bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular mortality in patients with advanced chronic kidney disease with and without diabetes: a nationwide cohort study
Authors: Kofod Dea Haagensen , Carlson Nicholas , Ballegaard Ellen Freese , Almdal Thomas Peter , Torp-Pedersen Christian , Gislason Gunnar , Svendsen Jesper Hastrup , Feldt-Rasmussen Bo , Hornum Mads 
Published: June 2023

Abstract
Background
Cardiovascular mortality and the impact of cardiac risk factors in advanced chronic kidney disease (CKD) remain poorly investigated. We examined the risk of cardiovascular mortality in patients with advanced CKD with and without diabetes as well as the impact of albuminuria, plasma hemoglobin, and plasma low-density lipoprotein (LDL) cholesterol levels.

Methods
In a Danish nationwide registry-based cohort study, we identified persons aged ≥ 18 years with an estimated glomerular filtration rate < 30 mL/min/1.73m2 between 2002 and 2018. Patients with advanced CKD were age- and sex-matched with four individuals from the general Danish population. Cause-specific Cox regression models were used to estimate the 1-year risk of cardiovascular mortality standardized to the distribution of risk factors in the cohort.

Results
We included 138,583 patients with advanced CKD of whom 32,698 had diabetes. The standardized 1-year risk of cardiovascular mortality was 9.8% (95% CI 9.6–10.0) and 7.4% (95% CI 7.3–7.5) for patients with and without diabetes, respectively, versus 3.1% (95% CI 3.1–3.1) in the matched cohort. 1-year cardiovascular mortality risks were 1.1- to 2.8-fold higher for patients with diabetes compared with those without diabetes across the range of advanced CKD stages and age groups. Albuminuria and anemia were associated with increased cardiovascular mortality risk regardless of diabetes status. LDL-cholesterol was inversely associated with cardiovascular mortality risk in patients without diabetes, while there was no clear association in patients with diabetes.

Conclusions
Diabetes, albuminuria, and anemia remained important risk factors of cardiovascular mortality whereas our data suggest a limitation of LDL-cholesterol as a predictor of cardiovascular mortality in advanced CKD.
Mesenchymal stem cell-derived exosomal miR-27b-3p alleviates liver fibrosis via downregulating YAP/LOXL2 pathway
Authors: Cheng Fang , Yang Fuji , Wang Yanjin , Zhou Jing , Qian Hui , Yan Yongmin 
Published: June 2023

AbstractLysyl oxidase-like 2 (LOXL2) is an extracellular copper-dependent enzyme that plays a central role in fibrosis by catalyzing the crosslinking and deposition of collagen. Therapeutic LOXL2 inhibition has been shown to suppress liver fibrosis progression and promote its reversal. This study investigates the efficacy and underlying mechanisms of human umbilical cord-derived exosomes (MSC-ex) in LOXL2 inhibition of liver fibrosis. MSC-ex, nonselective LOX inhibitor β-aminopropionitrile (BAPN), or PBS were administered into carbon tetrachloride (CCl4)-induced fibrotic livers. Serum LOXL2 and collagen crosslinking were assessed histologically and biochemically. MSC-ex’s mechanisms on LOXL2 regulation were investigated in human hepatic stellate cell line LX-2. We found that systemic administration of MSC-ex significantly reduced LOXL2 expression and collagen crosslinking, delaying the progression of CCl4-induced liver fibrosis. Mechanically, RNA-sequencing and fluorescence in situ hybridization (FISH) indicated that miR-27b-3p was enriched in MSC-ex and exosomal miR-27b-3p repressed Yes-associated protein (YAP) expression by targeting its 3ʹ untranslated region in LX-2. LOXL2 was identified as a novel downstream target gene of YAP, and YAP bound to the LOXL2 promoter to positively regulate transcription. Additionally, the miR-27b-3p inhibitor abrogated the anti-LOXL2 abilities of MSC-ex and diminished the antifibrotic efficacy. miR-27b-3p overexpression promoted MSC-ex mediated YAP/LOXL2 inhibition. Thus, MSC-ex may suppress LOXL2 expression through exosomal miR-27b-3p mediated YAP down-regulation. The findings here may improve our understanding of MSC-ex in liver fibrosis alleviation and provide new opportunities for clinical treatment.
Bone mineral density in egyptian children with juvenile idiopathic arthritis: possible correlation to serum RANKL / osteoprotegerin (OPG) ratio and OPG gene polymorphisms
Authors: Eid Riham , Abdelsalam Maha , Fathy Aya Ahmed , Abolenein Hadil M. , Elmarghany Eman Bakr , El-Hanafy Aya Ahmed , Hamdy Nashwa , Abd-Elmagid Dina Salama , Niazy Nermeen A. , Abd-El Ghaffar Dina M. 
Published: June 2023

