bluuebunny/crossref_metadata_2025_split huggingface dataset:
A feasibility and safety study of afamelanotide in acute stroke patients – an open label, proof of concept, phase iia clinical trial
Authors: Stanislaus Vimal , Kam Anthony , Murphy Lily , Wolgen Philippe , Walker Gill , Bilbao Pilar , Cloud Geoffrey C 
Published: July 2023

Abstract
Background
Neuroprotective agents have the potential to improve the outcomes of revascularisation therapies in acute ischemic stroke patients (AIS) and in those unable to receive revascularisation. Afamelanotide, a synthetic α-melanocyte stimulating hormone analogue, is a potential novel neuroprotective agent. We set out to assess the feasibility and safety of afamelanotide for the first time in AIS patients.

Methods
AIS patients within 24 h of onset, with perfusion abnormality on imaging (Tmax) and otherwise ineligible for revascularisation therapies were enrolled. Afamelanotide 16 mg implants were administered subcutaneously on Day 0 (D0, day of recruitment), D1 and repeated on D7 and D8, if not well recovered. Treatment emergent adverse events (TEAEs) and neurological assessments were recorded regularly up to D42. Magnetic resonance imaging (MRI) with FLAIR sequences were also performed on D3 and D9.

Results
Six patients (5 women, median age 81, median NIHSS 6) were recruited. Two patients received 4 doses and four patients received 2. One patient (who received 2 doses), suffered a fatal recurrent stroke on D9 due to a known complete acute internal carotid artery occlusion, assessed as unrelated to the study drug. There were no other local or major systemic TEAEs recorded. In all surviving patients, the median NIHSS improved from 6 to 2 on D7. The median Tmax volume on D0 was 23 mL which was reduced to a FLAIR volume of 10 mL on D3 and 4 mL on D9.

Conclusions
Afamelanotide was well tolerated and safe in our small sample of AIS patients. It also appears to be associated with good recovery and radiological improvement of salvageable tissue which needs to be tested in randomized studies.

ClinicalTrials.gov Identifier
NCT04962503, First posted 15/07/2021.
Psychosocial and organisational work factors as predictors of sickness absence among professionally active adults with common mental disorders
Authors: Helgesson Magnus , Gustafsson Klas , Leineweber Constanze 
Published: July 2023

Abstract
Background
The incidence of sickness absence (SA) due to common mental disorders (CMDs) has increased in recent decades. It is hence important to elucidate how individuals with CMDs can maintain work. The aim was to analyse the relationship between psychosocial and organisational workplace factors and a spell of > 14 days of SA among persons with CMDs.

Methods
Included were respondents of the Swedish Work Environment Survey (SWES) 1993–2013, diagnosed with a CMD up to five years before the interview in the SWES (n = 3,795). Relative Risk (RR) regression models with 95% Confidence Intervals (CIs) analysed associations between psychosocial-, and organisational workplace factors and a subsequent spell of SA > 14 days.

Results
Low control over work (RR:1.16; CI:1.01–1.35), job strain (RR:1.25; CI:1.04–1.49), no flexible working hours (RR:1.25; CI:1.08–1.45) or no possibility to work from home (RR:1.37; CI:1.13–1.66) were significantly related to an increased risk of SA. Persons diagnosed with depression experiencing job strain had the highest increased risk of SA (RR:1.55; CI: 1.07–2.25).

Conclusions
A sustainable work-life among working individuals with CMDs can be provided by reducing job strain, and if possible, by increasing flexibility regarding workplace and working hours. This may prevent spells of SA, and hereby increase productivity.
Long-term sickness absence trajectories among ageing municipal employees – the contribution of social and health-related factors
Authors: Suur-Uski Johanna , Pietiläinen Olli , Salonsalmi Aino , Pekkala Johanna , Fagerlund Pi , Rahkonen Ossi , Lallukka Tea 
Published: July 2023

Abstract
Background
The ageing work force is heterogeneous, following distinct development in work ability. This study aims to identify trajectories of long-term sickness absence (SA) in later careers and to examine potentially modifiable factors associated with the development of SA.

