bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combining in vivo proton exchange rate (kex) MRI with quantitative susceptibility mapping to further stratify the gadolinium-negative multiple sclerosis lesions
Authors: Liao Huiting , Cai Zimeng , Ye Haiqi , Chen QianLan , Zhang Yan , Shaghaghi Mehran , Lutz Sarah E. , Chen Weiwei , Cai Kejia 
Published: January 2023

BackgroundConventional gadolinium (Gd)-enhanced MRI is currently used for stratifying the lesion activity of multiple sclerosis (MS) despite limited correlation with disability and disease activity. The stratification of MS lesion activity needs further improvement to better support clinics.PurposeTo investigate if the novel proton exchange rate (kex) MRI combined with quantitative susceptibility mapping (QSM) may help to further stratify non-enhanced (Gd-negative) MS lesions.Materials and methodsFrom December 2017 to December 2020, clinically diagnosed relapsing-remitting MS patients who underwent MRI were consecutively enrolled in this IRB-approved retrospective study. The customized MRI protocol covered conventional T2-weighted, T2-fluid-attenuated-inversion-recovery, pre- and post-contrast T1-weighted imaging, and quantitative sequences, including kex MRI based on direct-saturation removed omega plots and QSM. Each MS lesion was evaluated based on its Gd-enhancement as well as its susceptibility and kex elevation compared to the normal appearing white matter. The difference and correlation concerning lesion characteristics and imaging contrasts were analyzed using the Mann–Whitney U test or Kruskal–Wallis test, and Spearman rank analysis with p &lt; 0.05 considered significant.ResultsA total of 322 MS lesions from 30 patients were identified with 153 Gd-enhanced and 169 non-enhanced lesions. We found that the kex elevation of all lesions significantly correlated with their susceptibility elevation (r = 0.30, p &lt; 0.001). Within the 153 MS lesions with Gd-enhancement, ring-enhanced lesions showed higher kex elevation than the nodular-enhanced ones’ (p &lt; 0.001). Similarly, lesions with ring-hyperintensity in QSM also had higher kex elevation than the lesions with nodular-QSM-hyperintensity (p &lt; 0.001). Of the 169 Gd-negative lesions, three radiological patterns were recognized according to lesion manifestations on the kex map and QSM images: Pattern I (kex+ and QSM+, n = 114, 67.5%), Pattern II (only kex+ or QSM+, n = 47, 27.8%) and Pattern III (kex– and QSM–, n = 8, 4.7%). Compared to Pattern II and III, Pattern I had higher kex (p &lt; 0.001) and susceptibility (p &lt; 0.05) elevation. The percentage of Pattern I of each subject was negatively correlated with the disease duration (r = –0.45, p = 0.015).ConclusionAs a potential imaging biomarker for inflammation due to oxidative stress, in vivo kex MRI combined with QSM is promising in extending the clinical classification of MS lesions beyond conventional Gd-enhanced MRI.
Associations between the Healthy Eating Index-2015 and S-Klotho plasma levels: A cross-sectional analysis in middle-to-older aged adults
Authors: Ma Teng-Chi , Zhou Jing , Wang Chen-Xi , Lin Zhi-Zhi , Gao Feng 
Published: January 2023

