bluuebunny/crossref_metadata_2025_split huggingface dataset:
Src homology 2-B adapter protein 3 C784 T and Methylenetetrahydrofolate reductase C677 T Polymorphisms and Inflammation Markers in ST-segment Elevation Myocardial Infarction Patients
Authors: Golestani Amin , Rahimi Atefeh , Moezi Bady Seyed Ali , Azdaki Nahid , Sajjadi Seyed Mehdi 
Published: January 2023

Neutrophil-lymphocyte (NLR), platelet-lymphocyte (PLR), eosinophil-lymphocyte (ELR), and monocyte-lymphocyte (MLR) ratios are systemic inflammatory markers related to myocardial infarction. The aim of this study is to investigate the association of Src homology 2-B adapter protein 3 (SH2B3) C784 T and methylenetetrahydrofolate reductase (MTHFR) C677 T polymorphisms (SNP) with systemic inflammatory markers and the severity of coronary artery disease (CAD) in 150 ST-elevation myocardial infarction (STEMI) patients. Single nucleotide polymorphisms were genotyped using the tetra-primer amplification refractory mutation system-polymerase chain reaction (T-ARMS-PCR) method. The inflammatory markers were calculated. An interventional cardiologist blinded to other data assessed the SYNTAX (SX) Score. Eosinophil and platelet counts were significantly higher in SH2B3 variants than in the wild type. Additionally, SH2B3 variants had significantly higher ELR than the wild type (.12 ± .19 vs .25 ± .34, p = .018). NLR, PLR, ELR, and MLR were considerably higher in MTHFR variants than in the wild type ( p < .05). The SX score was significantly higher in both SH2B3 C784 T (21.24 ± 8.90 vs 15.29 ± 9.40, p = .00) and MTHFR C677 T (20.34 ± 10.21 vs 16.08 ± 8.39, p = .00) variants when compared with wild type. In conclusion, these polymorphisms are associated with several markers of systemic inflammation as well as the severity of CAD.
Repression Works (Just Not in Moderation)
Authors: Zhukov Yuri M. 
Published: January 2023

Why does government violence deter political challengers in one context but inflame them in the next? This paper argues that repression increases opposition activity at low and moderate levels but decreases it in the extreme. There is a threshold level of violence, where the opposition becomes unable to recruit new members, and the rebellion unravels—even if the government kills more innocents. We find empirical support for this proposition in disaggregated data from Chechnya and a meta-analysis of sub-national conflict dynamics in 71 countries. The data suggest that a threshold exists, but the level of violence needed to reach it varies. Many governments, thankfully, are unable or unwilling to go that far. We explore conditions under which this threshold may be higher or lower and highlight a fundamental trade-off between reducing government violence and preserving civil liberties.JEL ClassificationD74, F51, H56.
Without Spouse: Phenomenology of Widowhood among Hindu Young Widows
Authors: Lamba Narendra 
Published: January 2023

When a woman is widowed, it is a traumatic moment in her life. The pain would aggravate a widowed woman whose husband died at a younger age. This paper attempts to depict the lived experience of widowhood from the perspective of young Hindu widows by using a descriptive phenomenological approach guided by Husserlian philosophy. The selected widows for this study were under 45 years old when they had lost their husbands. This paper excerpts from the author’s empirical study for his doctoral thesis. The article will focus on four major themes that emerged from analysing the transcribed data collected from seventieth widows through personal face-to-face interviews. These themes are grief, restrictiveness, suspiciousness, and loneliness, which will discuss elaborately throughout this article. The article advocates that researching the lived experience through a phenomenological approach can enhance understanding of any traumatic phenomenon humans encounter. This way, specific initiatives can be taken by the community, non-governmental organisations, etc., for better counselling and redressing widows’ mental issues.
Automatic mammographic breast density classification in Chinese women: clinical validation of a deep learning model
Authors: Lin Xiaohui , Wu Shibin , Li Lin , Ouyang Rushan , Ma Jie , Yi Chunyan , Tang Yuxing 
Published: January 2023

