bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations of Clinical Risk Factors and Novel Biomarkers With Age at Onset of Type 2 Diabetes
Authors: Chen Jun-Xiang , Geng Tingting , Zhang Yan-Bo , Wang Yi , Li Rui , Qiu Zixin , Wang Yuexuan , Yang Kun , Zhang Bing-Fei , Ruan Hua-Ling , Zhou Yan-Feng , Pan An , Liu Gang , Liao Yun-Fei 
Published: July 2023

Abstract

Context
Younger onset of type 2 diabetes (T2D) was associated with higher risks of vascular complications and mortality.

Objective
To prospectively assess risk profiles for incident T2D stratified by age at onset.

Methods
A total of 471 269 participants free of T2D at baseline were included from the UK Biobank. Approximately 70 clinical, lipid, lipoprotein, inflammatory, and metabolic markers, and genetic risk scores (GRSs) were analyzed. Stratified Cox proportional-hazards regression models were used to estimate hazard ratios (HRs) for T2D with age of diagnosis divided into 4 groups (≤50.0, 50.1-60.0, 60.1-70.0, and &gt;70.0 years).

Results
During 11 years of follow-up, 15 805 incident T2D were identified. Among clinical risk factors, obesity had the highest HR at any age, ranging from 13.16 (95% CI, 9.67-17.91) for 50.0 years and younger to 4.13 (3.78-4.51) for older than 70.0 years. Other risks associated with T2D onset at age 50.0 years and younger included dyslipidemia (3.50, 2.91-4.20), hypertension (3.21, 2.71-3.80), cardiovascular disease (2.87, 2.13-3.87), parental history of diabetes (2.42, 2.04-2.86), education lower than college (1.89, 1.57-2.27), physical inactivity (1.73, 1.43-2.10), smoking (1.38, 1.13-1.68), several lipoprotein particles, inflammatory markers, liver enzymes, fatty acids, amino acids, as well as GRS. Associations of most risk factors and biomarkers were markedly attenuated with increasing age at onset (P interaction &lt;.05), and some were not significant for onset at age older than 70.0 years, such as smoking, systolic blood pressure, and apolipoprotein B.

Conclusion
Most risk factors or biomarkers had stronger relative risks for T2D at younger ages, which emphasizes the necessity of promoting primary prevention among younger individuals. Moreover, obesity should be prioritized.
Promise and Perils of MicroRNA Discovery Research: Working Toward Quality Over Quantity
Authors: McIlwraith Emma K , He Wenyuan , Belsham Denise D 
Published: July 2023

Abstract
Since the first microRNA (miRNA) was described in 1993 in the humble worm Caenorhabditis elegans, the miRNA field has boomed, with more than 100 000 related patents filed and miRNAs now in ongoing clinical trials. Despite an advanced understanding of the biogenesis and action of miRNAs, applied miRNA research faces challenges and irreproducibility due to a lack of standardization. This review provides guidelines regarding miRNA investigation, while focusing on the pitfalls and considerations that are often overlooked in prevailing applied miRNA research. These include miRNA annotation and quantification, to modulation, target prediction, validation, and the study of circulating miRNAs.
Prolonged cyclical loading induces Haversian remodeling in mandibles of growing rabbits
Authors: Lad Susan E. , Kowalkowski Hannah , Liggio Daniel F. , Ding Hui , Ravosa Matthew J. 
Published: July 2023