Methods
Data comprised of municipal employees of the city of Helsinki aged 50–60 years during 2004–2018 (N = 4729, 80% women). The developmental trajectories of long-term (> 10 working days) SA were examined with Group-based trajectory modelling (GBTM) using SA records of the Social Insurance Institution of Finland during 2004–2018. All-cause and diagnosis-specific (mental disorder– and musculoskeletal disease–related) SA days were analysed. The association of social and health-related factors with trajectory membership was examined using multinomial logistic regression (odds ratios and 95% confidence intervals).

Results
A model with three trajectories was selected for both all-cause and diagnosis-specific SA. Regarding all-cause long-term SA trajectories, 42% had no long-term SA, 46% had low levels of SA, and 12% had a high rate of SA during follow-up. Lower occupational class, reporting smoking, overweight or obesity, moderate or low leisure-time physical activity, and sleep problems were associated with a higher likelihood of belonging to the trajectory with a high rate of SA in both all-cause and diagnosis-specific models.

Conclusions
Most ageing employees have no or little long-term SA. Modifiable factors associated with trajectories with more SA could be targeted when designing and timing interventions in occupational healthcare.
The association between periodontal diseases and helicobacter pylori: an updated meta-analysis of observational studies
Authors: Moradi Yousef , Majidi Lobat , Khateri Sorour , Azh Nima , Gheshlagh Reza Ghanei , Saniee Nadia , Zarei Mostafa , Moradpour Farhad 
Published: July 2023

AbstractIntroductionVarious studies have examined the association between periodontitis and helicobacter pylori and reported conflicting results. The aimed of this systematic review and meta-analysis estimating the association between these two variables.MethodsElectronic databases including PubMed (Medline), Scopus, Web of Sciences and Medline (Elsevier) were searched using the relevant keywords. All observational studies comparing the association between periodontitis and helicobacter pylori were considered. The Newcastle - Ottawa Quality Assessment Scale (NOS) checklist was used for assessing quality of included studies. All statistical analyses were completed using STATA (Version 16).ResultsTwenty-three studies with 8,638 patients (15 case-control with 2,366 patients and 8 cross-sectional with 6,272 patients) were included in this meta-analysis. After combining the selected studies, the odds of presence the Helicobacter pylori infection in patients with the periodontal disease was 2.47 (OR: 2.47; 95% CI: 2.01, 3.03; I2: 50.87%;P: 0.001). Also, the odds after combining case-control studies was 2.77 (OR: 2.77; % 95 CI: 2.11, 3.66; I2: 37.16%;P: 0.049) and after combining cross-sectional analytical ones, it was equal to 2.07 (OR: 2.07; 95% CI: 1.62, 2.65; I2: 43.25%;P: 0.050).ConclusionBased on the results of this meta-analysis, the association between Helicobacter pylori infection and the periodontal disease is evident.
Clinical features of uterine sarcomas presenting mainly with uterine masses: a retrospective study
Authors: Zhu Menghan , Chen Shouzhen 
Published: July 2023

Abstract
Background
Uterine sarcomas are uncommon mesenchymal tumors of the uterus. The clinical problem is that the features of uterine sarcomas can sometimes mimic uterine fibroids. This study aims to investigate the clinical characteristics of patients with uterine sarcomas who were preoperative presenting mainly with uterine masses.

Methods
A retrospective analysis of patients who underwent gynecological surgery for uterine sarcomas at the Obstetrics & Gynecology Hospital of Fudan University, between January 2016 and December 2021.

Results
Over the 5-year period, 277 patients were final diagnosed of uterine sarcomas. A total of 162 patients were preoperatively diagnosed as uterine fibroids for surgical treatment, the majority of whom were diagnosed of uterine leiomyosarcoma (uLMS) (49/162) and low-grade endometrial stromal sarcoma (LG-ESS) (100/162). Ninety people underwent total hysterectomy and bilateral salpingo-oophorectomy (TH + BSO), while 72 underwent myomectomy followed by supplemental TH + BSO. The group with direct hysterectomy had a higher average age than the group with prior myomectomy (47.20 ± 8.94 vs. 40.86 ± 5.88, p < 0.001). Among patients preoperatively diagnosed as uterine fibroids, patients with uLMS had a higher proportion of previous myomectomy (26.53% vs. 5.00%, p < 0.001), a larger uterine mass diameter on ultrasound (8.38 ± 3.39 cm vs. 6.41 ± 1.92 cm, p < 0.001), and richer hypervascularity (34.69% vs. 18%, p = 0.024) compared with LG-ESS.