Background and aimThe Healthy Eating Index (HEI) is a dietary index developed by the United States Department of Agriculture (USDA) to determine whether a diet adheres to US dietary guidelines. Soluble Klotho (S-Klotho) is a protein with essential anti-aging properties. However, whether HEI is linked to S-Klotho plasma levels is still debatable. This study aimed to assess the association between HEI-2015 and S-Klotho in middle-to-older aged adults in the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016.MethodsThe study included 8456 middle-to-older aged (40–79 years old) participants. Multivariate regression models were used to estimate the correlation between HEI-2015 and S-Klotho concentrations. General additive models and two-piece-wise regression models were used to investigate the possible non-linear relationships between HEI-2015 and S-Klotho concentrations. Moreover, a stratified analysis of potential influencing factors was performed.ResultsA positive correlation was observed between HEI-2015 and S-Klotho plasma levels (β = 0.74, 95% CI: 0.21, 1.27, P = 0.0067). According to the two-piece-wise regression, the turning point of HEI-2015 was 45.15. When the range of HEI-2015 was from 0 to 45.15, the relationship between HEI and S-Klotho was insignificant (β = −0.87, 95% CI: −2.47, 0.73, P = 0.2858). However, when the range of HEI-2015 was from 45.15 to 100, HEI-2015 increased by 1 unit, the S-Klotho increased by 1.30 pg/ml (β = 1.30, 95% CI: 0.55, 2.05, P = 0.0007), suggesting a dose-response relationship. Furthermore, the stratified analysis showed that the association between HEI-2015 and S-Klotho concentrations was more significant in people with normal body mass index (P-interaction = 0.0161).ConclusionThere is a dose-response relationship between the HEI-2015 and S-Klotho in the middle-to-older aged adults. This relationship suggests that adherence to healthy dietary patterns may benefit the prevention of aging and health maintenance. The underlying mechanisms require further investigation.
Epidemiological data of national Kawasaki disease registry in Iran, 2007–2019
Authors: Shahbaznejad Leila , Hosseininasab Ali , Mahboobi Leila , Mohammadi Hamid , Esmaeili Hassan , Farrokhi Far Seyed Majid , Alipour Mohammad Reza , Sedighi Iraj , Mansour Ghanaei Roxana , Sobouti Behnam , Taremiha Alireza , Malek Abdol Reza , Ghadiri Keyghobad , Soleimani Gholamreza , Tabasizadeh Hamed , Ghadimi Moghadam Abdolkarim , Barak Manouchehr , Salehi Abarghouei Forood , Hashemian Houman , Daryani Nezhad Hossein , Sherkatolabbasieh Hamid Reza , Abedini-Varamini Masoumeh , Rahmati Mohammad Bagher , Movahedi Faezeh Sadat , Rezai Mohammad Sadegh 
Published: January 2023

IntroductionKawasaki disease(KD) is a vasculitis of childhood that tends to influence the coronary arteries. There is no national data about the prevalence of KD in Iran. This study aimed to perform a national registry in Iran for 13 years.MethodsIn this retrospective study, the data for KD extracted from medical records of &lt;19 year-old patients admitted to tertiary hospitals in Iran between 2007 and 2019 were recorded in the national KD registry system. Age, admission date, gender, location, and presence of KD criteria, laboratory and echocardiography findings, and treatment modalities were evaluated. Complete KD was considered if ≥4 clinical criteria of the KD existed and otherwise, incomplete KD was considered.ResultsData from 1,682 KD patients including 999(59.39%) boys and 683(40.61%) girls and male/female ratio of 1.46 were evaluated. The mean age was 3.08 ± 2.49 years and 1465(87%) were living in urban regions. The yearly incidence of the disease was between 2.62 to 3.03 from 2015 to 2019. The highest age-specific incidence was observed in children &lt;1-year-old. Incomplete and resistant KD included 1,321(78.54%) and 9(0.54%) patients, respectively. Abnormal echocardiography was detected in 619(36.80%) patients. Leukocytosis, with dominancy of neutrophils, anemia, thrombocytosis and increased ESR and CRP were the most noticeable laboratory findings. No death due to KD disease was reported.ConclusionBased on this study, most of the KD cases are presented with atypical presentation in Iran. So, increasing awareness of primary healthcare workers by educating and updating their data is very important in timely diagnosis and management of the disease.
Management of diabetes mellitus in people living with HIV: A single-center experience
Authors: Cattaneo Dario , Gidaro Antonio , Rossi Antonio , Merlo Andrea , Formenti Tiziana , Meraviglia Paola , Antinori Spinello , Gervasoni Cristina 
Published: January 2023

Background: Diabetes mellitus (DM) is more common in people living with HIV (PLWH) than in HIV-negative patients. Here we aimed to describe the response of PLWH with DM to glucose-lowering therapies in a reference hospital of northern Italy.Setting: 200 PLWH and DM were identified from the database of our clinic.Methods: Good control of DM was defined as having fasting glucose &lt;130 mg/dl or HbA1c &lt; 53 mmol/mol. The distribution of glucose-lowering therapies in PLWH was compared with that of HIV-negative patients with DM.Results: Mean total fasting glucose and HbA1C were 143 ± 50 mg/dl (51% exceeding the 130 mg/dl cutoff) and 51 ± 16 mmol/mol (30% exceeding the 53 mmol/mol cutoff), respectively. PLWH were less treated with dipeptidyl peptidase-4 inhibitors (1.7% versus 9.6%, p &lt; 0.01) and sulfonylureas (3.3% versus 13.2%, p &lt; 0.01), being conversely more frequently treated with metformin (53.8% versus 37.7%, p &lt; 0.01), glifozins plus metformin (7.1% versus 2.0%, p &lt; 0.05) or insulin plus other glucose-lowering agents (5.5% versus 0.5%, p &lt; 0.01).Conclusion: An underuse of dipeptidyl peptidase-4 inhibitors was found which was, however, counterbalanced by a higher use of combination of drugs (including glifozins). A rational assessment of drug-drug interactions would contribute to a better selection of the best glucose lowering agent for each antiretroviral therapy.
Natural product manoalide promotes EGFR-TKI sensitivity of lung cancer cells by KRAS-ERK pathway and mitochondrial Ca2+ overload-induced ferroptosis
Authors: Ni Yinyun , Liu Jiaye , Zeng Lingyan , Yang Ying , Liu Lei , Yao Menglin , Chai Li , Zhang Lu , Li Yi , Zhang Li , Li Weimin 
Published: January 2023