ABSTRACT
Bone adaptation to mechanical loading happens predominantly via modeling and remodeling, but the latter is poorly understood. Haversian remodeling (cortical bone replacement resulting in secondary osteons) is thought to occur in regions of low strain as part of bone maintenance or high strain in response to microdamage. However, analyses of remodeling in primates have revealed an unappreciated association with the number of daily load cycles. We tested this relationship by raising 30 male domestic rabbits (Oryctolagus cuniculus) on disparate diets from weaning to adulthood (48 weeks), facilitating a naturalistic perspective on mandibular bone adaptation. A control group consumed only rabbit pellets and an ‘overuse’ group ate hay in addition to pellets. To process hay, which is tougher and stiffer, rabbits increase chewing investment and duration without increasing bite force (i.e. corpus mean peak strain is similar for the two foods). Corpus remodeling in overuse rabbits was ∼1.5 times that of controls, measured as osteon population density and percentage Haversian bone. In the same subjects, there was a significant increase in overuse corpus bone formation (ratio of cortical area to cranial length), consistent with previous reports on the same dietary manipulation and bone formation in rabbits. This is the first evidence that both modeling and remodeling are simultaneously driven by the number of load cycles, independent of strain magnitude. This novel finding provides unique data on the feeding apparatus, challenges traditional thought on Haversian remodeling, and highlights the need for experimental studies of skeletal adaptation that examine mechanical factors beyond strain magnitude.
Ontogenetic changes in bite force and gape in tufted capuchins
Authors: Laird Myra F. , Kanno Cláudia Misue , Yoakum Caitlin B. , Fogaça Mariana Dutra , Taylor Andrea B. , Ross Callum F. , Chalk-Wilayto Janine , Holmes Megan A. , Terhune Claire E. , de Oliveira José Américo 
Published: July 2023

ABSTRACT
Bite force and gape are two important performance metrics of the feeding system, and these metrics are inversely related for a given muscle size because of fundamental constraints in sarcomere length–tension relationships. How these competing performance metrics change in developing primates is largely unknown. Here, we quantified in vivo bite forces and gapes across ontogeny and examined these data in relation to body mass and cranial measurements in captive tufted capuchins, Sapajus spp. Bite force and gape were also compared across geometric and mechanical properties of mechanically challenging foods to investigate relationships between bite force, gape and food accessibility (defined here as the ability to breach shelled nuts). Bite forces at a range of gapes and feeding behavioral data were collected from a cross-sectional ontogenetic series of 20 captive and semi-wild tufted capuchins at the Núcleo de Procriação de Macacos-Prego Research Center in Araçatuba, Brazil. These data were paired with body mass, photogrammetric measures of jaw length and facial width, and food geometric and material properties. Tufted capuchins with larger body masses had absolutely higher in vivo bite forces and gapes, and animals with wider faces had absolutely higher bite forces. Bite forces and gapes were significantly smaller in juveniles compared with subadults and adults. These are the first primate data to empirically demonstrate the gapes at which maximum active bite force is generated and to demonstrate relationships to food accessibility. These data advance our understanding of how primates meet the changing performance demands of the feeding system during development.
Maternal and fetal outcomes in women undergoing induction of labor with low dose vaginal misoprostol
Authors: Shafqat Tanveer , Zeb Laila , Fatima Syeda Sitwat , Bhittani Rehana 
Published: July 2023

Objective: To determine Maternal and Fetal outcome in women undergoing induction of labour with low dose misoprostol.
Method: A cross-sectional study was carried out to determine the efficacy of Misoprostol for induction of labor (IOL) in MTI, Lady Reading Hospital (LRH), Peshawar from 21st January to 31st December 2021. All pregnant women with singleton pregnancy and cephalic presentation admitted for Induction of Labor were included in the study. Maternal and Fetal outcome was noted. Induction of labor was started with 25 micrograms of Misoprostol, repeated every six hours depending on Bishop Score.
Results: Three hundred and thirty-seven women were included in this study. The majority of females (76%) were in 18-35 years age group. In 92.3% of females, the Bishop score was less than six. The maximum number of females (33.5%) delivered after eight hours of IOL. Sixty-six (66.46%) of females had gestational age of 37-40 weeks. Premature rupture of membranes was the most common indication (32.9%). Three doses of misoprostol were required in 31.2% of females. Only 5.6% of females required six doses of misoprostol for induction. With Misoprostol 85.1% of females delivered spontaneously, 2.37% required forceps delivery, 1.7% required vacuum delivery, and 10.68% delivered by Caesarean Section. APGAR score was 8 /10 in 84% of neonates at birth. Eighty-seven %(87.8%) of neonates did not require NICU admission.
Conclusion: Misoprostol is a safe medicine to be used to induce labor in females. It can help shorten the duration of labor, with good fetomaternal outcome.
doi: https://doi.org/10.12669/pjms.39.5.7072
How to cite this: Shafqat T, Zeb L, Fatima SS, Bhittani R. Maternal and fetal outcomes in women undergoing induction of labor with low dose vaginal misoprostol. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7072
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hospital length of stay: A cross-specialty analysis and Beta-geometric model
Authors: Dehouche Nassim , Viravan Sorawit , Santawat Ubolrat , Torsuwan Nungruethai , Taijan Sakuna , Intharakosum Atthakorn , Sirivatanauksorn Yongyut 
Published: July 2023