Conclusions
Analysis of our data showed that a large proportion of uterine sarcomas, especially uLMS and LG-ESS, present mainly with uterine masses. Ultrasound features including a large uterine mass diameter and rich hypervascularity, and with a history of myomectomy may alert clinicians in suspicion of uLMS when compared with LG-ESS.
Impact of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region: propensity score matching analysis
Authors: Ding Changmian , Li Lidan , Li Guizhi , Li Xuehua , Xie Linli , Duan Zhizhou 
Published: July 2023

Abstract
Background
Owing to different social background factor in Yunnan-Myanmar Chinese border region, stressful working environment may lead to extra psychological burden among nurse staff in China. However, the prevalence of workplace violence and its effect on psychological characteristics among nurse staff are still unclear. This study aims to explore the effect of workplace violence against psychological health among nurse staff from Yunnan-Myanmar Chinese border region.

Methods
A cross-sectional survey was conducted among 18 local governmental hospitals in Dehong districts. Participants were 1,774 nurses. Psychosocial characteristics were screened by sleep quality, the 9-item Patient Health Questionnaire for depressive symptoms, the generalized anxiety disorder-7 for anxiety symptoms, the Connor Davidson Resilience Scale – 10 item for resilience, the multidimensional scale of perceived social support for social support, the Chinese version of Work place Violence Scale for workplace violence. Propensity score matching and multivariate linear regression were applied to analyze the data.

Results
The nurse staff with workplace violence have a higher risk of bad sleep quality (b = -0.883, 95%CI = [-1.171, -0.595]), anxiety symptoms (b = 2.531, 95%CI = [2.031, 3.031]) and depressive symptoms (b = 3.227, 95%CI = [2.635, 3.819]), loneliness (b = 0.683, 95%CI = [0.503, 0.863]), perceived cognitive deficits (b = 1.629, 95%CI = [1.131, 2.127]), poor resilience (b = -2.012, 95%CI = [-2.963, -1.061]), and poor social support (b = -5.659, 95%CI = [-7.307, -4.011]).

Conclusions
Preventing workplace violence can improve mental health outcomes significantly among nurse staff, including loneliness, perceived cognitive deficits, anxiety symptoms, depressive symptoms, sleep quality, resilience and social support.
The relationship between moral distress, burnout, and considering leaving a hospital job during the COVID-19 pandemic: a longitudinal survey
Authors: Maunder Robert G. , Heeney Natalie D. , Greenberg Rebecca A. , Jeffs Lianne P. , Wiesenfeld Lesley A. , Johnstone Jennie , Hunter Jonathan J. 
Published: July 2023

Abstract
Background
Previous research suggests that moral distress contributes to burnout in nurses and other healthcare workers. We hypothesized that burnout both contributed to moral distress and was amplified by moral distress for hospital workers in the COVID-19 pandemic. This study also aimed to test if moral distress was related to considering leaving one’s job.

Methods
A cohort of 213 hospital workers completed quarterly surveys at six time-points over fifteen months that included validated measures of three dimensions of professional burnout and moral distress. Moral distress was categorized as minimal, medium, or high. Analyses using linear and ordinal regression models tested the association between burnout and other variables at Time 1 (T1), moral distress at Time 3 (T3), and burnout and considering leaving one’s job at Time 6 (T6).

Results
Moral distress was highest in nurses. Job type (nurse (co-efficient 1.99, p < .001); other healthcare professional (co-efficient 1.44, p < .001); non-professional staff with close patient contact (reference group)) and burnout-depersonalization (co-efficient 0.32, p < .001) measured at T1 accounted for an estimated 45% of the variance in moral distress at T3. Moral distress at T3 predicted burnout-depersonalization (Beta = 0.34, p < .001) and burnout-emotional exhaustion (Beta = 0.38, p < .008) at T6, and was significantly associated with considering leaving one’s job or healthcare.

