bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of regional medical disparities on complications in patients with hypertension: Cox’s proportional hazard models
Authors: Yun Choa , Park Minah , Joo Jae Hong , Kang Soo Hyun , Jeong Sung Hoon , Nam Chung-Mo , Park Eun-Cheol , Jang Sung-In 
Published: June 2023

ObjectiveComplications associated with hypertension can be alleviated by providing necessary medical services. However, there may be disparities in their provision depending on regional differences. Thus, this study aimed to examine the effects of regional healthcare disparities on complications in patients with hypertension in South Korea.MethodsData from the National Health Insurance Service National Sample Cohort (2004–2019) were analyzed. The position value for the relative composite index was used to identify medically vulnerable regions. The diagnosis of hypertension within the region was also considered. The risk of complications associated with hypertension included cardiovascular, cerebrovascular, and kidney diseases. Cox proportional hazards models were used for statistical analysis.ResultsA total of 246,490 patients were included in this study. Patients who lived in medically vulnerable regions and were diagnosed outside their residential area had a higher risk of complications than those living in non-vulnerable regions and were diagnosed outside the residential area (hazard ratio: 1.156, 95% confidence interval: 1.119–1.195).ConclusionPatients living in medically vulnerable regions who were diagnosed outside their residential areas were more likely to have hypertension complications regardless of the type of complication. Necessary policies should be implemented to reduce regional healthcare disparities.
A functional MMP-9-1562C>T polymorphism, MMP-9 serum levels and nephrolithiasis risk in a southern Chinese population
Authors: Ding Qi , Cao Cheng , Shi Ying , Fan Zhijiang , Li Feng , Tu Wenjian , Jin Xiaohua , Zhu Hailiang , Fan Bo 
Published: June 2023

BackgroundThe role of matrix metalloproteinase 9 (MMP-9) in the pathophysiology of chronic kidney disease (CKD), which is associated with a nearly two-fold greater risk for urinary calculi compared to people without CKD, has been demonstrated. The aim of the research is to evaluate the association between MMP-9-1562C&gt;T polymorphism, MMP-9 serum levels and nephrolithiasis risk.MethodsA hospital-based case-control study involving 302 kidney stone patients and 408 controls without kidney stone from southern China was conducted. Sanger sequencing was used to genotype the MMP-9-1562C&gt;T polymorphism. The serum MMP-9 was measured in 105 kidney stone patients and 77 controls by enzyme-linked immunosorbent assay.ResultsCompared to the control group, the CT genotype was more frequent in nephrolithiasis patients (adjusted OR = 1.60, 95% CI = 1.09–2.37: the risk of developing nephrolithiasis in individuals with CT genotype compared to CC genotype). Moreover, there was also a higher frequency of CT/TT genotypes among patients with nephrolithiasis (adjusted OR = 1.49, 95% CI = 1.02–2.19: the risk of developing nephrolithiasis in individuals with CT/TT genotypes compared to CC genotype). The risk remained for the subgroups of patients aged &gt;53, smokers with pack-years of smoking &gt;20, non-drinkers, non-diabetic patients, patients with hypertension, recurrent episodes and calcium oxalate stones (OR = 2.26, 95% CI = 1.31–3.91; OR = 5.47, 95% CI = 1.10–27.30; OR = 1.76, 95% CI = 1.14–2.72; OR = 1.54, 95% CI = 1.03–2.30; OR = 1.97, 95% CI = 1.01–3.82; OR = 1.67, 95% CI = 1.06–2.62; OR = 1.54, 95% CI = 1.02–2.32, respectively). Biochemical parameters did not differ between genotypes. Compared to controls (18.57 ± 5.80 ng/mL), nephrolithiasis patients had significantly higher serum MMP-9 levels (30.17 ± 6.78 ng/mL, p &lt; 0.001). The serum MMP-9 levels of patients with CT/TT genotypes of MMP-9-1562C&gt;T were significantly higher than those with CC genotype (32.00 ± 6.33 vs. 29.13 ± 6.85 ng/mL, p = 0.037).ConclusionThe MMP-9-1562C&gt;T polymorphism in association with its soluble protein increased the risk of kidney stone, thus suggesting it could be used as a susceptibility biomarker for nephrolithiasis. Further functional studies and larger studies that include environmental exposure data are needed to confirm the findings.
Annexin-V positive extracellular vesicles level is increased in severe COVID-19 disease
Authors: Jacob Valentine , Lambour Alexis , Swinyard Benjamin , Zerbib Yoann , Diouf Momar , Soudet Simon , Brochot Etienne , Six Isabelle , Maizel Julien , Slama Michel , Guillaume Nicolas 
Published: June 2023