Background
The typical hospital Length of Stay (LOS) distribution is known to be right-skewed, to vary considerably across Diagnosis Related Groups (DRGs), and to contain markedly high values, in significant proportions. These very long stays are often considered outliers, and thin-tailed statistical distributions are assumed. However, resource consumption and planning occur at the level of medical specialty departments covering multiple DRGs, and when considered at this decision-making scale, extreme LOS values represent a significant component of the distribution of LOS (the right tail) that determines many of its statistical properties.

Objective
To build actionable statistical models of LOS for resource planning at the level of healthcare units.

Methods
Through a study of 46, 364 electronic health records over four medical specialty departments (Pediatrics, Obstetrics/Gynecology, Surgery, and Rehabilitation Medicine) in the largest hospital in Thailand (Siriraj Hospital in Bangkok), we show that the distribution of LOS exhibits a tail behavior that is consistent with a subexponential distribution. We analyze some empirical properties of such a distribution that are of relevance to cost and resource planning, notably the concentration of resource consumption among a minority of admissions/patients, an increasing residual LOS, where the longer a patient has been admitted, the longer they would be expected to remain admitted, and a slow convergence of the Law of Large Numbers, making empirical estimates of moments (e.g. mean, variance) unreliable.

Results
We propose a novel Beta-Geometric model that shows a good fit with observed data and reproduces these empirical properties of LOS. Finally, we use our findings to make practical recommendations regarding the pricing and management of LOS.
Sex differences in pediatric caudal epidural anesthesia under sedation without primary airway instrumentation
Authors: Opfermann Philipp , Schmid Werner , Obradovic Mina , Kraft Felix , Zadrazil Markus , Marhofer Daniela , Marhofer Peter 
Published: July 2023

Study objective
To identify sex differences associated with caudal epidurals, the most commonly used technique of pediatric regional anesthesia, based on individually validated data of ultrasound-guided blocks performed between 04/2014 and 12/2020.

Methods
Prospectively collected and individually validated data of a cohort of children aged between 0–15 years was analyzed in a retrospective observational study. We included pediatric surgeries involving a primary plan of caudal epidural anesthesia under sedation (without airway instrumentation) and a contingency plan of general anesthesia. Sex-specific rates were analyzed for overall failure of the primary anesthesia plan, for residual pain, for block-related technical complications and for critical respiratory events. We used Fisher´s exact tests and multivariable logistic regressions were used to evaluate sex-specific associations.

Results
Data from 487 girls and 2060 boys ≤15 years old (ASA status 1 to 4) were analyzed. The primary-anesthesia-plan failure rate was 5.5% (95%CI 3.8%-7.8%) (N = 27/487) among girls and 4.7% (95%CI 3.9%-5.7%) (N = 97/2060) among boys (p = 0.41). Residual pain was the main cause of failure, with rates of 4.5% (95%CI 2.9–6.6%) (N = 22/487) among girls and 3.0% (95%CI 2.3–3.8%) (N = 61/2060) among boys (p = 0.089). Block-related technical complications were seen at rates of 0.8% (95%CI 0.3%-1.9%) (N = 4/487) among girls vs 2.5% (95%CI 0.5–2.7%) (N = 51/2060) among boys and, hence, significantly more often among male patients (p = 0.023). Male sex was significantly associated with higher odds (adjusted OR: 3.18; 95% CI: 1.12–9; p = 0.029) for such technical complications regardless of age, ASA status, gestational week at birth or puncture attempts. Critical respiratory events occurred at a 1.7% (95%CI 1.2%-2.3%) rate (N = 35/2060) twice as high among boys as 0.8% (95%CI 0.3%-1.9%) (N = 4/487) among girls (p = 0.21).

