bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histidine-rich glycoprotein attenuates catheter thrombosis
Authors: Malik Rida A. , Liao Peng , Zhou Ji , Hussain Rawaa , Fredenburgh James C. , Hettrick Lisa , Revenko Alexey S. , Weitz Jeffrey I. 
Published: April 2023

Abstract
Factor XII (FXII) knockdown attenuates catheter thrombosis in rabbits. Because histidine-rich glycoprotein (HRG) modulates FXIIa activity, we hypothesized that HRG depletion would promote catheter thrombosis. To test this, rabbits were given either antisense oligonucleotides (ASOs) against HRG or FXII, a control ASO, or saline. The activated partial thromboplastin time (aPTT), prothrombin time (PT), and catheter-induced thrombin generation were determined in blood collected before and after treatment. Compared with the controls, the HRG- and FXII-directed ASOs reduced hepatic messenger RNA and plasma levels of HRG and FXII, respectively, by &gt;90%. Although HRG knockdown shortened the aPTT by 2.5 fold, FXII knockdown prolonged it by fourfold; neither of the ASOs affected the PT. Catheter segments shortened the lag time and increased peak thrombin in the plasma from control rabbits; effects were significantly enhanced and attenuated in the plasma from rabbits given the HRG- and FXII-directed ASOs, respectively. Catheters were then inserted into the right external jugular vein of the rabbits, and the time for catheter occlusion was determined. The catheter occlusion times with the control ASO or saline were 62 ± 8 minutes and 60 ± 11 minutes, respectively. The occlusion time was significantly reduced to 34 ± 9 minutes, with HRG knockdown and significantly prolonged to 128 ± 19 minutes with FXII knockdown. HRG levels are decreased with sepsis or cancer, and such patients are prone to catheter thrombosis. Because HRG modulates catheter thrombosis, our findings suggest that HRG supplementation may prevent this problem.
Acute effects of empagliflozin on open-loop baroreflex function and urine glucose excretion in Goto-Kakizaki diabetic rats
Authors: Kawada Toru , Yamamoto Hiromi , Yokoi Aimi , Nishiura Akitsugu , Kakuuchi Midori , Yokota Shohei , Matsushita Hiroki , Alexander Joe , Saku Keita 
Published: April 2023

AbstractAlthough suppression of sympathetic activity is suggested as one of the underlying mechanisms for the cardioprotective effects afforded by sodium–glucose cotransporter 2 (SGLT2) inhibitors, whether the modulation of glucose handling acutely affects sympathetic regulation of arterial pressure remains to be elucidated. In Goto–Kakizaki diabetic rats, we estimated the open-loop static characteristics of the carotid sinus baroreflex together with urine glucose excretion using repeated 11-min step input sequences. After the completion of the 2nd sequence, an SGLT2 inhibitor empagliflozin (10 mg kg−1) or vehicle solution was administered intravenously (n = 7 rats each). Empagliflozin did not significantly affect the baroreflex neural or peripheral arc, despite significantly increasing urine glucose excretion (from 0.365 ± 0.216 to 8.514 ± 0.864 mg·min−1·kg−1, P < 0.001) in the 7th and 8th sequences. The possible sympathoinhibitory effect of empagliflozin may be an indirect effect associated with chronic improvements in renal energy status and general disease conditions.
Efficacy and safety comparison of neoadjuvant chemotherapy followed by surgery and upfront surgery for treating intrahepatic cholangiocarcinoma: a systematic review and meta-analysis
Authors: Yang Zijiao , Jiang Xia 
Published: April 2023

Abstract
Background and aims
Currently, surgical resection is the most commonly performed and effective treatment for intrahepatic cholangiocarcinoma (ICC) worldwide. However, the prognosis of ICC is unsatisfactory. This study aimed to compare the efficacy and safety of neoadjuvant chemotherapy followed by surgery and upfront surgery in treating intrahepatic cholangiocarcinoma (ICC). The study also intends to explore whether chemotherapy should be introduced before surgery and which populations should be considered for neoadjuvant chemotherapy.