Abstract
Background
Children with juvenile idiopathic arthritis (JIA) are at higher risk of decreased bone mineral density (BMD) compared with healthy children due to genetic, disease and medication-related causes. This study aims to investigate the possible effects of osteoprotegerin (OPG) gene polymorphisms and serum levels of osteoprotegerin (OPG) and receptor activator of nuclear factor κB-ligand (RANKL) and RANKL/OPG ratio on BMD in children with JIA.

Methods
OPG gene rs2073617, rs3134069, serum RANKL, OPG and RANKL/OPG ratio were evaluated in 60 JIA children and 100 matched healthy controls. BMD was evaluated by lumbar dual energy X-ray absorptiometry (DEXA) according to which patients were classified in 2 groups (DEXA z-score above and below − 2). Composite disease activity was measured using the Juvenile Arthritis Disease Activity Score (JADAS) 27-joints. Articular damage was scored using the juvenile arthritis damage index (JADI).

Results
Patients aged 12.05 ± 3.2 years, included 38 females and 31% had BMD z-score below-2. Systemic-onset JIA was the most frequent phenotype (38%). Genotypes and alleles frequencies of the 2 studied polymorphisms did not differ between patients and controls (p > 0.05 for all) while serum RANKL and RANKL/OPG ratio were significantly higher in patients compared to controls (p = < 0.001 and 0.03 respectively). Patients with BMD < -2 had significantly greater frequencies of rs2073617 TT genotype and T allele (p < 0.001), higher serum RANKL, RANKL/OPG ratio (p = 0.01, 0.002), female predominance (p = 0.02), higher articular and extra-articular damage index (p = 0.008,0.009) and more frequent steroid usage (p = 0.02) compared to patients with BMD z-score >-2. Multivariate analysis showed rs2073617 TT genotype, RANKL/OPG ratio, long disease duration (above 36 months) and use of steroid to be associated with decreased BMD (p = 0.03,0.04,0.01,0.01 respectively) in JIA children.

Conclusions
Egyptian children with JIA have decreased BMD. rs2073617 TT genotype and T allele, RANKL/OPG ratio are possible determinants of reduced BMD in JIA. Our results underline the importance of frequent monitoring of BMD in JIA children and trying to control disease activity to preserve long term bone health.
A review of Duhuo Jisheng decoction mechanisms in intervertebral disc degeneration in vitro and animal studies
Authors: Zhou Daqian , Song Chao , Mei Yongliang , Cheng Kang , Liu Fei , Cai Weiye , Gao Silong , Wang Zhenlong , Liu Zongchao 
Published: June 2023

AbstractIntervertebral disc degeneration (IVDD) has become a serious public health problem, placing a heavy burden on society and the healthcare system. Its pathogenesis is not completely clear and may be closely related to mechanical damage, inflammatory factors, oxidative stress and death of nucleus pulposus cells (NPCs). The treatment of IVDD mainly includes conservative treatment and surgery. Conservative treatment is based on hormonal and anti-inflammatory drugs and massage techniques, which can relieve the pain symptoms to a certain extent, but cannot solve the problem from the root cause. Surgical treatment is mainly by removing the herniated nucleus pulposus, but it is more traumatic for IVDD patients, expensive and not suitable for all patients. Therefore, it is extremely important to clarify the pathogenesis of IVDD, to find an effective and convenient treatment and to further elaborate its mechanism of action. The effectiveness of traditional Chinese medicine in the treatment of IVDD has been well demonstrated in clinical medical research. We have been working on the Chinese herbal formula Duhuo Jisheng Decoction, which is a common formula for the treatment of degenerative disc disease. Not only does it have significant clinical effects, but it also has few adverse effects. At present, we found that its mechanism of action mainly involves regulation of inflammatory factors, reduction of apoptosis and pyroptosis of NPCs, inhibition of extracellular matrix degradation, improvement of intestinal flora, etc. However, a few relevant articles have yet comprehensively and systematically summarized the mechanisms by which they exert their effect. Therefore, this paper will comprehensively and systematically explain on it. This is of great clinical significance and social value for elucidating the pathogenesis of IVDD and improving the symptoms of patients, and will provide a theoretical basis and scientific basis for the treatment of IVDD with traditional Chinese medicine.
Scarf osteotomy for hallux valgus surgery: determining indications for an additional Akin osteotomy
Authors: Thever Yogen , Yongqiang Jerry Chen , Chuin Toh Rong , Meng Nicholas Yeo Eng 
Published: June 2023