Conclusions
While the the primary-anesthesia-plan failure rate was equal for girls and boys, technical complications and respiratory events are more likely to occur in boys.
Quality of Tissue Samples Obtained by Endoscopic Ultrasound-Guided Liver Biopsy: A Randomized, Controlled Clinical Trial
Authors: Lariño-Noia José , Fernández-Castroagudín Javier , de la Iglesia-García Daniel , Lázare Héctor , Nieto Laura , Porto Sol , Vallejo-Senra Nicolau , Molina Esther , San Bruno Alba , Martínez-Seara Xurxo , Iglesias-García Julio , García-Acuña Silvia , Domínguez-Muñoz J. Enrique 
Published: July 2023

INTRODUCTION:
Liver biopsy (LB) remains essential for the diagnosis and staging of parenchymal liver diseases. Endoscopic ultrasound-guided LB (EUS-LB) has emerged as an attractive alternative to percutaneous and transjugular routes. We aimed at comparing the adequacy of samples obtained by EUS-LB with percutaneous LB.

METHODS:
A single-center, randomized, controlled clinical trial was designed. Patients undergoing LB were randomly assigned to EUS-LB or percutaneous LB groups. EUS-LB was performed with a 19-gauge Franseen core needle through a transduodenal and transgastric route. Percutaneous LB was performed with a 16-gauge Tru-Cut needle. The main outcome was the percentage of adequate samples obtained. Secondary outcomes were the percentage of accurate histologic diagnosis, number of complete portal tracts (CPT), total and longest specimen length (TSL and LSL), sample fragmentation, adverse events, and patients' satisfaction. An adequate specimen was defined as TSL ≥20 mm and including ≥11 CPT.

RESULTS:
Ninety patients were randomized (44 to EUS-LB and 46 to percutaneous LB) and included in the analysis. The percentage of adequate tissue samples was 32.6% and 70.4% for percutaneous LB and EUS-LB, respectively (P < 0.001). A final histologic diagnosis was provided in all cases but one. TSL was longer after EUS-LB (23.5 vs 17.5 mm, P = 0.01), whereas the number of CPT was similar in both groups. Sample fragmentation occurred more often after EUS-LB (P < 0.001). No differences in adverse events were found. Satisfaction reported with both procedures was high.

DISCUSSION:
EUS-LB is safe and accurate and may be considered an alternative to percutaneous LB for the evaluation of parenchymal liver diseases.
Council of Experts: chronic shoulder pain as a multidisciplinary problem
Authors: Karateev A. E. , Lila A. M. , Zagorodniy N. V. , Alekseeva L. I. , Arkhipov S. V. , Arkov V. V. , Makarov M. S. , Rachin A. P. , Shirokov V. A. , Khokhlova M. N. , Nesterenko V. A. 
Published: July 2023

Chronic shoulder pain (CSP) is a clinical syndrome associated with inflammatory and degenerative musculoskeletal changes, characterized by pain in the shoulder that persists for at least 3 months, arising or aggravated by functional activity in this area. The frequency of CSP in the modern population reaches 20–33%, it is one of the leading causes of severe suffering, disability and seeking for medical attention. The main causes of CSP are shoulder rotator impingement syndrome (subacromial impingement syndrome), calcific tendinitis, adhesive capsulitis, shoulder and acromioclavicular joint osteoarthritis. Accurate diagnosis of these diseases is necessary for the correct choice of treatment. Differential diagnosis is carried out using tests that evaluate the function of the shoulder joint and the rotator cuff muscles (Neer, Speed, Hawkins tests, etc.), as well as using instrumental methods (ultrasound, magnetic resonance tomography, X-ray). In CSP, it is necessary to exclude septic, oncological, visceral, systemic rheumatic and other diseases, as well as musculoskeletal pathology of the cervical spine, upper chest and back, which can cause pain in the shoulder region.Therapy for diseases that cause CSP should be personalized and complex, aimed at maximum pain control and restoration of function. For this purpose, non-steroidal anti-inflammatory drugs, local injection therapy with glucocorticoids, hyaluronic acid, and platelet-rich plasma are used. In some cases, muscle relaxants, antidepressants, anticonvulsants, local injections of botulinum toxin type A are indicated. Physiotherapy and medical rehabilitation methods play a fundamental role in the treatment of CSP.
Clinical features of patients with ankylosing spondylitis with inefficacy of two or more biological disease modifying antirheumatic drugs
Authors: Erdes Sh. F. , Sakharova K. V. , Dubinina T. V. , Cherkasova M. V. 
Published: July 2023

