and 2022, hospital workers’ anxiety about infection decreased, whereas their exhaustion and workload increased. Multiple regression analysis revealed that 2 years after the coronavirus disease 2019 outbreak, nurses and young people were at a higher risk of experiencing stress and burnout due to emotional exhaustion, respectively.

Conclusions
This is the first study to examine the long-term stress of hospital workers measured in Japan. Exhaustion and workload were worsened 2 years into the pandemic. Therefore, health and medical institutions should continuously monitor the physical and psychological health of staff members.
To what extent is antenatal care in public health facilities associated with delivery in public health facilities? Findings from a cross-section of women who had facility deliveries in Nigeria
Authors: Ilesanmi Benjamin Bukky , Solanke Bola Lukman , Oni Tosin Olajide , Yinusa Rasheed Adebayo , Oluwatope Omolayo Bukola , Oyeleye Olaoye James 
Published: May 2023

Abstract
Background
Facility delivery remains an important public health issue in Nigeria. Studies have confirmed that antenatal care may improve the uptake of facility delivery. However, information is rarely available in Nigeria on the extent to which antenatal care in public health facilities is associated with delivery in public health facilities. The objective of the study was thus to examine the extent of the association between antenatal care in public health facilities and delivery in public health facilities in Nigeria. The study was guided by the Andersen behavioral model of health services use.

Methods
The cross-sectional design was adopted. Data were extracted from the most recent Nigeria Demographic and Health Survey (NDHS). A sample of 9,015 women was analyzed. The outcome variable was the facility for delivery. The main explanatory variable was the antenatal care facility. The predisposing factors were maternal age, age at first birth, parity, exposure to mass media, and, religion. The enabling factors were household wealth, work status, partners’ education, women’s autonomy, health insurance, and, perception of distance to the health facility. The need factors were pregnancy wantedness, the number of antenatal care visits, and the timing of the first antenatal care. Statistical analyses were performed with the aid of Stata version 14. Two binary logistic regression models were fitted.

Results
Findings showed that 69.6% of the women received antenatal care in public health facilities, while 91.6% of them subsequently utilized public health facilities for deliveries. The significant predisposing factors were age at first birth, parity, maternal education, and religion, while household wealth, work status, women’s autonomy, and partners’ education were the significant enabling factors. The timing of the first antenatal contact, pregnancy wantedness, and the number of antenatal care visits were the important need factors.

Conclusion
To a significant extent, antenatal care in public health facilities is associated with deliveries in public health facilities in Nigeria. It is imperative for governments in the country to take more steps to ensure the expanded availability of public health facilities in all parts of the country since their use for antenatal care is well-associated with their use for delivery care.
Third-child fertility intention and its socioeconomic factors among women aged 20–34 years in China
Authors: Yang Hanmo , Han Runlin , Wang Zhenjie 
Published: May 2023

Abstract
Background
The low birth rates and rapid population aging has drawn considerable attention from scholars and policymakers in China and around the world. In 2021, China launched the policy and supportive measures that allow up to 3 children per couple. This study aims to explore the influencing factors of the third-child fertility intention among women aged 20–34 years in China.

Methods
We draw data from the National Fertility Survey conducted in 2017. The nationally representative survey adopts a stratified, 3-stage, and probabilities proportional to size sampling method. A total of 61,588 valid samples aged 20–34 years old were obtained. Fertility desire and behavior, childbearing and service use, and potential influencing factors of fertility intention such as the history of pregnancy were assessed.

Results
In general, 5.01% of Chinese women of prime childbearing age had fertility intention for a third child, and the proportion varies by region across mainland China. Individual characteristics such as being ethnic minorities, being rural residents, and having more siblings are significantly positively correlated with the third-child fertility intention, while the intention was significantly lower among women with a higher income or education level, migrant women, and those engaged in the non-agricultural labor force. Women who already had a son had lower fertility intention for a third child. Moreover, it was the perceived acceptable costs of childcare services rather than the actual costs that mattered more for the fertility intention.