Abstract
Introduction
There is a lack of clear indications to carrying out an Akin osteotomy in addition to scarf osteotomy. Recent studies have shown that a proximal distal phalangeal articular angle (PDPAA) of > 8° as an indication to carrying out additional Akin osteotomy correlates with better radiological outcomes with lesser risk of recurrence. Our study aimed to validate carrying out the additional Akin osteotomy at a PDPAA > 8° while looking into functional outcomes which have not been studied.

Methods
Patients who underwent scarf and combined scarf and Akin osteotomy in our institutional registry was identified. Patient reported outcome measures were compared between patients who underwent scarf and combined scarf and Akin osteotomy. The Visual Analogue Scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), Short Form-36 Physical Component Score (PCS) and Mental Component Score (MCS) were measured pre-operatively and across a follow up period of 2 years.

Results
A total of 212 cases were identified. At a PDPAA > 8, there was no difference in VAS, AOFAS, PCS and MCS between patients that had isolated scarf osteotomy and those that received combined scarf and Akin osteotomy pre-operatively, and at 6 months. However, at 2 years post-operatively, patients that received scarf and Akin osteotomy had a significantly better AOFAS score as compared to patients with isolated scarf osteotomy (82.3 ± 15.3 vs 88.4 ± 13.0, p = 0.0224). On the contrary, at a PDPAA < 8, patients who underwent combined scarf and Akin osteotomy had a significantly lower VAS score at 6 months (1.16 ± 2.16 vs 0.321 ± 1.09, p = 0.00633) and 2 years (0.698 ± 1.73 vs 0.333 ± 1.46, p = 0.0466). They also had a higher AOFAS score at 6 months (80.7 ± 14.3 vs 85.4 ± 12.5, p = 0.0123) and 2 years (83.0 ± 14.0 vs 90.7 ± 9.9, p < 0.0001).

Conclusion
PDPAA > 8° can serve as a valid indication to carrying out additional Akin on top of scarf osteotomy based on functional outcomes. However, further studies should investigate a PDPAA threshold that is lower than 8°, which can potentially allow more patients to receive the additional Akin osteotomy that can bring better functional outcomes.
AXL in cancer: a modulator of drug resistance and therapeutic target
Authors: Tang Yaoxiang , Zang Hongjing , Wen Qiuyuan , Fan Songqing 
Published: June 2023

AbstractAXL is a member of the TAM (TYRO3, AXL, and MERTK) receptor tyrosine kinases family (RTKs), and its abnormal expression has been linked to clinicopathological features and poor prognosis of cancer patients. There is mounting evidence supporting AXL's role in the occurrence and progression of cancer, as well as drug resistance and treatment tolerance. Recent studies revealed that reducing AXL expression can weaken cancer cells' drug resistance, indicating that AXL may be a promising target for anti-cancer drug treatment. This review aims to summarize the AXL's structure, the mechanisms regulating and activating it, and its expression pattern, especially in drug-resistant cancers. Additionally, we will discuss the diverse functions of AXL in mediating cancer drug resistance and the potential of AXL inhibitors in cancer treatment.
Anti N-Methyl-D-Aspartate receptor antibody associated Acute Demyelinating Encephalomyelitis in a patient with COVID-19: a case report
Authors: Naidu Kuven , Tayler Rory 
Published: June 2023

Abstract
Background
Anti N-Methyl-D-Aspartate (NMDA) receptor antibody associated ADEM is a diagnosis that was first described relatively recently in 2007 by Dalmau et al. The recent COVID-19 pandemic has resulted in multiple neurological complications being reported. However, there is limited data on Anti-NMDA receptor antibody associated ADEM in COVID-19 patients. Furthermore, the MRI findings in these patients have not been fully elucidated. This case report adds to the growing body of knowledge of neurological complications in COVID-19 patients.