Conclusion
Aspects of burnout that were associated with experiencing greater moral distress occurred both prior to and following moral distress, consistent with the hypotheses that burnout both amplifies moral distress and is increased by moral distress. This potential vicious circle, in addition to an association between moral distress and considering leaving one’s job, suggests that interventions for moral distress may help mitigate a workforce that is both depleted and burdened with burnout.
Triglycerides and risk of cardiovascular events in statin-treated patients with newly diagnosed type 2 diabetes: a Danish cohort study
Authors: Kristensen Frederik Pagh Bredahl , Christensen Diana Hedevang , Mortensen Martin Bødtker , Maeng Michael , Kahlert Johnny , Sørensen Henrik Toft , Thomsen Reimar Wernich 
Published: July 2023

Abstract
Background
Elevated triglyceride levels are a clinically useful marker of remnant cholesterol. It is unknown whether triglycerides are associated with residual cardiovascular risk in CVD-naïve patients with newly diagnosed type 2 diabetes mellitus (T2DM), who are already on statin therapy. We aimed to assess the association between triglyceride levels and risk of major cardiovascular events (MACE) in statin-treated patients with newly diagnosed T2DM managed in routine clinical care.

Methods
This cohort study included newly diagnosed T2DM patients without a previous diagnosis of cardiovascular disease in Northern Denmark during 2005–2017. Individual triglyceride levels while on statin treatment were assessed within 1 year after T2DM diagnosis. The primary outcome was a composite of myocardial infarction, ischemic stroke, or cardiac death (MACE). Patients were followed from one year after T2DM diagnosis until 30 April 2021, MACE, emigration, or death. We used Cox regression to compute hazard ratios (HRs) controlling for confounding factors.

Results
Among 27,080 statin-treated patients with T2DM (median age 63 years; 53% males), triglyceride levels were < 1.0 mmol/L in 17%, 1.0–1.9 mmol/L in 52%, 2.0–2.9 mmol/L in 20%, and ≥ 3.0 mmol/L in 11%. During follow-up, 1,957 incident MACE events occurred (11.0 per 1000 person-years). Compared with triglyceride levels < 1.0 mmol/L, confounder-adjusted HRs for incident MACE were 1.14 (95% CI 1.00–1.29) for levels between 1.0 and 1.9 mmol/L, 1.30 (95% CI 1.12–1.51) for levels between 2.0 and 2.9 mmol/L, and 1.44 (95% CI 1.20–1.73) for levels ≥ 3.0 mmol/L. This association was primarily driven by higher rates of myocardial infarction and cardiac death and attenuated only slightly after additional adjustment for LDL cholesterol. Spline analyses confirmed a linearly increasing risk of MACE with higher triglyceride levels. Stratified analyses showed that the associations between triglyceride levels and MACE were stronger among women.

Conclusions
In statin-treated patients with newly diagnosed T2DM, triglyceride levels are associated with MACE already from 1.0 mmol/L. This suggests that high triglyceride levels are a predictor of residual cardiovascular risk in early T2DM and could be used to guide allocation of additional lipid-lowering therapies for CVD prevention.
Relationship between caffeine intake and thyroid function: results from NHANES 2007–2012
Authors: Zheng Jiaping , Zhu Xinyan , Xu Guiqing , Wang Xingchen , Cao Mengyang , Zhu Shusen , Huang Rui , Zhou Yu 
Published: July 2023

Abstract
Background
Moderate caffeine intake decreases the risk of metabolic disorders and all-cause mortality, and the mechanism may be related to its ergogenic actions. Thyroid hormones are vital in metabolic homeostasis; however, their association with caffeine intake has rarely been explored.

Objective
To investigate the association between caffeine intake and thyroid function.

Methods
We collected data on demographic background, medical conditions, dietary intake, and thyroid function from the National Health and Nutrition Examination Survey (NHANES) 2007–2012. Subgroups were classified using two-step cluster analysis, with sex, age, body mass index (BMI), hyperglycemia, hypertension, and cardio-cerebral vascular disease (CVD) being used for clustering. Restrictive cubic spline analysis was employed to investigate potential nonlinear correlations, and multivariable linear regression was used to evaluate the association between caffeine consumption and thyroid function.

Results
A total of 2,582 participants were included, and three subgroups with different metabolic features were clustered. In the most metabolically unhealthy group, with the oldest age, highest BMI, and more cases of hypertension, hyperglycemia, and CVD, there was a nonlinear relationship between caffeine intake and serum thyroid stimulating hormone (TSH) level. After adjusting for age, sex, race, drinking, smoking, medical conditions, and micronutrient and macronutrient intake, caffeine intake of less than 9.97 mg/d was positively associated with serum TSH (p = 0.035, standardized β = 0.155); however, moderate caffeine consumption (9.97–264.97 mg/d) indicated a negative association (p = 0.001, standardized β = − 0.152).