ObjectivesTo evaluate extracellular vesicles levels in a cohort of SARS-CoV-2’s patients hospitalized in an intensive care unit with and without COVID-19 associated thromboembolic events.MethodsIn this study, we aim to assess endothelial and platelet membrane-derived extracellular vesicles levels in a cohort of SARS-CoV-2 patients with and without COVID-19-associated thromboembolic events who were hospitalized in an intensive care unit. Annexin-V positive extracellular vesicles levels were prospectively assessed by flow cytometry in one hundred twenty-three critically ill adults diagnosed with acute respiratory distress syndrome associated with a SARS-CoV-2 infection, ten adults diagnosed for moderate SARS-CoV-2 infection and 25 healthy volunteers.ResultsOn our critically ill patients, thirty-four patients (27.6%) had a thromboembolic event, Fifty-three (43%) died. Endothelial and platelet membrane-derived extracellular vesicles were drastically increased in SARS-CoV-2 patients hospitalized in the ICU compared to healthy volunteers. Moreover a slighty higher small/large ratio for platelets membrane-derived extracellular vesicles in patients was linked to thrombo-embolic events.ConclusionA comparison between total annexin-V positive extracellular vesicles levels in severe and moderate SARS-CoV-2 infection and healthy controls showed a significant increase in patients with severe infection and their sizes could be considered as biomarkers of SARS-CoV-2 associated thrombo-embolic events.
The use of a scented face mask in pediatric patients may facilitate mask acceptance before anesthesia induction
Authors: Abukawa Yukako , Takano Koji , Hobo Yuko , Hosaka Erika , Kimura Ayano , Suga Yoshifumi , Katori Nobuyuki , Tsubokawa Tsunehisa 
Published: June 2023

BackgroundScented face masks are commonly used during the induction phase of anesthesia. The present study investigated whether the use of a scented mask improved mask acceptance before the slow induction of anesthesia in pediatric patients.MethodsThis prospective, randomized controlled trial enrolled patients aged 2–10 years who were scheduled to undergo surgery under general anesthesia. Patients were randomly assigned to either of regular unscented (control group) or scented (experimental group) face masks before anesthesia induction with a parent. The primary outcome was the mask acceptance score, rated on a validated 4-point from 1 point (not afraid; easily accepts the mask) to 4 points (afraid of a mask; crying or struggling). The secondary outcome was heart rate assessed by pulse oximetry in the pediatric ward before transfer to the operating room (OR), at the entrance to the OR, at the patient notification of mask fitting by the anesthesiologist, and after mask fitting.ResultsSeventy-seven patients were accessed for eligibility, with 67 enrolled in the study: 33 in the experimental group and 34 in the control group. Mask acceptance was significantly greater among patients aged 2–3 years in the experimental than in the control group (p &lt; 0.05).ConclusionThe use of a scented mask can improve mask acceptance before anesthesia induction with a parental presence in pediatric patients aged 2–3 years.Clinical Trial Registration: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000040819.
Impact of Aerobika® oscillating positive expiratory pressure in improving small airway resistance, lung function, symptoms and exercise capacity in chronic obstructive pulmonary disease
Authors: Sahardin Siti Nurhanis , Jailaini Mas Fazlin Mohamad , Abeed Nik Nuratiqah Nik , Ban Andrea Yu-Lin , Hau Ng Boon , Azmel Azat Azrai , Shah Shamsul Azhar , Hamid Mohamed Faisal Abdul 
Published: June 2023