Background High breast density is a strong risk factor for breast cancer. As such, high consistency and accuracy in breast density assessment is necessary. Purpose To validate our proposed deep learning (DL) model and explore its impact on radiologists on density assessments. Material and Methods A total of 3732 mammographic cases were collected as a validated set: 1686 cases before the implementation of the DL model and 2046 cases after the DL model. Five radiologists were divided into two groups (junior and senior groups) to assess all mammograms using either two- or four-category evaluation. Linear-weighted kappa (K) and intraclass correlation coefficient (ICC) statistics were used to analyze the consistency between radiologists before and after implementation of the DL model. Results The accuracy and clinical acceptance of the DL model for the junior group were 96.3% and 96.8% for two-category evaluation, and 85.6% and 89.6% for four-category evaluation, respectively. For the senior group, the accuracy and clinical acceptance were 95.5% and 98.0% for two-category evaluation, and 84.3% and 95.3% for four-category evaluation, respectively. The consistency within the junior group, the senior group, and among all radiologists improved with the help of the DL model. For two-category, their K and ICC values improved to 0.81, 0.81, and 0.80 from 0.73, 0.75, and 0.76. And for four-category, their K and ICC values improved to 0.81, 0.82, and 0.82 from 0.73, 0.79, and 0.78, respectively. Conclusion The DL model showed high accuracy and clinical acceptance in breast density categories. It is helpful to improve radiologists’ consistency.
The predictive role of fatigue and neuropsychological components on functional outcomes in COVID-19 after a multidisciplinary rehabilitation program
Authors: Bompani Nicole , Bertella Laura , Barbieri Valentina , Scarabel Luca , Scarpina Federica , Perucca Laura , Rossi Paolo 
Published: January 2023

Objective To verify the impact of altered cognitive functioning and higher levels of mental fatigue, both reported after coronavirus disease 2019 (COVID-19), on rehabilitation treatment outcomes. Methods In this real-practice retrospective pre–post intervention cohort study, cognitive functioning, measured through standardized neuropsychological measures, and individual levels of fatigue, depression and anxiety symptoms, were evaluated at admission to a rehabilitation program in individuals who had been hospitalized for COVID-19. The rehabilitation program effectiveness was measured through the Functional Independence Measure. Results Among the patient sample ( n = 66), 87.88% reported experiencing high levels of fatigue at admission, while 16.67% reported depressive symptoms, and 22.73% reported anxiety symptoms. After rehabilitation, the sample displayed a significant decrease in the level of disability, in both the motor and cognitive subscales. Neuropsychological and psychological functioning did not play a predictive role. The 45 patients who received mechanical ventilation during intensive care, representing 68.18% of the sample, benefited more from rehabilitation treatment. Conclusions The results support the importance of an early rehabilitation program after COVID-19 infection, independent of the initial neuropsychological and psychological functioning. Respiratory assistance may represent a crucial factor for short-term neuropsychological disease after-effects. Future studies on the long-term neuropsychological effect of COVID-19 infection on individual levels of disability are necessary.
Establishment and validation of a nomogram to predict structural incomplete response in papillary thyroid carcinoma patients: a retrospective study
Authors: Geng Chenchen , Tian Shuxu , Gao Xiaoqian , Li Xiaoguang , Ru Qi , Zhang Ping 
Published: January 2023

Objective To identify risk factors related to structural incomplete response (SIR) in papillary thyroid carcinoma (PTC) and develop a nomogram for PTC patients. Methods In this respective study, clinical, ultrasonic, and pathological data of PTC patients treated at our institute between 2016 and 2020 were analyzed. Patients were randomly split into training and validation sets at a ratio of 7:3. Multivariate Cox regression analysis was conducted to determine independent prognostic factors. On the basis of these factors, a nomogram was built to predict SIR. P value, concordance index, calibration plots and decision curve analysis were used to evaluate the model. Results Multivariate Cox regression analysis showed that BRAF V600E status, lymph node metastasis, sex, tumor size, margin, and surgical procedure were independent prognostic factors. In the validation set, the concordance index of the nomogram was 0.774 (95% confidence interval: 0.703–0.845). Calibration plots at 3 and 5 years showed no apparent difference between predicted SIR probability and the actual SIR proportion. Additionally, the nomogram had good net clinical benefit according to the decision curve analysis compared with cases that were treat-all or treat-none. Conclusion We build a nomogram to predict individualized outcomes and help postoperative surveillance in PTC patients.
Diagnostic approach to monkeypox outbreak, a case-control study
Authors: Moretti Marco , Heymans Benjamin , Yin Nicolas , Kaur Simran , Libois Agnes , Quoilin Sophie , Martin Charlotte 
Published: January 2023