Conclusions
Our study concludes a series of socioeconomic factors, and previous childbearing and childrearing experiences are crucial for women’s fertility intention for a third child. These findings highlight the importance of launching supportive measures in addition to the introduction of the 3-child policy in promoting a fertility-friendly society.
Sex-based differences and relationship with the restricted knee flexion angle due to aging: a comparative study
Authors: Ohko Hiroshi , Ota Susumu 
Published: May 2023

AbstractBackgroundThe relationship between inferior patellar mobility (IPM) and knee flexion angle has yet to be elucidated. This study aimed to develop quantitative IPM measurement methods and clarify the relationship between IPM and knee flexion angle in community-dwelling older females.MethodsThis was a cross-sectional study. Overall, 128 healthy older women (age 65–79 years) were recruited from the community to evaluate the relationship between IPM and knee flexion angle. This study was performed between May 2015 and December 2017. The reference value of and sex differences in IPM were evaluated in 205 healthy young adults aged between 19 and 21 years. IPM was compared between healthy older and young women and was objectively measured using our specially designed patellofemoral arthrometer (PFA). Patellar mobility was calculated by normalization to body height. IPM reliability was assessed before all measurements.ResultsIntraclass correlation coefficients for intratester and intertester reliabilities varied from 0.87 to 0.99. The normal range based on two standard deviations of inferior patellar displacement/body height was 5.9–13.5% (young men), 5.1–14.3% (young women), and 1.2–8.8% (older women). IPM was significantly lower in older than young women (P < 0.001). There was a significant positive correlation (r = 0.72 andP < 0.01) between IPM and knee flexion angle in healthy older women unable to flex the knee joint fully.ConclusionsOur PFA has good intratester and intertester reliability. The results suggest that IPM decreases with aging in women. IPM and knee flexion angle are correlated among older women unable to flex the knee joint fully.Clinical trial registrationNot applicable.
SIAP: an intelligent algorithm for multiple prescription pattern recognition based on weighted similarity distances
Authors: Wang Yifei , Xu Julia , Zhang Jie , Xu Hong , Sun Yuzhong , Miao Yuan , Wen Tiancai 
Published: May 2023

Abstract
Background
Clinical practices have demonstrated that disease treatment can be very complex. Patients with chronic diseases often suffer from more than one disease. Complex diseases are often treated with a variety of drugs, including both primary and auxiliary treatments. This complexity and multidimensionality increase the difficulty of extracting knowledge from clinical data.

Methods
In this study, we proposed a subgroup identification algorithm for complex prescriptions (SIAP). We applied the SIAP algorithm to identify the importance level of each drug in complex prescriptions. The algorithm quickly classified and determined valid prescription combinations for patients. The algorithm was validated through classification matching of classical prescriptions in traditional Chinese medicine. We collected 376 formulas and their compositions from a formulary to construct a database of standard prescriptions. We also collected 1438 herbal prescriptions from clinical data for automated prescription identification. The prescriptions were divided into training and test sets. Finally, the parameters of the two sub-algorithms of SIAP and SIAP-All, as well as those of the combination algorithm SIAP + All, were optimized on the training set. A comparison analysis was performed against the baseline intersection set rate (ISR) algorithm. The algorithm for this study was implemented with Python 3.6.

Results
The SIAP-All and SIAP + All algorithms outperformed the benchmark ISR algorithm in terms of accuracy, recall, and F1 value. The F1 values were 0.7568 for SIAP-All and 0.7799 for SIAP + All, showing improvements of 8.73% and 11.04% over the existing ISR algorithm, respectively.

Conclusion
We developed an algorithm, SIAP, to automatically match sub-prescriptions of complex drugs with corresponding standard or classic prescriptions. The matching algorithm weights the drugs in the prescription according to their importance level. The results of this study can help to classify and analyse the drug compositions of complex prescriptions.