BackgroundAerobika® oscillating positive expiratory pressure (OPEP) device promotes airway clearance in many respiratory diseases. However, studies have yet to focus on its effectiveness in improving small airway resistance via impulse oscillometry (IOS) measurement in COPD subjects. We aim to evaluate the improvement of small airway resistance (via IOS), lung function (spirometry), exercise capacity [via 6-min walking test (6MWT)], symptoms [COPD assessment test (CAT)] and severe exacerbation events among COPD subjects using Aerobika® OPEP.MethodsThis was a prospective, single-arm interventional study among COPD subjects with small airway disease. Subjects were instructed to use twice daily Aerobika® OPEP (10 min each session); for 24 weeks; as an additional to standard therapy. IOS, spirometry, 6MWT, CAT score and severe exacerbation events were evaluated at baseline, 12 weeks and 24 weeks.ResultsFifty-three subjects completed the study. Aerobika® usage showed improvement of IOS parameters; e.g. measurement of airway resistance at 5 Hz (R5), cmH20/L/s, (12-week p = 0.008, 24-week p &lt; 0.001), R5% predicted (12-week p = 0.007, 24-week p &lt; 0.001) and small airway resistance (R5–R20), cmH20/L/s, (12-week p = 0.021, 24-week p &lt; 0.001). There were improvement of lung function; e.g. FEV1, L (12-week p = 0.018, 24-week p = 0.001), FEV1% predicted (12-week p = 0.025, 24-week p = 0.001), FEF25–75, L (12-week p = 0.023, 24-week p = 0.002), and FEF25–75% predicted (12-week p = 0.024, 24-week p &lt; 0.001). CAT score improved at 12 weeks (p &lt; 0.001) and 24 weeks (p &lt; 0.001). Subjects had improved exercise capacity (6MWT, metres) after 24 weeks (p = 0.016). However, there was no significant difference in severe exacerbation events 24 weeks before and after Aerobika® usage.ConclusionAerobika® OPEP demonstrated significant improvement in small airway resistance as early as 12 weeks of usage, with sustained improvement at 24 weeks. Aerobika® OPEP administration had significantly improved lung function, 6MWT, and CAT scores over 24 weeks. There was no difference in severe exacerbation events.
Uncovering neuroinflammation-related modules and potential repurposing drugs for Alzheimer's disease through multi-omics data integrative analysis
Authors: Li Shensuo , Lu Changhao , Zhao Zhenzhen , Lu Dong , Zheng Guangyong 
Published: June 2023

BackgroundNeuroinflammation is one of the key factors leading to neuron death and synapse dysfunction in Alzheimer's disease (AD). Amyloid-β (Aβ) is thought to have an association with microglia activation and trigger neuroinflammation in AD. However, inflammation response in brain disorders is heterogenous, and thus, it is necessary to unveil the specific gene module of neuroinflammation caused by Aβ in AD, which might provide novel biomarkers for AD diagnosis and help understand the mechanism of the disease.MethodsTranscriptomic datasets of brain region tissues from AD patients and the corresponding normal tissues were first used to identify gene modules through the weighted gene co-expression network analysis (WGCNA) method. Then, key modules highly associated with Aβ accumulation and neuroinflammatory response were pinpointed by combining module expression score and functional information. Meanwhile, the relationship of the Aβ-associated module to the neuron and microglia was explored based on snRNA-seq data. Afterward, transcription factor (TF) enrichment and the SCENIC analysis were performed on the Aβ-associated module to discover the related upstream regulators, and then a PPI network proximity method was employed to repurpose the potential approved drugs for AD.ResultsA total of 16 co-expression modules were primarily obtained by the WGCNA method. Among them, the green module was significantly correlated with Aβ accumulation, and its function was mainly involved in neuroinflammation response and neuron death. Thus, the module was termed the amyloid-β induced neuroinflammation module (AIM). Moreover, the module was negatively correlated with neuron percentage and showed a close association with inflammatory microglia. Finally, based on the module, several important TFs were recognized as potential diagnostic biomarkers for AD, and then 20 possible drugs including ibrutinib and ponatinib were picked out for the disease.ConclusionIn this study, a specific gene module, termed AIM, was identified as a key sub-network of Aβ accumulation and neuroinflammation in AD. Moreover, the module was verified as having an association with neuron degeneration and inflammatory microglia transformation. Moreover, some promising TFs and potential repurposing drugs were presented for AD based on the module. The findings of the study shed new light on the mechanistic investigation of AD and might make benefits the treatment of the disease.
Gait performance and prefrontal cortex activation during single and dual task walking in older adults with different cognitive levels
Authors: Weng Wei-Han , Yang Yea-Ru , Yeh Nai-Chen , Ku Pei-Hsin , Wang Po-Shan , Liao Ying-Yi , Wang Ray-Yau 
Published: June 2023