Method
Four databases, including PubMed, EMBASE, Cochrane Library, and Web of Science, were searched from their inception dates to January 2022 for relevant articles. The statistical analysis was performed using the Review Manager Software (version5.3). The non-randomized interventions (ROBINS-I) was used to assess the methodological quality of included studies and the overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Moreover, the primary outcomes included 1-year, 3-year and 5-year overall survival (OS), while the secondary outcomes were R0 resection, 1-year, 3-year and 5-year recurrence-free survival (RFS), postoperative complications and ninety-day postoperative mortality.

Results
Five studies involving 2412 patients were included in this meta-analysis. There was no significant difference in 1-year OS, 3-year OS, 1-year, 3-year and 5-year RFS, postoperative complications and ninety-day postoperative mortality between the two groups. However, the meta-analysis showed that the neoadjuvant chemotherapy group had a better 5-year OS benefit in ICC patients than the upfront surgery group (OR = 1.27, 95% CI: 1.02–1.58), while the R0 resection rate was lower in neoadjuvant chemotherapy group than that in the upfront surgery group (OR = 0.49, 95% CI: 0.26–0.91).

Conclusion
Compared with the upfront surgery, neoadjuvant chemotherapy followed by surgery could prolong the 5-year OS without increasing the risk of postoperative complications in ICC patients. Considering that the patients in the neoadjuvant chemotherapy followed by surgery group had more advanced ICC cases, the benefits of neoadjuvant chemotherapy may be more significant in patients with more advanced ICC.
Impact of family functioning on mental health problems of college students in China during COVID-19 pandemic and moderating role of coping style: a longitudinal study
Authors: Liu Lili , Chen Jianbin , Liang Shunwei , Yang Wenwen , Peng Xiaodan , Cai Chengcheng , Huang Andi , Wang Xiayong , Zhao Jingbo 
Published: April 2023

Abstract
Background
During the COVID-19 pandemic, college students were required to stay at home and maintain social distance for the entire spring semester of 2020. There is little research on how family functioning influenced mental health problems and how coping styles moderated the relationship between family functioning and mental health problems among college students during their stay-at-home period.

Methods
A total of 13,462 college students (age = 16–29 years) completed four online surveys between February and October 2020, namely the outbreak phase, remission phase, online study phase, and school reopening phase in Guangdong Province, China. Family functioning was assessed by the Family APGAR; coping styles were assessed by the Simplified Coping Style Questionnaire (SCSQ), depression symptoms and anxiety symptoms were evaluated by the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7) respectively. Generalized estimating equations were used to assess associations between variables, the logit link function was used to estimate the odds ratio of different subgroups, the Newton–Raphson method was used to estimate parameters, and the Wald test was used to test the main effect and the interaction effect.

Results
The incidence rates of depression increased during the stay-at-home period from 33.87%, 95% CI (29.88%, 38.10%) to 40.08% 95% CI (35.76%, 44.55%) after schools reopened, χ2 = 193.68, p < 0.001. The incidence rates of anxiety increased from 17.45%, 95% CI (14.59%, 20.73%) to 26.53%, 95% CI (16.94%, 23.67%) over the entire period, χ2 = 195.74, p < 0.001. The percentages of students with highly functional, moderately dysfunctional and severely dysfunctional family functioning were 48.23%, 43.91 and 7.86% at T1 and 46.20%, 45.28%, and 8.52 at T4, respectively. The percentage of subjects with active coping style was 23.9%, negative coping style was 17.4%, strong response coping was 26.9%, and weak response coping was 31.7%. The incidence rate of depression and anxiety for different family functioning groups varied at different time points, and the interaction effect was significant (χ2 = 52.97, p < 0.001 and χ2 = 51.25, p < 0.001, respectively). The incidence rate of depression and anxiety for different family functioning groups with different coping styles also varied at different time points, the interaction effect was likewise significant (χ2 = 862.09, p < 0.001 and χ2 = 583.29, p < 0.001, respectively).