The “Treat-to-target” (T2T) strategy for axial spondyloarthritis (axSpA) has made it possible to optimize therapy in most patients, but in some of them the treatment goals are not achieved.Objective: to analyze the clinical features of patients with ankylosing spondylitis (AS) with inefficacy of two or more biological disease modifying antirheumatic drugs (bDMARDs).Material and methods. From February 2020 to March 2022 458 patients with AS, who met the modified New York criteria of 1984, were admitted to V.A. Nasonova Research Institute of Rheumatology. From this group, 30 (6.6%) patients with high clinical disease activity and inefficacy of at least two bDMARDs were selected. The control group consisted of 139 (30.5%) patients with AS, who either had no history of bDMARDs use, or had previously received only one of them. All patients were examined in accordance with generally accepted methods and underwent a double expert control.Results and discussion. Men predominated in the main and control groups (67 and 60%, respectively). In patients of the main group, there was a higher laboratory activity of the disease, especially ESR (p=0.002), more often peripheral arthritis was detected. In both groups, there was a high incidence of coxitis (69.2 and 69.7%, respectively), while in the main group there were significantly more patients who underwent total joint arthroplasty, and the frequency of detected syndesmophytes was 2 times lower compared to the control. Differences in the features of AS onset were also established: in the main group, the disease often began with reactive arthritis (ReA), while in the control group, with inflammatory back pain.Conclusion. The T2T strategy in axSpA does not always lead to the achievement of the intended goals, and, according to our data, among inpatients with AS, the number of people with a history of inefficacy of two or more bDMARDs reaches 6%. In these patients, compared with the control, the following features of the disease can be distinguished: frequent onset with ReA, a significant incidence of peripheral arthritis and joint arthroplasty, and a higher ESR.
Role of ecotourism in conserving forest biomass: A mathematical model
Authors: Pathak Rachana , Bhadauria Archana Singh , Chaudhary Manisha , Verma Harendra , Mathur Pankaj , Agrawal Manju , Singh Ram 
Published: July 2023

Abstract
Ecotourism is a form of tourism involving responsible travel to natural areas, conserving the environment, and improving the well-being of the local people. Its purpose may be to educate the traveler, to provide funds for ecological censervation, to directly benifit the economic development, and political empowerment of local communities. Ecotourism has come up as an important conservation strategy in the tropical areas where diversity of species and habitats are threatened because of the traditional forms of development. This study deals with a non-linear mathematical model with a novel idea for sustainable development of biomass with ecotourism which is imperative in the present scenario. Stability and bifurcation analysis of the model is done and it is observed from our study that the system predicts unstability and exhibits bifurcation if ecotourism goes beyond a threshold value.
Positioning English as the international language during the Interamerican scientific integration: the role of multilingualism in defining the scope of a scientific journal in the mid-20th century
Authors: Hernández-Socha Yuirubán 
Published: July 2023

Abstract
Caldasia, a journal published by the Instituto de Ciencias Naturales of the Universidad Nacional de Colombia, was the arena of language tensions originating in scientific exchanges in the mid-20th century at a time when English was in the process of affirming its place as the lingua franca of science. In the 1940s, the journal showed indications of a multilingual process reflected in the considerable presence of US authors and their articles in English published in its pages. This paper examines Caldasia’s communication circuit, specifically the negotiations that emerged between the editor and US researchers when deciding on the most appropriate language for publishing the articles. Selecting the language of the articles was considered by them as a critical element in determining the geographical scope of the journal, positioning Caldasia as a regional or international journal. This analysis demonstrates how the tension between multilingual repertoires and linguistic ideologies was experienced in Caldasia. The editor promoted Caldasia as a multilingual journal and to reach this objective the editor managed the multilingual repertoires of the authors in the journal. The case of Caldasia indicates that the Anglicization process of science in the XX century required intense scientific contacts carried out in non-English-speaking spaces; multilingualism was one of the strategies by which English became a globally accepted language.