Conclusions
Caffeine consumption had a nonlinear relationship with serum TSH in people with metabolic disorders, and moderate caffeine intake (9.97 ~ 264.97 mg/d) was positively associated with serum TSH.
Oxidized dietary lipids induce vascular inflammation and atherogenesis in post-menopausal rats: estradiol and selected antihyperlipidemic drugs restore vascular health in vivo
Authors: Folahan Joy Temiloluwa , Olorundare Olufunke Esan , Ajayi Abayomi Mayowa , Oyewopo Adeoye Oyetunji , Soyemi Sunday Sokunle , Adeneye Adejuwon Adewale , Okoye Ikechukwu Innocent , Afolabi Saheed Olanrewaju , Njan Anoka Ayembe 
Published: July 2023

Abstract
Background
Thermoxidation of edible oil through deep fat frying results in the generation of several oxidized products that promote lipid peroxidation and ROS production when eaten. Consumption of thermoxidized oil in post-menopausal conditions where the estrogen level is low contributes to cardiovascular disease. This study evaluates the role of estradiol and antihyperlipidemic agents (AHD) in restoring the vascular health of ovariectomized (OVX) rats fed with thermoxidized palm oil (TPO) and thermoxidized soya oil (TSO) diets.

Method
A total of 10 groups of rats (n = 6) were set up for the experiment. Group I (normal control) rats were sham handled while other groups were OVX to bring about estrogen deficient post-menopausal state. Group II (OVX only) was not treated and received normal rat chow. Groups III-X were fed with either TPO or TSO diet for 12 weeks and treated with estradiol (ETD) 0.2 mg/kg/day, atorvastatin (ATV) 10 mg/kg/day, and a fixed-dose combination of ezetimibe and ATV (EZE 3 mg/kg/day + ATV 10 mg/kg/day).

Results
Pro-atherogenic lipids levels were significantly elevated in untreated TSO and TPO groups compared to OVX and sham, resulting in increased atherogenic and Coronary-risk indices. Treatment with Estradiol and AHDs significantly reduced the total cholesterol, triglycerides, low-density lipoprotein cholesterol as well as AI and CRI compared to untreated TSO and TPO groups, whereas TSO and TPO groups showed significant elevation in these parameters compared to Group I values. Moreover, aortic TNF-α levels were extremely elevated in the untreated TSO and TPO compared to Group I. TNF-α levels were significantly reduced in rats treated with AHDs and ETD. Localized oxidative stress was indicated in the aortic tissues of TSO and TPO-fed OVX rats by increased malondialdehyde and decreased glutathione, catalase, and superoxide dismutase levels. This contributed to a depletion in aortic nitric oxide. AHDs and ETD replenished the nitric oxide levels significantly. Histological evaluation of the aorta of TSO and TPO rats revealed increased peri-adventitia fat, aortic medial hypertrophy, and aortic recanalization. These pathologic changes were less seen in AHDs and ETD rats.

Conclusion
This study suggests that ETD and AHDs profoundly attenuate oxidized lipid-induced vascular inflammation and atherogenesis through oxidative-stress reduction and inhibition of TNF-α signaling.
Extremely rare pediatric primary scrotum tumor: spermatic cord hemolymphangioma for a case report and literature review
Authors: Liu Liang , Xiao Yu , Yue Xiao , Wang Qiang 
Published: July 2023

AbstractHemolymphangioma is an uncommon benign tumor type that commonly occurs in the head and neck. Primary spermatic cord hemolymphangioma (SCH) with only several reported, however, is extremely rare. Clinical diagnosis can be challenging because of its rarity. Although spermatic cord hemolymphangiomas are benign tumors, there is still a high recurrence rate in postoperative. A 15-year-old boy presented to our hospital with complaints of scrotal for 15 days and did not have other associated symptoms. The male genital color Doppler ultrasound revealed that a cystic echo in the left spermatic cord region and above the testes was about 32 mm × 20 mm × 14 mm. He underwent left en bloc scrotum tumor resection under general anesthesia, and pathologic examination showed SCH. He was discharged from the hospital in the second postoperative day. After 1-month follow-up, the patient recovered well without recurrence. The patient is currently in follow-up phase. Up to date, only a few cases have been reported in the literature about SCH. So, we hope to raise the awareness of the diagnosis of SCH in clinical practice although this case.