Background: Manoalide (MA), a proven natural inhibitor of PLA2 has anticancer effects, but its potential application and mechanism as an anticancer drug to promote EGFR-TKI sensitivity in lung cancer cells have not been studied.Methods: KRAS-mutated lung cancer cells and organoids, acquired osimertinib-resistant lung cancer cell lines HCC827OR, were used as EGFR-TKI-resistant models. CCK-8, clone formation, apoptosis assays, and calcein-AM staining were performed to investigate the inhibitory effects of MA in lung cancer cells and organoids. The flow cytometry or confocal microscope was used to detect lipid droplets, ROS, lipid peroxidation, mitochondria Ca2+, and iron content. The oxygen consumption rate (OCR) and fatty acid oxidation (FAO) were used to estimate the effect of MA on mitochondrial function.Results: MA inhibits the proliferation of KRAS-mutated lung cancer cells and organoids. In addition, MA induces ER stress in a ROS-dependent mechanism. The ROS induced by MA is mainly in mitochondrial and causes lipid peroxidation, thereby inhibiting mitochondrial FAO metabolism and promoting the accumulation of lipid droplets. MA also suppresses the KRAS-ERK pathway through ROS and promotes the sensitivity of KRAS-mutated lung cancer cells and organoids to osimertinib. Furthermore, MA induces ferroptosis by suppressing the NRF2-SLC7A11 axis and mitochondrial Ca2+ overload induced-FTH1 pathways to promote the sensitivity of osimertinib-resistant lung cancer cells to osimertinib.Conclusions: MA is a candidate EGFR-TKI sensitizer in KRAS-mutated and osimertinib-resistant lung cancer cells.
Under pressure – The working situation of Swedish healthcare managers during the first wave of COVID-19
Authors: Björk Lisa , Corin Linda , Akerstrom Magnus , Jonsdottir Ingibjörg H. , Innocenti Alessio Degl , Wijk Helle , Ahlstrom Linda 
Published: January 2023

IntroductionThe aim of this study is to provide insight into the psychosocial work situation of hospital managers during the first wave of the COVID-19 pandemic.MethodsMixed-effect modelling was used on survey data on job demands, job resources, job motivation, and work-life balance among over 500 managers working in 55 departments of a large Swedish university hospital in 2019 and 2020. Responses from 6011 employees were then used to stratify the analysis for COVID-19 exposure. Inductive content analysis was applied to open-ended questions on the managers’ views on organisational prerequisites during the onset of the pandemic.ResultsThe proportion of managers reporting difficulties with role clarity, quantitative demands, decision-making authority, and emotional support, time for recovery at work, motivation deficits, or problems with work-life balance clearly increased during the first wave of the pandemic. The proportion of managers reporting negative responses was higher in departments with high COVID-19 exposure. The qualitative analysis shows that overall governance in terms of clear, fair, and well-communicated routines, resource allocation, and division of responsibilities constituted an important framework for managerial during the crisis. First-line managers also require a mandate to re-organize their roles and their teams to successfully adapt to the situation. Organisational and social support was also important resources.DiscussionThis is the first study investigating healthcare managers’ work situation during the first wave of the COVID-19 pandemic in a Swedish context. As expected, it indicates an increasingly strained work situation during the crisis, but it also provides findings on organisational prerequisites that allow healthcare managers to cope with stressful situations. In line with previous research on organisational resilience, the study provides suggestions for how higher-level managers can act in order to provide front-line managers with the organisational prerequisites they need to adapt, learn and develop successfully during times of unpredictability, insecurity, and rapid change in order to offer the best possible support to health care workers.
Anxiety, depression, and academic stress among medical students during the COVID-19 pandemic
Authors: Avila-Carrasco Lorena , Díaz-Avila Daisy Lorena , Reyes-López Adrian , Monarrez-Espino Joel , Garza-Veloz Idalia , Velasco-Elizondo Perla , Vázquez-Reyes Sodel , Mauricio-González Alejandro , Solís-Galván Jorge Alfonso , Martinez-Fierro Margarita L. 
Published: January 2023

