bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Conventional Stroke Risk Factors on Early- and Late-Onset Ischemic Stroke: A Mendelian Randomization Study
Authors: Nguyen Kevin T.K. , Xu Huichun , Gaynor Brady J. , McArdle Patrick F. , O’Connor Timothy D. , Perry James A. , Worrall Bradford B. , Malik Rainer , Boncoraglio Giorgio B. , Adebamowo Sally N. , Zand Ramin , Cole John W. , Kittner Steven J. , Mitchell Braxton D. ,   on behalf of the Stroke Genetic Network and Early-Onset Stroke Consortia
Published: February 2025

BACKGROUND:
Stroke incidence is decreasing in older ages but increasing in young adults. These divergent trends are at least partially attributable not only to diverging trends in stroke risk factors but may also be due to differences in the impact of stroke risk factors at different ages. To address this latter possibility, we used Mendelian randomization to assess differences in the association of stroke risk factors between early-onset ischemic stroke ([EOS]; onset 18–59 years) and late-onset ischemic stroke ([LOS]; onset ≥60 years).

METHODS:
We identified genetic variants from the GWAS Catalog for use as instrumental variables to proxy conventional stroke risk factors and then estimated the effects of these variants on risk factors in younger and older individuals in the UK Biobank. We then used these estimates to estimate the causal effects of stroke risk factors on EOS (n=6728 cases) and LOS (n=9272) cases from SiGN (Stroke Genetic Network) and the EOSC (Early-Onset Stroke Consortium). Lastly, we compared odds ratios between EOS and LOS, stratified by TOAST (Trial of ORG 10172 in Acute Stroke Treatment) subtypes, to determine if differences between estimates could be attributed to differences in stroke subtype distributions.

RESULTS:

EOS was associated with higher levels of body mass index, blood pressure, type 2 diabetes, and lower levels of HDL (high-density lipoprotein) cholesterol (all
P
≤0.002), whereas LOS was associated with higher levels of systolic blood pressure (
P
=0.0001). The causal effect of body mass index on stroke was significantly stronger for EOS than for LOS (odds ratio, 1.26 versus 1.03;
P
=0.008). After the subtype-stratified analysis, the difference in causal effect sizes between EOS and LOS for body mass index diminished and was no longer significant.

CONCLUSIONS:
These results support a causal relationship between body mass index, blood pressure, type 2 diabetes, and HDL cholesterol levels with EOS and blood pressure levels in LOS. Interventions that target these traits may reduce stroke risk.
Putin's Preventive War: The 2022 Invasion of Ukraine
Authors: Posen Barry R. 
Published: February 2025

Abstract
The 2022 Russian invasion of Ukraine is consistent with the logic of preventive war. States often initiate wars because they fear the consequences of a shifting balance of military power and thus strike to forestall it. They fear that, once the balance changes, the rising power may either attempt to coerce them, or initiate war later under much more favorable circumstances. The tendency to consider preventive war is exacerbated if the declining state also sees itself as having a special, and fleeting, window of opportunity to prevent the shift. This essay reviews a range of evidence to argue that Vladimir Putin likely viewed Russia's strategic situation through a preventive war frame. NATO membership for Ukraine would shift the balance of power against Russia, and U.S. and NATO military cooperation with Ukraine intensified during the Joe Biden administration. These developments likely convinced Putin that he did not have much time to forestall Ukraine's NATO membership.
A Study on Synchronous Bilateral Breast Cancer Radiotherapy Based on an Accelerator Integrated with Optical Surface Monitoring System
Authors: Zhou Zhen , Dong Tingting , Wang Bei , Wang Zhiqun , Zhu Heling , Li Wenbo , Yang Bo , Qiu Jie 
Published: February 2025