Background An international outbreak of the monkeypox (MPX) virus is ongoing with a different clinical presentation than previously reported. Objective A monocentric retrospective study was designed to investigate clinical predictors of confirmed MPX cases among a group of patients referred for MPX screening. Furthermore, the additional value of performing a real-time polymerase chain reaction (RT-PCR) on multiple anatomical sites was analyzed. Methods Between 28/05/2022 and 22/07/2022, the medical records of patients referred for MPX screening were investigated. Patients with positive RT-PCR were defined as cases, while the ones with negative RT-PCR as controls. Multivariable regression analysis was performed to estimate predictors of MPX diagnosis. Results Among the 141 included patients, 85 (60%) had at least one positive RT-PCR for MPX. Carrying out RT-PCR only on the swab obtained by skin lesion sampling, 7 patients (7/85: 8%) would have been misdiagnosed. Multivariable regression analysis showed significant differences in the independent variables: “being men who have sex with men (MSM)”, “living with HIV”, “having multiple sexual partners in the last 3 weeks”, and “having skin lesions in the anogenital area” for prediction of MPX diagnosis. These four discriminants were used to create a score to improve diagnosis in patients screened for MPX. Conclusion MPX diagnosis was associated with being MSM, living with HIV, having multiple sexual partners, and presenting with anogenital skin lesions. In this study, the derived score had good sensitivity and specificity to predict MPX diagnosis. Finally, performing multi-site swabs for MPX RT-PCR might lower false negative rates.
Cysteine-rich 61(CYR61) alleviates cyclophosphamide-induced proliferation inhibition in ovarian granulosa cells via suppressing NLRP3/caspase1-mediated pyroptosis
Authors: Xu Hongxia , Bao Xiumin , Yang Junya , Kong Hanxin , Li Yan , Sun Zhiwei 
Published: January 2023

Background We investigated the level of Cysteine-rich 61 (CYR61) in premature ovarian failure as well as its regulatory molecular mechanism in this study. Methods and Results Cyclophosphamide (CTX) was used to induce OGCs (rat ovarian granulosa cells) and rats to establish in vivo and in vitro premature ovarian failure models. H&E staining was used to detect the pathological changes of ovarian histopathology. Si-NLRP3 (NOD-like receptor thermal protein domain associated protein 3, NLRP3) and si-CYR61 were transfected into OGCs using lipofectamine 3000. RT-qPCR and western blot were used to detect the expressions of CYR61 in ovarian tissue and OGCs. It showed that the expression of CYR61 was significantly down-regulated in premature ovarian failure model. Cell viability was detected using a Cell Counting Kit-8 (CCK-8) kit. TUNEL (Terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end labeling) staining was used to detect the apoptosis. 5-Ethynyl-2′-deoxyuridine (EdU) and SA-β-gal (senescence-associated β-galactosidase) staining were used to assess the proliferation and senescence. The expression of CYR61 in OGCs and ovarian tissues were detected by immunofluorescence and immunohistochemical staining. Overexpression of CYR61 significantly promoted OGCs proliferation and inhibited pyroptosis and apoptosis. Western blot was used to detect the protein expressions of p53 and p21 in OGCs. Flow cytometry was used to detect the pyroptosis. CYR61 overexpression inhibited the expression of NLRP3 and caspase-1 in CTX-induced OGCs according to western blot results. Moreover, we found that CYR61 overexpression down-regulated the protein expressions of p53 and p21 in CTX-induced OGCs. Conclusion: CYR61 inhibited CTX-induced OGCs senescence, and the mechanism may be related to the regulation of caspase-1/NLRP3-induced pyroptosis.
Relationship between the EULAR/ACR classification criteria and organ damage in systemic lupus erythematosus
Authors: Mok Chi Chiu , Chung Yuen Kwan , Lee Carolyn , Ho Ling Yin , To Chi Hung 
Published: January 2023