BackgroundThe social distancing policies implemented by the health authorities during the COVID-19 pandemic in Mexico and elsewhere led to major changes in teaching strategies for college undergraduates. So far, there is limited data regarding the impact of the lockdown on the academic stress and mental health of these students.ObjectiveTo assess the occurrence of academic difficulties, anxiety, depression, and academic stressors resulting in somatization with subsequent coping strategies linked to the pandemic.Materials and methodsA cross-sectional study was conducted with 728 medical students (years 1–5). A purposely designed questionnaire to assess academic difficulties associated with the pandemic was administered electronically. The validated Goldberg anxiety and depression scale was also used, as well as the SISCO-II inventory on academic stress.ResultsScreening for anxiety and depression led to a prevalence of 67.9 and 81.3%, respectively. Most relevant stressors, reported always or nearly always, included professors’ evaluations (63.9%), and reading overload of academic papers (50.6%). Factorial analyses showed that women were more prone to stress than men (p &lt; 0.001). Somatization symptomatology included drowsiness or increased need of sleep, anxiety, anguish, desperation, chronic fatigue, and sleep disorders. Common coping strategies included practicing a hobby, done always or nearly always by 65% of students with high stress, and 34% of those with low stress (p &lt; 0.001).ConclusionThere was a relevant impact of the mandatory lockdown during COVID-19 pandemic on the mental health of medical students reflected in the high prevalence rates of anxiety, depression, and stressors in the studied population pointing to the need for designing and implementing preventive strategies to deal with the effects of lockdowns.
A psychometric evaluation of the Italian short version of the Fear of Pain Questionnaire-III: Psychometric properties, measurement invariance across gender, convergent, and discriminant validity
Authors: Diotaiuti Pierluigi , Corrado Stefano , Mancone Stefania , Cavicchiolo Elisa , Chirico Andrea , Siqueira Thais Cristina , Andrade Alexandro 
Published: January 2023

IntroductionTheFear of Pain Questionnaire-III(FPQ-III) is a self-assessment instrument developed specifically to measure fear based on various pain stimuli converging on three factors: severe pain, medical pain, and minor pain. It actually remains the most studied and internationally used tool even in its short versions. The aim of this work was to propose a new validation study oriented to confirm the good psychometric properties of a short model of the FPQ-III for the Italian context.MethodsA large sample of participants was recruited (n  = 1,064) and Exploratory Factor Analysis (EFA) as well as Confirmatory Factor Analysis (CFA) were performed. Measurement invariance of the FPQ-III across gender was also evaluated. In order to examine convergent validity, a further convenient sample (n  = 292) was used and variables related to the individual’s pain experience, locus of control and coping orientations were assessed. A final discriminant assessment using experimental manipulation through fear eliciting videos was performed.ResultsThe three factors structure of the 13-item version of the questionnaire was confirmed (χ2= 148.092, CFI = 0.971, TLI = 0.962, RMSEA = 0.046, RMSEA 90% CI = 0.037–0.056) as well as the measurement invariance across gender. Item internal reliability was satisfactory. The results provided evidence of the good predictive validity of the FPQ-III and the discriminant assessment demonstrated that the instrument is suitable in detecting changes in fear of pain induced by specific situational conditions.DiscussionThe scale in this short version is suitable for quickly and efficiently gathering information about the perceived intensity of such anticipatory fears that might affect even the healthy person dysfunctionally.
A qualitative exploration of stakeholders’ perspectives on the experiences, challenges, and needs of persons with serious mental illness as they consider finding a partner or becoming parent
Authors: Dubreucq Marine , Lysaker Paul H. , Dubreucq Julien 
Published: January 2023