Objective To investigate the optimal radiotherapy regimen for synchronous bilateral breast cancer (SBBC) by utilizing dosimetric and radiobiological indicators, and to assess the impact of applying an optical surface monitoring system(OSMS) on the precision of SBBC radiotherapy treatment. Methods Nine patients with SBBC who underwent breast-conserving radiotherapy were retrospectively selected. Four treatment plans were designed for each patient using the Versa HD (Elekta, Stockholm) accelerator: single-isocenter intensity-modulated radiotherapy/volumetric modulated arc therapy(IMRT-ISO1/VMAT-ISO1) and dual-isocenter IMRT/VMAT(IMRT-ISO2/VMAT-ISO2), with a prescription dose of 42.4 Gy in 16 fractions. Dosimetric parameters and radiobiological impact were measured for the target and organs at risk(OARs). The monitoring log files of three SBBC patients were analyzed to quantitatively assess real-time delta shifts encompassing six degrees of freedom (DOFs) during intrafraction and interfraction treatment processes. Results Compared to both the IMRT techniques, the VMAT techniques offered superior target conformity, uniformity, and dose fall-off capability. Among the four treatment plans, VMAT-ISO1 exhibited optimal performance by significantly reducing radiation exposure volume to OARs while maintaining exceptional precision in dose delivery and execution efficiency. The tumor control probability (TCP) was exceeded by 98.5% for all four modalities. According to the OSMS logs, the maximum absolute error in translational motion during the treatment of three SBBC patients was predominantly manifested along the vertical(VRT) axis, with an mean value of 2.2 mm. Additionally, it was observed that the coronal plane (YAW) exhibited the largest error in terms of rotational angle, with an mean deviation of 1.1°. Conclusions The VMAT-ISO1 technique demonstrates apparent dosimetric and radiobiological advantages in SBBC radiotherapy, ensuring precise dose delivery and shortening treatment durations. The accuracy of SBBC radiotherapy is ensured by OSMS through pre-treatment positioning correction and real-time monitoring throughout the treatment process.
Protective effects of statins on pulmonary function in patients with persistent hyperlipidemia: a retrospective cohort study
Authors: Shen Hsiao-Chin , Tseng Che-Hao , Lin Yi-Hsuan , Yeh Hsiao-Yun , Tsai Hung-Cheng , Hong Shiao-Ya , Li Tzu-Hao , Su Chien-Wei , Perng Diahn-Warng , Yang Ying-Ying , Hou Ming-Chih 
Published: February 2025

Background: Pulmonary function tests offer crucial parameters for evaluating lung health and predicting clinical outcomes. Hyperlipidemia, a prevalent metabolic disorder, has been linked to declining pulmonary function. Statins are an essential therapy for lowering lipid levels in hyperlipidemia. Objectives: This study aims to investigate the therapeutic potential of statins in mitigating the decline in pulmonary function. Design: This is a retrospective cohort study. Methods: Out of 8286 patients who underwent spirometry testing from January 2018 to December 2020, 492 patients were included in the final analysis. The relationship between statin usage, dosage, along with other biometric indices and spirometry parameters were evaluated. Multivariate logistic regression analyses were employed to assess the association between statin use and the decline in pulmonary function. Results: In patients with persistent hyperlipidemia, the use of statins was associated with a higher predicted percentage of forced expiratory volume in 1 second (FEV1) compared to non-users (84.0% vs 78.0%, p = 0.015). Logistic regression models further revealed that statin use independently prevented FEV1 decline, irrespective of dosage (adjusted OR 0.036, 95% CI: 0.002–0.618 in lower statins dose group and adjusted OR 0.170, 95% CI: 0.019–1.552 in higher statins dose group). Conclusion: The findings suggested that statin usage, regardless of dosage, independently mitigated the decline in pulmonary function among patients with persistent hyperlipidemia. Early initiation of statin therapy may hold promise for individuals experiencing hyperlipidemia and declining pulmonary function.
Body mass index changes after fecal microbiota transplantation for recurrent Clostridioides difficile infection
Authors: Sehgal Kanika , Berry Parul , Cho Janice , Saffouri George , Dierkhising Ross A. , Battaglioli Eric , Kashyap Purna C. , Pardi Darrell , Khanna Sahil 
Published: February 2025