Conclusions
Having a severely dysfunctional family and a negative coping style increase the incidence rates of depression and anxiety. These findings highlight the importance of paying special attention to college students' family functioning and promoting appropriate coping strategies during and after COVID-19.
Effect of household toilet accessibility on physical health of ethnic minority adolescents: a longitudinal study from the China Education Panel Survey 2013 and 2014
Authors: Jiang Yao , Yang Fan 
Published: April 2023

Abstract
Background
Accessing household toilets is vital for adolescent health during crucial stages of growth and development; however, some ethnic minority families in China lack toilets. The relationship between household toilet accessibility and the physical health of adolescents in China’s ethnic minority areas has been underexamined.

Methods
Using two waves of data from the China Education Panel Survey (2013 and 2014), this study explored the effect of household toilet accessibility on Chinese ethnic minority adolescents’ physical health. The sample consisted of 576 ethnic minority adolescents with an average age of approximately 13 years. To test the health effect of household toilet accessibility on ethnic minority adolescents, a fixed effects ordinary least squares model and difference-in-differences combined with propensity score matching method were used.

Results
The results of the fixed effects model and difference-in-differences combined with propensity score matching showed a significant and positive effect of household toilet accessibility on adolescents’ physical health. The heterogeneity analysis indicated that among the toilet types of soil cesspits, cement cesspits, squat toilets, and flush toilets, the flush toilets were proven to be the most efficient in improving adolescents’ physical health. Moreover, the family living arrangement was proven to play a moderating role in the effect of household toilet accessibility on the physical health of ethnic minority adolescents. The average marginal effects of household toilet accessibility on the physical health of ethnic minority adolescents who lived without parents were more evident and significant than those who lived with their parents.

Conclusion
Promoting household toilet accessibility in China’s ethnic minority areas is essential for improving adolescents’ health. Moreover, having a household toilet is not sufficient, the quality and dignity of household toilets are also important.
Learning styles of medical students from a university in China
Authors: Liu Hai-ping , Liu Yue-hui 
Published: April 2023

Abstract
Background
Investigating students’ learning styles can generate useful information that can improve curriculum design. This study adopts diverse measures to identify the learning styles of students despite limited literature related to clinical medical students in China. We utilized Felder’s Index of Learning Styles to examine the learning style characteristics of clinical medical students at Inner Mongolia Minzu University.

Methods
Cluster sampling (probability sampling) was used. This cross-sectional study investigated clinical medicine students with regard to their learning style preference and the difference across genders. This study also analysed data collected from other published studies. A total of 411 students from the medical school at Inner Mongolia Minzu University completed the Index of Learning Styles Questionnaire. The questionnaire assessed the learning styles of students in four dimensions: visual-verbal learning, sequential-global learning, active-reflective leaning, and sensing-intuitive learning.

Results
The analysis results show that clinical medicine students choose to receive visual information (73.97% of the student sample) instead of verbal information. These students prioritize sensory information (67.15%) rather than intuitive information and process reflective information (51.82%) rather than active information. They prefer to process information sequentially (59.85%) instead of globally. Our results also show that male students present a higher preference for an active learning style over a reflective learning style, while female students seem to present a higher preference for a reflective learning style over an active learning style. These preferences vary between cohorts (gender), but the difference is not statistically significant. Compared to data collected from other published studies, active, visual, sensing, and sequential are the most popular styles of learning adopted by medical science students.

Conclusions
The identification of medical students’ learning style in China provides information that medical educators and others can use to make informed choices about modification, development and strengthening of medical educational programs. Our outcomes may potentially improve motivation, engagement and deep learning in medical education when used as a supplement to teaching/learning activities.
Adolescents and youths’ opinions about the factors associated with cannabis use: a qualitative study based on the I-Change model
Authors: González-Cano-Caballero María , Torrejón-Guirado María-Carmen , Cano-Caballero María Dolores , Mac Fadden Isotta , Barrera-Villalba María-Del-Carmen , Lima-Serrano Marta 
Published: April 2023

Abstract
Background
To learn about the experiences and opinions of adolescent non-consumers and regular cannabis users about cannabis use and the factors that determine its use, using the I-Change explanatory model as a basis.

