bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dissonance in views between healthcare professionals and adults with a spinal cord injury with their understanding and interpretation of exercise intensity for exercise prescription
Authors: Jung Kyung Su , Hutchinson Mike J , Chotiyarnwong Chayaporn , Kusumawardani Martha K , Yoon Seung-Hyun , Mikami Yukio , Laohasinnarong Phairin , Tinduh Damayanti , Prachgosin Pannika , Narasinta Inggar , Chotiyarnwong Pojchong , Utami Ditaruni A , Umemoto Yasonori , Tajima Fumihiro , Goosey-Tolfrey Vicky L 
Published: March 2023

ObjectivesTo evaluate the difference between healthcare professionals (HCPs) and adults with spinal cord injury (SCI) in Asia regarding knowledge and interpretation of ‘exercise intensity’ for aerobic exercise prescription.Methods and study designA survey was distributed to practising HCP and adults with SCI. It was completed in participants’ local language on topics related to the importance of exercise frequency, intensity, time and type; methods for monitoring and terms related to exercise intensity prescription. χ2analysis was used to detect differences in HCP or those with SCI.Results121 HCP and 107 adults with an SCI ≥1 years (C1–L4) participated. Responses revealed 61% of all HCP ranked ‘intensity’ being most important whereas only 38% respondents from the SCI group ranked it as high importance (p=0.008). For those with SCI, ‘frequency’ was most important (61%) which was significantly higher than the 45% selected by HCPs (p=0.030). Of the 228 respondents on average only 34% believed that the terms, ‘moderate’ and ‘vigorous’ provided enough information for aerobic exercise intensity prescription. HCP most often used HR methods compared with the SCI group (90% vs 54%; p<0.01). Both groups frequently used the subjective measures of exercise intensity, for example, Ratings of Perceived Exertion (8%3 vs 76% for HCP and SCI), HCP also frequently used speed (81%) and SCI also frequently relied on ‘the affect’ or feelings while exercising (69%).ConclusionsThese differences must be considered when developing clinical-practice exercise guidelines and health referral educational pathways for adults with SCI in Asia.
High burden of polypharmacy and comorbidity in persons with psoriatic arthritis: an analysis of claims data, stratified by age and sex
Authors: Albrecht Katinka , Regierer Anne Constanze , Strangfeld Anja , Marschall Ursula , Callhoff Johanna 
Published: March 2023

ObjectiveTo assess polypharmacy in women and men with psoriatic arthritis (PsA).MethodsFrom the German BARMER health insurance database, 11 984 persons with PsA and disease-modifying antirheumatic drug therapy in 2021 were included and compared with sex-matched and age-matched controls without inflammatory arthritis. Medications were analysed by Anatomical Therapeutic Chemical (ATC) groups. Polypharmacy (≥5 concomitant drugs) was compared by sex, age and comorbidity using the Rheumatic Disease Comorbidity Index (RDCI) and the Elixhauser Score. The mean difference in the number of medications between persons with PsA and controls was estimated using a linear regression model.ResultsCompared with controls, all ATC drug classes were significantly more frequent in persons with PsA, most commonly musculoskeletal (81% vs 30%), immunomodulatory (56% vs 2.6%), cardiovascular (62% vs 48%), alimentary tract/metabolic (57% vs 31%) and nervous system (50% vs 31%) drugs. Polypharmacy was significantly higher in PsA (49%) compared with controls (17%), more frequent in women (52%) compared with men (45%) and strongly increased with age and comorbidity. For each unit increase of the RDCI, the age-adjusted number of medications increased by 0.98 (95% CI 0.95 to 1.01) units in men and 0.93 (95% CI 0.90 to 0.96) units in women. Compared with controls, the number of medications in PsA (mean 4.9 (SD 2.8)) was 2.4 (95%CI 2.34; 2.43) units higher in women and 2.3 (95% CI 2.21 to 2.35) units higher in men.ConclusionsPolypharmacy is common in PsA and is composed of PsA-specific medication as well as frequent medications for comorbidities, equally affecting women and men.
IgG4-related disease administered dupilumab: case series and review of the literature
Authors: Kanda Masatoshi , Kamekura Ryuta , Sugawara Masanari , Nagahata Ken , Suzuki Chisako , Takano Kenichi , Takahashi Hiroki 
Published: March 2023