Background: Fecal microbiota transplantation (FMT) is a successful therapy for Clostridioides difficile infection (CDI). FMT from overweight donors is speculated to influence the recipient’s body mass index (BMI) after administration for CDI. Objectives: We investigated changes in the recipient’s BMI after FMT in relation to the donor’s BMI. Design: We conducted a retrospective cohort study involving patients who underwent FMT for recurrent CDI at Mayo Clinic between 2012 and 2019. Methods: We analyzed demographic and donor data for patients undergoing FMT at Mayo Clinic (2012–2019). Recipient BMI (pre- and post-FMT) and donor BMI were extracted from medical records. Mixed-effects linear regression was used to evaluate the impact of donor BMI, donor BMI category, recipient baseline BMI, time before and after FMT, and interactions between these variables on overall BMI change and BMI change per month. Kaplan–Meier curves were used to assess BMI changes (⩾5 units) based on the last recorded post-FMT BMI. Results: We analyzed data from 401 patients with recorded BMI measurements before and after FMT. The median age of the recipients at the time of FMT was 59.1 years (interquartile range (IQR): 40.5–70.1 years), with 61.6% being female. The median BMI for recipients prior to FMT was 26.7 kg/m² (IQR: 22.7–31.6 kg/m²), while the median BMI of the donors was 24.5 kg/m2 (IQR: 23.9–27.5 kg/m2). Stool from donors with a normal BMI was used for 58.2% of recipients, while 41.8% received stool from pre-obese donors. Donor BMI data were missing for 3.2% of recipients. Donor BMI was not significantly associated with changes in recipient BMI; for each 1-unit increase in donor BMI, a 0.01-unit monthly increase was observed (95% confidence interval: −0.0003, 0.02; p = 0.11). The log-rank test for BMI increases (⩾+5) and decreases (⩽−5) revealed no significant differences among the donor BMI groups (Chi-squared = 4.4, p = 0.1 for increases, Chi-squared = 2, p = 0.4 for decreases). Conclusion: The lack of impact of donor BMI on BMI changes post-FMT suggests that these changes are more dependent on the recipient’s metabolic profile. Prospective, controlled trials are required to analyze these results more comprehensively.
Treatment response of patients with tuberculosis and HIV co-infection: a retrospective analysis of secondary data from Shanghai, China, 2010–2020
Authors: Dong Chenyu , Zhang Renfang , Li Shenyang , Chen Jun , Liu Yunhe , Xia Xiaoqiong , Liu Gang , Shen Yinzhong , Liu Lei , Zeng Liyan 
Published: February 2025

Background: At present, there is a need for more substantial real-world evidence on the factors influencing the effectiveness of tuberculosis (TB) treatment in HIV/TB co-infected patients. Objectives: This retrospective study aims to identify factors affecting TB treatment effectiveness in HIV/TB co-infected patients. Design: Retrospective cross-sectional study. Methods: We included 461 HIV/TB co-infected patients, deriving 742 samples based on each initial positive TB test period. A total of 7788 valid treatment records corresponding to 17 TB drug compositions and 150 clinical indicators (each > 100 records) were used for analysis. Data mining techniques were employed, including consensus clustering, Fisher’s exact test, stratified analysis, multivariate logistic regression analysis, and three modeling approaches (logistic regression, support vector machine, and random forest). Results: The TB treatment effectiveness of CD4+ T cell count ⩽ 42 is significantly lower than that of the sample group > 42 (aOR: 1.77, 95% CI: 1.15–2.74, p = 0.010). The TB treatment effectiveness of the “rifabutin and levofloxacin alone or in combination” group is significantly higher than that of the “other first- and second-line anti-TB drugs in combination” group (aOR: 0.10, 95% CI: 0.01–0.64, p = 0.022). Significant differences exist in factors between TB treatment effective and ineffective groups, including age (aOR: 2.12, 95% CI: 1.10–4.20, p = 0.027), pre-treatment high-density lipoprotein (HDL) cholesterol (aOR: 0.47, 95% CI: 0.25–0.89, p = 0.022), pre-treatment CD8+ T cell count (aOR: 0.55, 95% CI: 0.33–0.90, p = 0.019), pre-treatment neutrophil percentage (aOR: 0.68, 95% CI: 0.48–0.96, p = 0.030), rifabutin (aOR: 1.59, 95% CI: 1.09–2.32, p = 0.016), and cycloserine (aOR: 0.21, 95% CI: 0.03–0.77, p = 0.041). The best area under the receiver operating characteristic curve of the test set under three modeling methods is 0.560–0.763. Rate of lymphocyte percentage recovering to normal is significantly higher in the TB treatment-effective group than in the treatment-ineffective group (aOR: 1.83, 95% CI: 1.09–3.10, p = 0.022). Conclusion: CD4+ T cell count of 42/μL assists TB treatment effectiveness evaluation. Rifabutin and levofloxacin show more therapeutic benefits. Lymphocyte percentage can serve as an effective TB therapeutic and diagnostic target. Age, pre-treatment factors (HDL cholesterol, CD8+ T cell count, and neutrophil percentage), rifabutin, and cycloserine are significantly associated with TB treatment effectiveness. Factors affecting TB treatment effectiveness for HIV/TB co-infected patients need more evidence.
Rod Contour Angle and Postoperative Thoracic Kyphosis: Key Predictors of Proximal Junctional Kyphosis in Pediatric Neuromuscular Scoliosis after Spinopelvic Fusion
Authors: Shen Pochih , Keeter Carson , Sullivan Tyler , Hadley-Miller Nancy , Erickson Mark A. 
Published: February 2025