BackgroundGrowing evidence shows the cognitive function influences the motor performance. The prefrontal cortex (PFC) as a part of the executive locomotor pathway is also important for cognitive function. This study investigated the differences in motor function and brain activity among older adults with different cognitive levels, and examined the significance of cognition on motor functions.MethodsNormal control (NC), individuals with mild cognitive impairment (MCI) or mild dementia (MD) were enrolled in this study. All participants received a comprehensive assessment including cognitive function, motor function, PFC activity during walking, and fear of fall. The assessment of cognitive function included general cognition, attention, executive function, memory, and visuo-spatial. The assessment of motor function included timed up and go (TUG) test, single walking (SW), and cognitive dual task walking (CDW).ResultsIndividuals with MD had worse SW, CDW and TUG performance as compared to individuals with MCI and NC. These gait and balance performance did not differ significantly between MCI and NC. Motor functions all correlated with general cognition, attention, executive function, memory, and visuo-spatial ability. Attention ability measured by trail making test A (TMT-A) was the best predictor for TUG and gait velocity. There were no significant differences in PFC activity among three groups. Nevertheless, the PFC activated more during CDW as compared with SW in individuals with MCI (p = 0.000), which was not demonstrated in the other two groups.ConclusionMD demonstrated worse motor function as compared to NC and MCI. The greater PFC activity during CDW in MCI may be considered as a compensatory strategy for maintaining the gait performance. Motor function was related to the cognitive function, and the TMT A was the best predictor for the gait related performance in present study among older adults.
Supporting stroke survivors to meet their personal rehabilitation needs in community-based arm rehabilitation: development of initial programme theories to explore what may work for whom, how and under what circumstances
Authors: Schnabel Stefanie , van Wijck Frederike , Kidd Lisa 
Published: June 2023

ObjectiveThis study explored what worked for whom, how and under what circumstances in a community-based augmented arm rehabilitation programme that was designed to enable stroke survivors to meet their personal rehabilitation needs.DesignA mixed methods realist-informed study of data from a randomised controlled feasibility trial, comparing augmented arm rehabilitation after stroke with usual care. The analysis was designed to develop initial programme theories and refine these through triangulation of qualitative and quantitative trial data. Participants with a confirmed stroke diagnosis and stroke-related arm impairment were recruited from five health boards in Scotland. Only data from participants in the augmented group were analysed. The augmented intervention comprised evidence-based arm rehabilitation (27 additional hours over 6 weeks) including self-managed practice, and focused on individual rehabilitation needs identified through the Canadian Occupational Performance Measure (COPM). The COPM indicated to which extent rehabilitation needs were met following the intervention, the Action Research Arm Test provided data on changes in arm function, and qualitative interviews provided information about the context and potential mechanisms of action.FindingsSeventeen stroke survivors (11 males, age range 40–84 years, NIHSS median (IQR) 6 (8)) were included. Median (IQR) COPM Performance and Satisfaction scores (min.1-max.10) improved from pre-intervention 2 (5) to post-intervention 5 (7). Findings suggested that meeting rehabilitation needs was facilitated by strengthening participants’ sense of intrinsic motivation (through grounding exercises in everyday activities linked to valued life roles, and enabling them to overcome barriers to self-managed practice), and via therapeutic relationships (through trust and expertise, shared decision-making, encouragement and emotional support). Collectively, these mechanisms enabled stroke survivors to build confidence and gain mastery experience necessary to engage in new self-managed practice routines.ConclusionThis realist-informed study enabled the development of initial programme theories to explain how and in what circumstances the augmented arm rehabilitation intervention may have enabled participants to meet their personal rehabilitation needs. Encouraging participants’ sense of intrinsic motivation and building therapeutic relationships appeared instrumental. These initial programme theories require further testing, refinement, and integration with the wider literature.
Primary motor hand area corticospinal excitability indicates overall functional recovery after spinal cord injury
Authors: Dai Chun-Qiu , Gao Ming , Lin Xiao-Dong , Xue Bai-Jie , Liang Ying , Xu Mu-Lan , Wu Xiang-Bo , Cheng Gui-Qing , Hu Xu , Zhao Chen-Guang , Yuan Hua , Sun Xiao-Long 
Published: June 2023