Case presentation
A 50 year old Caucasian female with no previous medical co-morbidities presented with symptoms of COVID-19 and subsequently developed neurological symptoms which included confusion, limb weakness and seizures. The patient developed marked behavioural abnormalities which required attention. She was found to have anti NMDA receptor antibodies present in a significant titres, an elevated total protein on lumbar puncture and cytotoxic magnetic resonance imaging (MRI) changes in the brain and spinal cord and was subsequently diagnosed with an anti-NMDA Receptor Antibody associated ADEM. The bilateral symmetric involvement of the corticospinal tract on MRI was considered unusual in our case. She was treated with a combination of corticosteroids and plasmapheresis which halted disease progression. Thereafter she was commenced on intravenous immunoglobulin as maintenance therapy and she has shown continuous improvement with ongoing physiotherapy.

Conclusion
The recognition of COVID 19 neurological complications may be difficult in the initial disease as early symptoms of lethargy, weakness and confusion may be very nondescript. However, it is imperative that these complications are sought for as they are imminently treatable. Early institution of therapy is imperative in decreasing long term neurological consequences.
Retention time and fix acquisition rate of glued-on GPS transmitters in a semi-aquatic species
Authors: Pitman John B. , Bastille-Rousseau Guillaume 
Published: June 2023

Abstract
Background
Movement is a core mechanism through which animals interact with their environment. GPS telemetry is a popular approach used to investigate animal movement, providing access to both the spatial and temporal behavioral patterns exhibited by an individual or population. However, while some species are easily tracked through traditional GPS attachment methods (such as GPS collars or backpacks), other species such as the North American beaver (Castor canadensis) present unique challenges given their fusiform shape and tapered neck.

Results
We tested three different GPS transmitter attachment methods (tail-mounted, lower back glued-on, and upper back glued-on) for beavers over two seasons to determine which treatment was most effective in terms of retention time (RT, total number of days a transmitter remains attached) and GPS fix success rate (FSR, % of successful fixes vs. attempted) and investigated to what degree various factors (season, sex, and age class) affected these results. We then evaluated whether the data collected were sufficient for identifying home-ranging behavior (when an individual begins to display restricted space use and range residency). We found transmitters attached to the lower back during the fall to be the top performing treatment, having a similar mean FSR (51.59%) to upper back attachments in fall, but a significantly greater average RT (42.8 days). Of the 23 individuals included in the home-ranging behavior analysis, all but two had sufficient data for identifying home-ranging behavior.

Conclusions
Our tests show that glued-on GPS tags can provide up to 2 months of fine-scale relocation data in a safe and effective manner. This allows the opportunity to answer novel questions regarding movement patterns of beavers and other semi-aquatic mammals.
Patients’ well-being during the transition period after psychiatric hospitalization to school: insights from an intensive longitudinal assessment of patient–parent–teacher triads
Authors: Finkbeiner Marlene , Wahl Lena-Marie , Kühnhausen Jan , Schmid Johanna , Hellwig Leona , Brenner Vera , Dürrwächter Ute , Conzelmann Annette , Kelava Augustin , Renner Tobias J. , Gawrilow Caterina 
Published: June 2023

Abstract
Background
The transition period after psychiatric hospitalization back to school is accompanied by various challenges, including a substantial risk for rehospitalization. Self-efficacy and self-control, as transdiagnostic variables and important predictors of coping with school demands, should be crucial factors for successful adaptation processes as well as an overall high well-being during school reentry. The present study therefore investigates how patients’ well-being develops during this period, and how it is related to patients’ self-control and academic self-efficacy, as well as parents’ and teachers’ self-efficacy in dealing with the patient.

Methods
In an intensive longitudinal design, daily ambulatory assessment measures via smartphone were collected with self-reports from the triadic perspective of 25 patients (Mage = 10.58 years), 24 parents, and 20 teachers on 50 consecutive school days, starting 2 weeks before discharge from a psychiatric day hospital (mean compliance rate: 71% for patients, 72% for parents and 43% for teachers). Patients answered daily questions between five and nine o'clock in the evening about their well-being, self-control, academic self-efficacy and about positive and negative events at school, as well as parents and teachers about their self-efficacy in dealing with the patient.

Results
Multilevel modeling revealed that on average, patients’ well-being and self-control decreased during the transition period, with trends over time differing significantly between patients. While patients’ academic self-efficacy did not systematically decrease over time, it did show considerable intra-individual fluctuation. Importantly, patients experienced higher well-being on days with higher self-control and academic self-efficacy as well as with higher parental self-efficacy. Daily teacher self-efficacy did not show a significant within-person relationship to daily patients’ well-being.