Study Design Retrospective cohort study. Objectives Proximal junctional kyphosis (PJK) is a postoperative complication in spinal deformity surgery causing pain, functional deterioration, and potential revision surgery, with challenges in the neuromuscular scoliosis (NMS) population. We investigated the incidence, risk factors, and clinical impact of PJK in nonambulatory pediatric NMS patients following spinopelvic fusion. Methods Seventy-two NMS patients who underwent spinopelvic fusion from the upper thoracic vertebra to the pelvis were reviewed, with a minimum 2-year follow-up. Radiographic measurements and clinical data were analyzed to identify PJK predictors and evaluate outcomes. PJK was defined as a proximal junctional angle (PJA) ≥10° and an increase of ≥10° from preoperative measurements. Statistical analyses included t-tests, ROC curve analysis, logistic regression, and linear regression. Results The incidence of PJK was 25%. Significant predictors included rod contour angle (RCA) (odds ratio [OR]: 1.11, P = 0.04), postoperative T2-T12 kyphosis (OR: 1.04, P = 0.043), and the difference between postoperative T2-T12 kyphosis and RCA (OR: 1.04, P = 0.021). A bidirectional relationship between pre- and postoperative PJA was observed. Lower preoperative PJA was associated with an increased risk of PJK (area under the curve [AUC]: 0.78, P < 0.001). Conversely, high preoperative PJA tended to decrease after surgery. No revision surgeries were performed for PJK. Conclusion This study reveals a 25% incidence of PJK in NMS patients undergoing spinopelvic fusion. Preoperative radiographic evaluation warrants particular attention in cases exhibiting decreased PJA values. Furthermore, meticulous intraoperative optimization of PJA, RCA, and thoracic kyphosis appears crucial for minimizing PJK occurrence.
Toward an updated corporate governance framework: Fundamentals, disruptions, and future research
Authors: Aguilera Ruth V , Ruiz Castillo Maria 
Published: February 2025

This essay explores the evolving landscape of corporate governance amid global disruptions and changing stakeholder demands. We argue that traditional governance models are unable to effectively address contemporary challenges such as technological advancements, sustainability pressures, and geopolitical conflicts. While corporate governance has traditionally prioritized financial metrics and majority shareholders, there is a growing shift toward incorporating broader societal and environmental considerations. As a result, we highlight the need for a new corporate governance framework that supports the evolving nature of organizations and their corporate governance practices. We argue that the future of corporate governance must integrate ethical leadership, transparency, and a commitment to sustainability to remain relevant in a rapidly changing global marketplace. We conclude by suggesting research areas that require deeper exploration to build robust corporate governance systems. JEL CLASSIFICATION: A10, A13, D21, F23, G34, L2, M14, P48, Q56
How Point (Single-Probability) Tasks Are Affected by Probability Format, Part 2: A Making Numbers Meaningful Systematic Review
Authors: Ancker Jessica S. , Benda Natalie C. , Sharma Mohit M. , Johnson Stephen B. , Demetres Michelle , Delgado Diana , Zikmund-Fisher Brian J. 
Published: February 2025