BackgroundWhile many persons with serious mental illness (SMI) consider intimate relationships and becoming parent as central parts of their lives deeply affecting wellbeing and recovery, others anticipate facing multiple challenges in these life domains. This qualitative study sought to explore the perspectives of persons with SMI and mental health providers (MHPs) with diverse backgrounds and practices on the experiences, challenges, needs and expectations of persons with SMI as they consider finding a partner or becoming parent.MethodsFor this qualitative study, we conducted five focus groups between March and December 2020 for a total number of 22 participants (nine persons with SMI and thirteen MHPs) recruited from a center for psychiatric rehabilitation and a community mental health center in France. We used the inductive six-step process by Braun and Clarke for the thematic analysis.ResultsParticipants reported some challenges related to intimate relationships, stigma/self-stigma, disclosure and decision-making about start a family. Their expectations included: (i) psychoeducation about decision-making about finding a partner and starting a family; (ii) support in making empowered decisions about finding a partner, starting a family or disclosure to a prospective partner or their child; (iii) peer-support interventions; (iv) enhancing coping strategies; (v) integrated service provision including home treatment interventions, training to recovery-oriented practices and access to dedicated resources for providers.ConclusionIn short, intimate relationships and desire to start a family for persons with SMI should be more considered in psychiatric rehabilitation and additional support and interventions should therefore be provided.
Prophylactic intravitreal injection of aflibercept for preventing postvitrectomy hemorrhage in proliferative diabetic retinopathy: A randomized controlled trial
Authors: Qu Jinfeng , Chen Xiuju , Liu Qinghuai , Wang Fang , Li Mingxin , Zhou Qiong , Yao Jin , Li Xiaoxin 
Published: January 2023

IntroductionThe aim of this study was to assess the effects of preoperative intravitreal aflibercept (IVA) injection on the incidence of postoperative vitreous hemorrhage (VH) after vitrectomy for proliferative diabetic retinopathy (PDR).MethodsThis study involved a prospective, randomized clinical trial. One hundred twenty-eight eyes of 128 patients of PDR who underwent pars plana vitrectomy (PPV) were enrolled. Sixty-four eyes were assigned randomly to either the IVA group (IVA injection 1 to 5 days before PPV) or the control group (no IVA injection). The primary outcome was the incidence of VH at 1 month after PPV. Secondary outcome measures were best-corrected visual acuity (BCVA) changes from baseline to at 1 week, 1 month, 2 months, and 3 months after surgery.ResultsThe VH incidences in the IVA group and the control group were 14.8 and 39.3% at week 1, 8.6 and 31.7% at month 1, 11.7 and 30.5% at month 2, and 8.6 and 30.5% at month 3, respectively. Intergroup differences showed a significantly decreased VH rate in the IVA group compared with that in the control group at week 1, month 1, and month 3 (p = 0.021, 0.006, and 0.047, respectively). Compared to the baseline, neither the mean BCVA nor the BCVA change in the Logarithm of the Minimum Angle of Resolution (logMAR) scale did differ significantly between the two groups at each visit point. There are a greater number of eyes with BCVA improvement of more than 2 logMAR in the IVA group than in the control group at week 1 (8 vs. 2, p = 0.048).ConclusionsThis study found that the adjunctive use of preoperative IVA reduces early and late postoperative VH in vitrectomy for PDR.
The positive effect of mother-performed infant massage on infantile eczema and maternal mental state: A randomized controlled trial
Authors: Lin Lin , Yu Lin , Zhang Shuying , Liu Jing , Xiong Ying 
Published: January 2023

ObjectiveTo observe the influence of MPIM on infantile eczema, quality of life, growth and maternal mental state.MethodsThis trial was a randomized controlled study. Sixty-six full-term infants with eczema were randomly divided into eczema control group (EC group, n = 33) and eczema with MPIM group (EM group, n = 33), along with healthy full-term infants in the healthy control group (HC group, n = 31). The mothers in the EC group received the instruction of routine care, while the mothers in the EM group applied massage on the infants plus receiving the same instruction of the routine care. HC group received none of any specific intervention. Data were collected in the three groups at the baseline and at the end of 2- and 5-month intervention. Before and at the end of 2-month intervention, the following indexes were investigated in infants including the growth indexes, eczema area severity index (EASI), infantile dermatitis quality of life index (IDQOL). And the scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were investigated in mothers at the same timepoints. At the end of 5-month intervention, the infants' growth and relapse condition of eczema were observed.ResultsOverall, 31 cases in HC group, 31 in EC group and 32 in EM group were included for data analysis. There were no significant differences in the indexes of infantile growth among the three groups (all P &gt;0.05). The scores of EASI and IDQOL significantly lowered (both P &lt; 0.001) in EC group following the instruction of routine care, along with reduced maternal scores of SAS and SDS (both P &lt; 0.05). Compared with the EC group, the EM group showed significantly lower scores of EASI and IDQOL (both P &lt; 0.001) and lower relapse rate (P &lt; 0.01) in infants with eczema, along with significantly lower scores of SAS and SDS in mothers (both P &lt; 0.01). Moreover, none of obvious adverse reaction was reported following MPIM, to which most of the mothers could adhere.ConclusionMPIM could effectively promote the remission of infantile eczema and reduce its relapse, along with relieving maternal anxiety and depression mood.Clinical trial registrationIdentifier: ChiCTR2200066246.