Dupilumab (DUP) is a monoclonal antibody that acts on the interleukin (IL)-4 receptor alpha, which inhibits IL-4 and IL-13 signalling and is approved for type 2 inflammatory diseases such as asthma, chronic rhinosinusitis with nasal polyposis and atopic dermatitis; however, the efficacy of DUP to IgG4-related disease (IgG4-RD) is under discussion due to the controversial outcomes based on the several case reports. Here, we reviewed the efficacy of DUP in four consecutive patients with IgG4-RD in our institute and the previous literature.All patients administered DUP fulfilled the 2019 ACR/EULAR classification criteria for IgG4-RD complicated with severe asthma and chronic rhinosinusitis with nasal polyposis. Two cases were administered DUP without systemic glucocorticoids (GCs), and in 6 months, the volume of swollen submandibular glands (SMGs) was reduced by approximately 70%. Two cases receiving GCs successfully reduced their daily dose of GCs (10 and 50% reduction, respectively) with dupilumab in 6 months. In all four cases, serum IgG4 concentration and IgG4-RD responder index decreased in 6 months.DUP reduced the volume of the swollen SMGs, serum IgG4 levels, responder index and the daily dose of GCs in patients with IgG4-RD with severe asthma or eosinophilic rhinosinusitis in 6 months.The efficacy of DUP to IgG4-RD is under discussion due to the limited case reports with controversial outcomes. Here, we demonstrated that two patients with IgG4-RD treated by DUP without systemic GCs, showed volume reduction of swollen SMGs and two cases showed GC-sparing effects by DUP. DUP can ameliorate the disease activity and be a steroid-sparing agent in patients with IgG4-RD.
Analgesic Efficacy of Intravenous Ibuprofen in the Treatment of Postoperative Acute Pain: A Phase III Multicenter Randomized Placebo-ControlledDouble-Blind Clinical Trial
Authors: Zhou Hong-Su , Li Ting-Ting , Pi Yu , Wang Ting-Hua , Liu Fei , Xiong Liu-Lin 
Published: March 2023

Objective. To evaluate the analgesic efficacy and safety of different does of intravenous ibuprofen (IVIB) in the treatment of postoperative acute pain. Methods. Patients with an intravenous (IV) patient-controlled analgesia device after abdominal or orthopedic surgery were randomly divided into placebo, IVIB 400 mg, and IVIB 800 mg groups. The first dosage of study medicines was given intravenously 30 minutes (min) before surgery ended, followed by six hours (h) intervals for a total of eight doses following surgery. The demographic characteristics and procedure data, cumulative morphine consumption, the visual analog scale (VAS), the area under the curve (AUC) of VAS, patient satisfaction score (PSS), the rates of treatment failure (RTF), and adverse events (AEs) and serious adverse event (SAEs) were recorded during the period of trial. Result. A total of 345 patients were enrolled in the full analysis set (FAS), and of 326 participants were valid data set (VDS). Demographic characteristics, disease features, and medical history of patients were not significantly different between groups. Total morphine consumption of the IVIB 400 mg group (11.14 ± 7.14 mg;

P

= 0.0011) and the IVIB 800 mg group (11.29 ± 6.45 mg;

P

= 0.0014) was significantly reduced compared with the placebo group (14.51 ± 9.19 mg) for 24 h postoperatively, there was no significant difference between the IVIB 400 mg and IVIB 800 mg groups (

P

= 0.9997). The placebo group had significantly higher VAS and the AUCs of VAS than those in the IVIB 400 mg and the IVIB 800 mg groups at rest and movement for 24 h postoperatively (

P

< 0.05), and there was no significant difference between the IVIB 400 mg and IVIB 800 mg groups (

P

> 0.05). RTF was slightly higher in the placebo group than IVIB 400 mg group and 800 mg group, and no statistical significance (

P

< 0.690). PSS in the IVIB 400 mg (

P

= 0.0092) and the IVIB 800 mg groups (

P

= 0.0011) was higher than the placebo group for pain management, there was also no significant difference between the IVIB 400 mg and IVIB 800 mg groups (