Conclusions
Well-being in the transition period is related to self-control and self-efficacy of patients and their parents. Thus, addressing patients’ self-control and academic self-efficacy, as well as parental self-efficacy, seems promising to enhance and stabilize well-being of patients during transition after psychiatric hospitalization.
Trial registration Not applicable, as no health care intervention was conducted.
Three-dimensional changes of a porcine collagen matrix and free gingival grafts for soft tissue augmentation to increase the width of keratinized tissue around dental implants: a randomized controlled clinical study
Authors: Ramanauskaite Ausra , Obreja Karina , Müller Katharina Melissa , Schliephake Carla , Wieland Johanna , Begic Amira , Dahmer Iulia , Parvini Puria , Schwarz Frank 
Published: June 2023

Abstract
Background
Emerging clinical data points to the relevance of the presence of keratinized tissue (KT). Although apically positioned flap/vestibuloplasty along with free gingival graft (FGG) is considered as a standard intervention for augmenting KT, substitute materials appear to be a viable treatment alternative. So far, there is a lack of data investigating the dimensional changes at implant sites treated with soft-tissue substitutes or FGG.

Aim
The present study aimed at comparing three-dimensional changes of a porcine derived collagen matrix (CM) and FGG for increasing KT at dental implants over a 6-month follow-up period.

Materials and Methods
The study enrolled 32 patients exhibiting deficient KT width (i.e., < 2 mm) at the vestibular aspect who underwent soft tissue augmentation using either CM (15 patients/23 implants) or FGG (17 patients/31 implants). The primary outcome was defined as tissue thickness change (mm) at treated implant sites between 1- (S0), 3- (S1), and 6-months (S2). Secondary outcomes considered changes of KT width over a 6-month follow-up period, surgical treatment time, and patient-reported outcomes.

Results
Dimensional analyses from S0 to S1 and from S0 to S2 revealed a mean decrease in tissue thickness of − 0.14 ± 0.27 mm and − 0.04 ± 0.40 mm in the CM group, and − 0.08 ± 0.29 mm and − 0.13 ± 0.23 mm in the FGG group, with no significant differences noted between the groups (3 months: p = 0.542, 6 months: p = 0.659). Likewise, a comparable tissue thickness decrease was observed from S1 to S2 in both groups (CM: − 0.03 ± 0.22 mm, FGG: − 0.06 ± 0.14 mm; p = 0.467). The FGG group exhibited a significantly greater KT gain after 1, 3 and 6 months compared to the CM group (1 month: CM: 3.66 ± 1.67 mm, FGG: 5.90 ± 1.58 mm; p = 0.002; 3 months: CM: 2.22 ± 1.44; FGG: 4.91 ± 1.55; p = 0.0457; 6 months: CM: 1.45 ± 1.13 mm, FGG: 4.52 ± 1.40 mm; p < 0.1). Surgery time (CM: 23.33 ± 7.04 min.; FGG: 39.25 ± 10.64 min.; p = 0.001) and postoperative intake of analgesics were significantly lower in the CM group (CM: 1.2 ± 1.08 tablets; FGG: 5.64 ± 6.39 tablets; p = 0.001).

Conclusions
CM and FGG were associated with comparable three-dimensional thickness changes between 1 and 6 months. While a wider KT band could be established with FGG, the use of CM significantly reduced surgical time and patients´ intake of analgesics.

Graphical abstract
Childhood Obesity, Diabetes, and Cardiovascular Disease Risk
Authors: Salama Mostafa , Balagopal Babu , Fennoy Ilene , Kumar Seema 
Published: June 2023

Abstract
This mini-review aims to briefly summarize the pathophysiology of childhood obesity, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) risk in children and adolescents. Recent data on efficacy of lifestyle interventions, medications, and metabolic surgery for obesity, T2DM, and CVD risk factors are also reviewed. We conducted a PubMed search of English-language original and review articles relevant to childhood obesity, T2DM, and CVD risk factors, and biomarkers in children with an emphasis on recent publications. Childhood obesity arises from an intricate interaction between genetic, physiologic, environmental, and socioeconomic factors. The rise in the prevalence of childhood obesity is associated with the development of comorbidities including T2DM and CVD at an early age. A multipronged approach is central to the detection, monitoring, and management of childhood obesity and associated adverse metabolic consequences.