Background. The Making Numbers Meaningful review is intended to create guidance on the effect of data presentation format on comprehension of numbers in health. Purpose. This article (one of a series) covers research studying so-called “point tasks,” in which a reader examines materials to obtain information about single probabilities. The current article presents evidence on the effects of data presentation format on probability perceptions and feelings, health behaviors and behavioral intentions, trust, preference, and discrimination outcomes. Data Sources. MEDLINE, Embase, CINAHL, the Cochrane Library, PsycINFO, ERIC, ACM Digital Library; hand search of 4 journals. Study Selection. Manual pairwise screening to identify experimental and quasi-experimental research that compared 2 or more formats for presenting quantitative health information to patients or other lay audiences. This article reports 466 findings of probability communication from 161 articles. Data Extraction. Pairwise extraction of information on stimulus (data in a data presentation format), task, and outcomes. Data Synthesis. Moderate to strong evidence is available on the effects of several format interventions to influence probability perceptions and feelings, including the 1-in-X number format, foreground-only (numerator-only) icon arrays, bar charts, anecdotes, framing, and verbal probabilities. However, only 3 (the 1-in-X effect, anecdotes, and framing) had moderate to strong evidence of influencing health behaviors and behavioral intentions. Research on patient preferences for numerical, graphical, and verbal formats yielded only weak evidence. Conclusions. The link between probability perceptions/feelings and health behaviors is not strongly reflected in the evidence about communicating numbers because many communication-focused studies measure short-term response rather than longer-term behaviors. Also, research into patient preferences for numerical, graphical, and verbal formats has not yielded strong evidence suggesting stable and predictable preferences. Highlights Formatting a probability as 1 in X, using a foreground-only icon array, adding anecdotes to numbers, and gain-loss framing all affect probability perceptions and feelings. The evidence on communicating numbers to influence perceptions is far stronger than the evidence on using it to change health behavior or behavioral intention. Only weak evidence is available on patient preferences for verbal, graphical, and numerical probability formats.
The impact of systemic sclerosis on women’s health evaluated with an ad hoc-developed patient-reported questionnaire
Authors: Lazzaroni Maria-Grazia , Moschetti Liala , Pedretti Eleonora , Andreoli Laura , Ramazzotto Francesca , Zatti Sonia , Galetti Ilaria , Airò Paolo , Tincani Angela , Franceschini Franco 
Published: February 2025

Objective: The impact of disease on women’s health-related quality of life has become increasingly important in patients with rheumatic diseases (RDs). Systemic sclerosis (SSc) mostly affects women with a broad spectrum of clinical presentations and severity, and a variable impact on daily living. The objective of the present study was to specifically address “women’s health” in systemic sclerosis patients through a dedicated questionnaire. Methods: An anonymous self-reported questionnaire (only in Italian) was developed in collaboration with obstetricians and gynecologists and subsequently revised and approved by five patient representatives. The questionnaire was administered to SSc patients during scheduled visits in an outpatient Rheumatology SSc Clinic. Results: Between April 2021 and March 2023, 168 patients accepted to participate; among them, 44.1% had received their SSc diagnosis during reproductive age (<45 years). The questionnaire was composed of 44 questions and included 5 sections encompassing different topics. A high rate of adherence to female cancer screening programs was recorded (86.9% for cervix and 93.6% for breast cancer), while a non-regular gynecological follow-up was observed in 36.4%, mostly in patients with more severe disease phenotype. Only 42.3% accepted to compile the Female Sexual Function Index (FSFI), which indicated a sexual dysfunction (score ⩽ 26.55) in 66.2% of patients. A worse sexual function was shown to be associated with different disease manifestations, including digital ulcers. More than 90% of patients who expressed a desire for pregnancy after diagnosis received medical pre-conception counseling and were satisfied with the information provided. In contrast, discussion about contraception occurred in 37.8% of patients who had been diagnosed during fertile age. Family planning still represents an unmet need, as 43.6% of patients did not achieve their desired family size, mainly due to concerns about their capacity to care for their children. Conclusion: The newly developed questionnaire provides a unique opportunity to comprehensively assess the experience of women with SSc. Disease burden was shown to negatively impact sexual function and adherence to regular gynecological visits. Furthermore, receiving a diagnosis during reproductive age may increase the likelihood of a reduced family size. Clinicians who take care of women with SSc should implement these domains into routine management, thus improving the health literacy of their patients.