P

= 0.456). The incidence of RTF (

P

= 0.690) and AEs (

P

> 0.05) were not different among the three groups. Conclusion. Intermittent IV administration of ibuprofen 400 mg or 800 mg within 24 h after surgery in patients undergoing abdominal and orthopedic surgery significantly decreased morphine consumption and relieved pain, without increasing the incidence of AEs.
Peripheral Ischemia Imprints Epigenetic Changes in Hematopoietic Stem Cells to Propagate Inflammation and Atherosclerosis
Authors: Coppin Emilie , Zhang Xinyi , Ohayon Lee , Johny Ebin , Dasari Ankush , Zheng Kang H. , Stiekema Lotte , Cifuentes-Pagano Eugenia , Pagano Patrick J. , Chaparala Srilakshmi , Stroes Erik S. , Dutta Partha 
Published: March 2023

Background:
Peripheral ischemia caused by peripheral artery disease is associated with systemic inflammation, which may aggravate underlying comorbidities such as atherosclerosis and heart failure. However, the mechanisms of increased inflammation and inflammatory cell production in patients with peripheral artery disease remain poorly understood.

Methods:

We used peripheral blood collected from patients with peripheral artery disease and performed hind limb ischemia (HI) in
Apoe

−/−

mice fed a Western diet and C57BL/6J mice with a standard laboratory diet. Bulk and single-cell RNA sequencing analysis, whole-mount microscopy, and flow cytometry were performed to analyze hematopoietic stem and progenitor cell (HSPC) proliferation, differentiation, and relocation.

Results:

We observed augmented numbers of leukocytes in the blood of patients with peripheral artery disease and
Apoe

−/−

mice with HI. RNA sequencing and whole-mount imaging of the bone marrow revealed HSPC migration into the vascular niche from the osteoblastic niche and their exaggerated proliferation and differentiation. Single-cell RNA sequencing demonstrated alterations in the genes responsible for inflammation, myeloid cell mobilization, and HSPC differentiation after HI. Heightened inflammation in
Apoe

−/−

mice after HI aggravated atherosclerosis. Surprisingly, bone marrow HSPCs expressed higher amounts of the receptors for IL (interleukin)-1 and IL-3 after HI. Concomitantly, the promoters of
Il1r1
and
Il3rb
had augmented H3K4me3 and H3K27ac marks after HI. Genetic and pharmacological inhibition of these receptors resulted in suppressed HSPC proliferation, reduced leukocyte production, and ameliorated atherosclerosis.

Conclusions:
Our findings demonstrate increased inflammation, HSPC abundance in the vascular niches of the bone marrow, and elevated IL-3Rb and IL-1R1 (IL-1 receptor 1) expression in HSPC following HI. Furthermore, the IL-3Rb and IL-1R1 signaling plays a pivotal role in HSPC proliferation, leukocyte abundance, and atherosclerosis aggravation after HI.
Economic and Health Value of Delaying Atrial Fibrillation Progression Using Radiofrequency Catheter Ablation
Authors: Berman Adam E. , Kabiri Mina , Wei Tom , Galvain Thibaut , Sha Qun , Kuck Karl-Heinz 
Published: March 2023

Background:
Radiofrequency catheter ablation (RFCA) is an established treatment for atrial fibrillation (AF) refractory to antiarrhythmic drugs. The economic value of RFCA in delaying disease progression has not been quantified.

Methods:
An individual-level, state-transition health economic model estimated the impact of delayed AF progression using RFCA versus antiarrhythmic drug treatment for a hypothetical sample of patients with paroxysmal AF. The model incorporated the lifetime risk of progression from paroxysmal AF to persistent AF, informed by data from the ATTEST (Atrial Fibrillation Progression Trial). The incremental effect of RFCA on disease progression was modeled over a 5-year duration. Annual crossover rates were also included for patients in the antiarrhythmic drug group to mirror clinical practice. Estimates of discounted costs and quality-adjusted life years asssociated with health care utilization, clinical outcomes, and complications were projected over patients’ lifetimes.

Results:
From the payer’s perspective, RFCA was superior to antiarrhythmic drug treatment with an estimated mean net monetary benefit per patient of $8516 ($148–$16 681), driven by reduced health care utilization, cost, and improved quality-adjusted life years. RFCA reduced mean (95% CI) per-patient costs by $73 (−$2700 to $2200), increased mean quality-adjusted life years by 0.084 (0.0–0.17) and decreased the mean number of cardiovascular-related health care encounters by 24%.