Objectives To study the relationship between the 2019 EULAR/ACR classification criteria and organ damage in patients with systemic lupus erythematosus (SLE). Methods Patients involved in a cross-sectional validation study of the EULAR/ACR criteria and judged by a panel of rheumatologists to be clinical SLE were studied. Those who fulfilled the EULAR/ACR criteria at their last clinic visit were stratified into 2 groups based on a cutoff score of 20. The last SLE International Collaborating Clinic (SLICC) Organ Damage Index (SDI) was compared between these two groups. Relationship among the domains of the EULAR/ACR criteria and SDI in all patients was studied by using Spearman’s rank correlation. Results A total of 562 SLE patients were studied (93.6% women; age 36.5 ± 14.1 years; follow-up duration 11.6 ± 6.6 years). The mean and median EULAR/ACR criteria scores in those who fulfilled the EULAR/ACR criteria ( N = 542) were 24.6 ± 7.3 and 24 (interquartile range 19–30), respectively. A total of 392 patients had EULAR/ACR scores of ≥20 (group 1), and 150 patients had scores of 10–19 (group 2). Group 1 patients had significantly higher prevalence of fever, alopecia, oral ulcers, acute lupus skin lesions, arthritis, serositis, seizure, hemolytic anemia, leukopenia, and renal disease and so were the anti-dsDNA, anti-Sm, antiphospholipid antibodies, and low complement state. Organ damage (SDI score of ≥1) occurred in 232 (42.8%) patients. Patients in group 1 had significantly higher SDI scores in the renal, cardiovascular, dermatological, and gonadal domains than group 2. The renal, neuropsychiatric, and antiphospholipid antibody domain scores of the EULAR/ACR criteria correlated positively with the total SDI. The renal domain of the EULAR/ACR criteria had the strongest correlation with renal damage (Rho 0.30; p < 0.001). Patients who scored 10 points in the renal domain had significantly higher renal damage score than those scored 8 points or 4 points. Gonadal damage score was also significantly more common in the 10-point than in the 8-point group. Conclusion In addition to disease classification, the EULAR/ACR SLE criteria may have value in predicting prognosis.
Prospective Cohort Study on the Impact of Early Versus Late Inpatient Palliative Care on Length of Stay and Cost of Care
Authors: Srinivasan Vamshek J. , Akhtar Saad , Huppertz John W. , Sidhu Mandeep , Coates Andrew , Knudsen Nancy 
Published: January 2023

Aim: To evaluate the impact of early vs late palliative care on (1) length of stay (LOS) in the context of expected LOS measures and (2) total cost of care to the hospital for each patient. Methods: A prospective cohort study was performed at a single large academic medical center on patients who received an inpatient palliative care consultation. The two cohorts were early palliative care (within 3 days of admission) and late palliative care (after 3 days of admission). Comparisons were made between patients’ actual LOS, expected LOS, and total hospital costs between both cohorts. Results: Compared to the late palliative care cohort (N = 126), patients who received early palliative care (N = 68) had a significantly shorter LOS ( P < .001) and also performed better compared to CMS-Expected LOS standards (Observed/Expected 3.1 vs 1.5 respectively; P < .001). Early palliative care patients also saw an average decline of $1431 in total costs 1-day pre/post consult as opposed to a more modest $403 decline in the later palliative care cohort ( P < .001). Similarly, patients who received early palliative care had a $5839 decline in aggregated total 3-day costs, as opposed to a $1478 decline in those who received late palliative care ( P < .001). Conclusions: In the competitive and rapidly evolving healthcare system, the opportunity to suppress costs and lower patient LOS has increasing importance. Our study strongly supports the implementation of earlier palliative care intervention to assist hospitals in approaching LOS targets and reducing patient costs.
Current Practice Patterns and Training Pathways for Feeding Infants with Cleft Palate
Authors: Kotlarek Katelyn J. , Benson Mikayla , Williams Jessica 
Published: January 2023

Objective To examine the current trends and practices across disciplines for feeding infants with cleft palate with or without cleft lip and to describe provider training within this area Design Prospective survey Setting ACPA approved cleft palate teams and healthcare providers in the United States and Canada Participants Interdisciplinary providers that regularly provide feeding services to infants with cleft palate Intervention 50-item survey designed and distributed electronically via the ACPA Main Outcome Measures Information on provider demographics and practice patterns Results 76 respondents included providers in North America that have either currently or previously served on a cleft palate team. The majority of respondents were in speech-language pathology (49%) or nursing (38%) disciplines, worked in an outpatient setting (70%), and received no information (68%) regarding cleft palate feeding in their academic training. While specific practice patterns were relatively consistent across the respondent cohort, provider characteristics were significantly associated with squeezing the Haberman ( p = .013) and likelihood of collaboration with other providers when counseling parents/caregivers ( p = .039). Conclusions While provider characteristics varied, there were similar practice patterns observed across disciplines. Future research is needed explore training related to feeding knowledge as well as practice patterns in locations with a lower patient volume.
Drugs That Interact With Colchicine Via Inhibition of Cytochrome P450 3A4 and P-Glycoprotein: A Signal Detection Analysis Using a Database of Spontaneously Reported Adverse Events (FAERS)
Authors: Gómez-Lumbreras Ainhoa , Boyce Richard D. , Villa-Zapata Lorenzo , Tan Malinda S. , Hansten Philip D. , Horn John , Malone Daniel C. 
Published: January 2023