BackgroundAfter spinal cord injury (SCI), the excitability of the primary motor cortex (M1) lower extremity area decreases or disappears. A recent study reported that the M1 hand area of the SCI patient encodes the activity information of both the upper and lower extremities. However, the characteristics of the M1 hand area corticospinal excitability (CSE) changes after SCI and its correlation with extremities motor function are still unknown.MethodsA retrospective study was conducted on the data of 347 SCI patients and 80 healthy controls on motor evoked potentials (MEP, reflection of CSE), extremity motor function, and activities of daily living (ADL) ability. Correlation analysis and multiple linear regression analysis were conducted to analyze the relationship between the degree of MEP hemispheric conversion and extremity motor function/ADL ability.ResultsThe CSE of the dominant hemisphere M1 hand area decreased in SCI patients. In 0–6 m, AIS A grade, or non-cervical injury SCI patients, the degree of M1 hand area MEP hemispheric conversion was positively correlated with total motor score, lower extremity motor score (LEMS), and ADL ability. Multiple linear regression analysis further confirmed the contribution of MEP hemispheric conversion degree in ADL changes as an independent factor.ConclusionThe closer the degree of M1 hand area MEP hemispheric conversion is to that of healthy controls, the better the extremity motor function/ADL ability patients achieve. Based on the law of this phenomenon, targeted intervention to regulate the excitability of bilateral M1 hand areas might be a novel strategy for SCI overall functional recovery.
Stiffness changes in internal rotation muscles of the shoulder and its influence on hemiplegic shoulder pain
Authors: Jia Fan , Zhu Xin-Rui , Kong Ling-Yu , Fan Jie-Cheng , Zhu Zong-Jing , Lin Li-Zhen , Zhang Shu-Yun , Yuan Xiang-Zhen 
Published: June 2023

BackgroundHemiplegic shoulder pain (HSP) is a common complication in patients with stroke. The pathogenesis of HSP is complex, and muscle hypertonia, especially the hypertonia of internal rotation muscles of the shoulder, may be one of the important causes of shoulder pain. However, the relationship between muscle stiffness and HSP has not been well studied. The purpose of this study is to explore the correlations between the stiffness of internal rotation muscles and clinical symptoms in patients with HSP.MethodsA total of 20 HSP patients and 20 healthy controls were recruited for this study. The stiffness of internal rotation muscles was quantified using shear wave elastography, and Young's modulus (YM) of the pectoralis major (PM), anterior deltoid (AD), teres major ™, and latissimus dorsi (LD) were measured. Muscle hypertonia and pain intensity were evaluated using the Modified Ashworth Scale (MAS) and Visual Analog Scale (VAS), respectively. The mobility of the shoulder was evaluated using the Neer score. The correlations between muscle stiffness and the clinical scales were analyzed.ResultsYM of internal rotation muscles on the paretic side was higher than that of the control group in the resting and passive stretching positions (P &lt; 0.05). YM of internal rotation muscles on the paretic side during passive stretching was significantly higher than that at rest (P &lt; 0.05). YM of PM, TM, and LD during passive stretching were correlated with MAS (P &lt; 0.05). In addition, the YM of TM during passive stretching was positively correlated with VAS and negatively correlated with the Neer score (P &lt; 0.05).ConclusionIncreased stiffness of PM, TM, and LD was observed in patients with HSP. The stiffness of TM was associated with pain intensity of the shoulder and shoulder mobility.
Detection of brain regions responsible for chronic pain in osteoarthritis: an fMRI-based neuroimaging study using deep learning
Authors: Chatterjee Indranath , Baumgartner Lea , Cho Migyung 
Published: June 2023

IntroductionChronic pain is a multifaceted condition that has yet to be fully comprehended. It is frequently linked with a range of disorders, particularly osteoarthritis (OA), which arises from the progressive deterioration of the protective cartilage that cushions the bone endings over time.MethodsIn this paper, we examine the impact of chronic pain on the brain using advanced deep learning (DL) algorithms that leverage resting-state functional magnetic resonance imaging (fMRI) data from both OA pain patients and healthy controls. Our study encompasses fMRI data from 51 pain patients and 20 healthy subjects. To differentiate chronic pain-affected OA patients from healthy controls, we introduce a DL-based computer-aided diagnosis framework that incorporates Multi-Layer Perceptron and Convolutional Neural Networks (CNN), separately.ResultsAmong the examined algorithms, we discovered that CNN outperformed the others and achieved a notable accuracy rate of nearly 85%. In addition, our investigation scrutinized the brain regions affected by chronic pain and successfully identified several regions that have not been mentioned in previous literature, including the occipital lobe, the superior frontal gyrus, the cuneus, the middle occipital gyrus, and the culmen.DiscussionThis pioneering study explores the applicability of DL algorithms in pinpointing the differentiating brain regions in OA patients who experience chronic pain. The outcomes of our research could make a significant contribution to medical research on OA pain patients and facilitate fMRI-based pain recognition, ultimately leading to enhanced clinical intervention for chronic pain patients.