Conclusions:
RFCA is a dominant (less costly and more effective) treatment strategy for patients with AF, especially those with early AF for whom RFCA could delay progression to advanced AF. Increased utilization of RFCA—particularly among patients earlier in their disease progression—may provide clinical and economic benefits.
Ablation of Ventricular Preexcitation to Cure Preexcitation-Induced Dilated Cardiomyopathy in Infants: Diagnosis and Outcome
Authors: Zhang Yi , Jiang He , Cui Jian , Li Mei-ting , Zhou Hui-ming , Li Xiao-mei 
Published: March 2023

Background:
To investigate the clinical features of preexcitation-induced dilated cardiomyopathy in infants and evaluate safety and efficacy of radiofrequency ablation (RFCA) in these patients.

Methods:
This study included 10 infants (4 males and 6 females) with mean age of 6.78±3.14 months, mean weight of 8.11±1.71 kg, and mean left ventricular ejection fraction (LVEF) was 32.6±10.34%. Tachycardiomyopathy has been excluded and all patients were refractory to the drugs. All of these 10 patients underwent RFCA.

Results:
All the accessory pathways in these patients were located on right free wall and the acute success rate was 100%. No complication associated with the procedure occurred. In one case preexcitation recurred and was ablated successfully during the second attempt. There were 3 patients with mild cardiac dysfunction (LVEF, 40≤LVEF<50%), 3 with moderate (30≤LVEF<40%), and 4 with severe cardiac dysfunction (LVEF<30%, the ages were 3, 6, 7, and 10 months, respectively). The time for LVEF normalization was 1 week, 1 to 3 months, and ≥3 months, respectively. In 3 of the 4 severe cardiac dysfunction patients, the LVEF normalized at 3, 6, and 12 months after ablation, the LVEF of the remaining case did not recover at 3 months and is still being followed.

Conclusions:
Ventricular preexcitation could lead to severe cardiac dysfunction during infancy. RFCA may be a safe and effective treatment option in right free wall accessory pathways, even in infants with cardiac dysfunction. Cases of more severe cardiac dysfunction might require a longer time for LVEF recovery after RFCA.
Preadmission Opioid Use and 1‐Year Mortality Following Incident Myocardial Infarction: A Danish Population‐Based Cohort Study (1997–2016)
Authors: Korsgaard Søren , Munch Troels , Horváth–Puhó Erzsébet , Adelborg Kasper , Christiansen Christian Fynbo , Pedersen Lars , Schmidt Morten , Sørensen Henrik Toft 
Published: March 2023

Background
Opioid use has been linked to an increased risk of myocardial infarction and cardiovascular mortality, but the prognostic impact of opioid use before an incident myocardial infarction is largely unknown.

Methods and Results
We conducted a nationwide population‐based cohort study including all patients hospitalized for an incident myocardial infarction in Denmark (1997–2016). Based on their last redeemed opioid prescription before admission, patients were categorized as current users (0–30 days), recent users (31–365 days), former users (>365 days), and nonusers. One‐year all‐cause mortality was calculated using the Kaplan–Meier method. Hazard ratios (HRs) were computed using Cox proportional hazards regression analyses, adjusting for age, sex, comorbidity, any preceding surgery within 6 months before the myocardial infarction admission, and medication use before the myocardial infarction admission. We identified 162 861 patients with an incident myocardial infarction. Of these, 8% were current opioid users, 10% were recent opioid users, 24% were former opioid users, and 58% were nonusers of opioids. One‐year mortality was highest among current users (42.5% [95% CI, 41.7%–43.3%]) and lowest among nonusers (20.5% [95% CI, 20.2%–20.7%]). Compared with nonusers, current users had an elevated 1‐year all‐cause mortality risk (adjusted HR, 1.26 [95% CI, 1.22–1.30]). Following adjustment, neither recent users nor former users of opioids were at elevated risk.

Conclusions
Preadmission opioid use was associated with an increased 1‐year all‐cause mortality risk following an incident myocardial infarction. Opioid users thus represent a high‐risk subgroup of patients with myocardial infarction.
Association Between Risk Factors in Childhood and Sex Differences in Prevalence of Carotid Artery Plaques and Intima‐Media Thickness in Mid‐Adulthood in the Childhood Determinants of Adult Health Study
Authors: Shah Mohammad , Buscot Marie‐Jeanne , Tian Jing , Phan Hoang T. , Fraser Brooklyn J. , Marwick Thomas H. , Dwyer Terence , Venn Alison , Gall Seana 
Published: March 2023

Background
The origins of sex differences in cardiovascular diseases are not well understood. We examined the contribution of childhood risk factors to sex differences in adult carotid artery plaques and intima‐media thickness (carotid IMT).