Background: Colchicine has a narrow therapeutic index. Its toxicity can be increased due to concomitant exposure to drugs inhibiting its metabolic pathway; these are cytochrome P450 3A4 (CYP3A4) and P-glycoprotein (P-gp). Objective: To examine clinical outcomes associated with colchicine drug interactions using the spontaneous reports of the US Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS). Methods: We conducted a disproportionality analysis using FAERS data from January 2004 through June 2020. The reporting odds ratio (ROR) and observed-to-expected ratio (O/E) with shrinkage for adverse events related to colchicine’s toxicity (ie, rhabdomyolysis/myopathy, agranulocytosis, hemorrhage, acute renal failure, hepatic failure, arrhythmias, torsade de pointes/QT prolongation, and cardiac failure) were compared between FAERS reports. Results: A total of 787 reports included the combined mention of colchicine, an inhibitor of both CYP3A4 and P-gp drug, and an adverse event of interest. Among reports that indicated the severity, 61% mentioned hospitalization and 24% death. A total of 37 ROR and 34 O/E safety signals involving colchicine and a CYP3A4/P-gp inhibitor were identified. The strongest ROR signal was for colchicine + atazanavir and rhabdomyolysis/myopathy (ROR = 35.4, 95% CI: 12.8-97.6), and the strongest O/E signal was for colchicine + atazanavir and agranulocytosis (O/E = 3.79, 95% credibility interval: 3.44-4.03). Conclusion and Relevance: This study identifies numerous safety signals for colchicine and CYP3A4/P-gp inhibitor drugs. Avoiding the interaction or monitoring for toxicity in patients when co-prescribing colchicine and these agents is highly recommended.
Conversion From Intravenous Alteplase to Tenecteplase for Treatment of Acute Ischemic Stroke Across a Large Community Hospital Health System
Authors: Dittmar Erika , Wolfel Thomas , Menendez Lourdes , Pozo Jessilyn , Ramirez Maygret , Belnap Starlie C. , De Los Rios La Rosa Felipe 
Published: January 2023

Background: Recent evidence suggests tenecteplase at an intravenous dose of 0.25 mg/kg is as safe and efficacious as intravenous alteplase standard dose and demonstrates a more favorable pharmacokinetic profile for treatment of acute ischemic stroke. Objective: The purpose was to compare the safety and efficacy of alteplase versus tenecteplase for the treatment of acute ischemic stroke at a large community hospital health system following conversion in the preferred formulary thrombolytic. Methods: Prior to converting, medication safety and operationalization analyses were conducted. A multicenter, retrospective medical record review was performed for patients who received alteplase 6 months prior to formulary thrombolytic conversion and for tenecteplase 6 months post-conversion for the treatment of acute ischemic stroke. Primary outcomes included the rate of symptomatic intracranial and extracranial hemorrhage complications. Secondary outcomes included door-to-needle time, reduction in National Institute Health Stroke Scale at 24 hours and at discharge, order-to-administration time, and thrombolytic errors. The rates of hemorrhage were compared using binomial regression. Results: Of the 287 patients reviewed, 115 received alteplase and 172 received tenecteplase. Symptomatic intracranial hemorrhagic complications occurred in 1 patient (1%) who received alteplase compared with 3 patients (2%) who received tenecteplase ( P = 0.9). There was no statistical difference in rates of symptomatic intracranial or extracranial hemorrhagic complications. Conclusion and Relevance: Conversion from alteplase to tenecteplase can be safely and effectively achieved at a large community hospital health system with differing levels of stroke certification. There were also additional cost savings and practical advantages including workflow benefits.