Methods
Qualitative methodology with a content analysis was used. Focus groups were conducted with adolescents who were non-regular cannabis users (those who had not tried cannabis or had only experimented with it before) and semi-structured interviews were conducted with adolescent and young adult in recovery who were in a detoxification program. A deductive analysis of the audio-recorded and transcribed interviews was performed, using the domains of the I-Change Model as a reference.

Results
Personal problems, social problems or family problems can lead to cannabis use. There was a lack of knowledge and low risk perception about consumption of this drug. There are other factors that influence consumption, the perception of advantages, such as the feeling of freedom and the influence of the peer group. The consumption of this substance in girls is changing, becoming more and more equal to that of boys. The family has an important role to play in preventing drug use.

Conclusion
Knowledge of these factors is of vital importance as a prior step to the development of efficient intervention measures adjusted to the needs identified and the characteristics of the population.
Associations between the stringency of COVID-19 containment policies and health service disruptions in 10 countries
Authors: Reddy Tarylee , Kapoor Neena R. , Kubota Shogo , Doubova Svetlana V , Asai Daisuke , Mariam Damen Haile , Ayele Wondimu , Mebratie Anagaw Derseh , Thermidor Roody , Sapag Jaime C. , Bedregal Paula , Passi-Solar Álvaro , Gordon-Strachan Georgiana , Dulal Mahesh , Gadeka Dominic Dormenyo , Mehata Suresh , Margozzini Paula , Leerapan Borwornsom , Rittiphairoj Thanitsara , Kaewkamjornchai Phanuwich , Nega Adiam , Awoonor-Williams John Koku , Kruk Margaret E. , Arsenault Catherine 
Published: April 2023

Abstract
Background
Disruptions in essential health services during the COVID-19 pandemic have been reported in several countries. Yet, patterns in health service disruption according to country responses remain unclear. In this paper, we investigate associations between the stringency of COVID-19 containment policies and disruptions in 31 health services in 10 low- middle- and high-income countries in 2020.

Methods
Using routine health information systems and administrative data from 10 countries (Chile, Ethiopia, Ghana, Haiti, Lao People’s Democratic Republic, Mexico, Nepal, South Africa, South Korea, and Thailand) we estimated health service disruptions for the period of April to December 2020 by dividing monthly service provision at national levels by the average service provision in the 15 months pre-COVID (January 2019-March 2020). We used the Oxford COVID-19 Government Response Tracker (OxCGRT) index and multi-level linear regression analyses to assess associations between the stringency of restrictions and health service disruptions over nine months. We extended the analysis by examining associations between 11 individual containment or closure policies and health service disruptions. Models were adjusted for COVID caseload, health service category and country GDP and included robust standard errors.

Findings
Chronic disease care was among the most affected services. Regression analyses revealed that a 10% increase in the mean stringency index was associated with a 3.3 percentage-point (95% CI -3.9, -2.7) reduction in relative service volumes. Among individual policies, curfews, and the presence of a state of emergency, had the largest coefficients and were associated with 14.1 (95% CI -19.6, 8.7) and 10.7 (95% CI -12.7, -8.7) percentage-point lower relative service volumes, respectively. In contrast, number of COVID-19 cases in 2020 was not associated with health service disruptions in any model.