Methods and Results
Children in the 1985 Australian Schools Health and Fitness Survey were followed up when they were aged 36 to 49 years (2014–19, n=1085–1281). Log binomial and linear regression examined sex differences in adult carotid plaques (n=1089) or carotid IMT (n=1283). Childhood sociodemographic, psychosocial, and biomedical risk factors that might contribute to sex differences in carotid IMT/plaques were examined using purposeful model building with additional adjustment for equivalent adult risk factors in sensitivity analyses. Women less often had carotid plaques (10%) than men (17%). The sex difference in the prevalence of plaques (relative risk [RR] unadjusted 0.59 [95% CI, 0.43 to 0.80]) was reduced by adjustment for childhood school achievement and systolic blood pressure (RR adjusted 0.65 [95% CI, 0.47 to 0.90]). Additional adjustment for adult education and systolic blood pressure further reduced sex difference (RR adjusted 0.72 [95% CI, 0.49 to 1.06]). Women (mean±SD 0.61±0.07) had thinner carotid IMT than men (mean±SD 0.66±0.09). The sex difference in carotid IMT (β unadjusted −0.051 [95% CI, −0.061 to −0.042]) reduced with adjustment for childhood waist circumference and systolic blood pressure (β adjusted −0.047 [95% CI, −0.057 to −0.037]) and further reduced with adjustment for adult waist circumference and systolic blood pressure (β adjusted −0.034 [95% CI, −0.048 to −0.019]).

Conclusions
Some childhood factors contributed to adult sex differences in plaques and carotid IMT. Prevention strategies across the life course are important to reduce adult sex differences in cardiovascular diseases.
Association of Joint Genetic and Social Environmental Risks With Incident Myocardial Infarction: Results From the Health and Retirement Study
Authors: Tang Junhan , Sheng Chen , Wu Yan Yan , Yan Lijing L. , Wu Chenkai 
Published: March 2023

Background
Myocardial infarction (MI) is a significant clinical and public health problem worldwide. However, little research has assessed the interplay between genetic susceptibility and social environment in the development of MI.

Methods and Results
Data were from the HRS (Health and Retirement Study). The polygenic risk score and polysocial score for MI were classified as low, intermediate, and high. Using Cox regression models, we assessed the race‐specific association of polygenic score and polysocial score with MI and examined the association between polysocial score and MI in each polygenic risk score category. We also examined the joint effect of genetic (low, intermediate, and high) and social environmental risks (low/intermediate, high) on MI. A total of 612 Black and 4795 White adults aged ≥65 years initially free of MI were included. We found a risk gradient of MI across the polygenic risk score and polysocial score among White participants; no significant risk gradient across the polygenic risk score was found among Black participants. A disadvantaged social environment was associated with a higher risk of incident MI among older White adults with intermediate and high genetic risk but not those with low genetic risk. We revealed the joint effect of genetics and social environment in the development of MI among White participants.

Conclusions
Living in a favorable social environment is particularly important for people with intermediate and high genetic risk for MI. It is critical to developing tailored interventions to improve social environment for disease prevention, especially among adults with a relatively high genetic risk.
Multilateral Climate Finance Coordination: Politics and Depoliticization in Practice
Authors: Skovgaard Jakob , Adams Kevin M. , Dupuy Kendra , Dzebo Adis , Funder Mikkel , Fejerskov Adam Moe , Shawoo Zoha 
Published: March 2023

Abstract
The governance of public climate finance for mitigation and adaptation in developing countries is fragmented on both the international and national levels, with a high diversity of actors with overlapping mandates, preferences, and areas of expertise. In the absence of one unifying actor or institution, coordination among actors has emerged as a response to this fragmentation. In this article, we study the coordination efforts of the two most important multilateral climate funds, the Climate Investment Funds (CIF) and the Green Climate Fund (GCF), on the global level as well as within two recipient countries, Kenya and Zambia. The CIF and the GCF are anchored within the World Bank and the United Nations Framework Convention on Climate Change, respectively, and represent two diverging perspectives on climate finance. We find that on both levels, coordination was depoliticized by treating it as a technical exercise, rendering invisible the political divergences among actors. The implications of this depoliticization are that both funds coordinate mainly with actors with similar preferences, and consequently, coordination did not achieve its objectives. The article contributes to the literatures on coordination, climate finance, and environmental governance by showing how a response to the fragmentation of climate governance did not overcome political fault lines but rather reinforced them.