Conclusions
Although containment policies were crucial in reducing COVID-19 mortality in many contexts, it is important to consider the indirect effects of these restrictions. Strategies to improve the resilience of health systems should be designed to ensure that populations can continue accessing essential health care despite the presence of containment policies during future infectious disease outbreaks.
Immunosuppressive therapy for progressive idiopathic membranous nephropathy: a cost-effectiveness analysis in China
Authors: Xu Wanyi , Zhang Zhiqi , Li Dandan , Dai Wendi , Pan Chen , Guo Mingxing , Zhao Ying , Cui Xiangli 
Published: April 2023

Abstract
Background
This study aims to evaluate the cost-effectiveness of immunosuppressive therapy for patients with progressive idiopathic membranous nephropathy (IMN) from the Chinese healthcare system perspective.

Methods
To estimate the cost-effectiveness of four regimens namely cyclophosphamide, cyclosporine, rituximab and tacrolimus-rituximab in treatment of IMN recommended by the updated Kidney Disease: Improving Global Outcomes (KDIGO) guideline 2021, a Markov model with five discrete states (active disease, remission, dialysis, kidney transplant and death) based on IMN patients aged 50 or above over a 30-years time horizon was constructed. Total costs were imputed from the Chinese healthcare system perspective, and health outcomes were converted into quality-adjusted life years (QALYs). The incremental cost-effectiveness ratio (ICER) was used to describe the results. The willingness-to-pay (WTP) threshold was set at $12,044 (China’s 2021 Gross Domestic Product per capita). Sensitivity analyses were performed to test the uncertainties of the results.

Result
Compared with cyclophosphamide, both cyclosporine (incremental cost $28,337.09, incremental QALY-1.63) and tacrolimus-rituximab (incremental cost $28,324.13, incremental QALY -0.46) were considered at strictly dominated for their negative values in QALYs, and the ICER value of rituximab was positive (incremental cost $9,162.19, incremental QALY 0.44). Since the ICER of rituximab exceeds the pre-determined threshold, cyclophosphamide was likely to be the best choice for the treatment of IMN within the acceptable threshold range. The results of the sensitivity analysis revealed that the model outcome was mostly affected by the probability of remission in rituximab. In a probabilistic sensitivity analysis, cyclophosphamide had 62.4% probability of being cost-effective compared with other regimens when the WTP was $12,044 per QALY. When WTP exceeded $18,300, rituximab was more cost-effective than cyclophosphamide.

Conclusion
Compared with cyclosporine, rituximab and tacrolimus-rituximab, our model results indicated that cyclophosphamide represented the most cost-effective regimen for patients with progressive IMN in China.
Metastasis pattern and prognosis in children with neuroblastoma
Authors: Liu Shan , Yin Weimin , Lin Yaobin , Huang Sihan , Xue Shufang , Sun Gaoyuan , Wang Chengyi 
Published: April 2023

Abstract
Background
We aimed to investigate the different metastases and prognoses of neuroblastoma (NB) and determine the risk factors of metastasis.

Method
Data of 1224 patients with NB were obtained from the Surveillance, Epidemiology and End Results database (2010–2018). Pearson’s chi-square test, Kaplan–Meier analysis, multivariable logistic regression and Cox regression analysis were used to determine the factors associated with prognosis.

Results
The overall incidence of NB was an age-adjusted rate of 8.2 patients per 1,000,000 children. In total, 1224 patients were included in our study, with 599 patients (48.9%) exhibiting distant metastases. Compared to patients with non-metastatic NB, a greater proportion of patients with metastatic NB were under 1 year, male, had an adrenal primary site, unilateral tumour, a tumour size > 10 cm, neuroblastoma-not otherwise specified (NB-NOS), second malignant neoplasms and were more likely to choose radiotherapy and chemotherapy. Multivariate Cox regression showed that metastasis was an independent risk factor for overall survival (OS) and cancer-specific survival (CSS). The survival rate of non-metastatic patients with NB was better than those with metastasis (OS: hazard ratio (HR): 0.248, P < 0.001; CSS: HR: 0.267, P < 0.001). The bone and liver were the two most common isolated metastatic sites in NB. However, no statistical difference was observed in OS and CSS between the only bone metastasis group, only liver metastasis group and bone metastasis combined with liver metastasis group (all P > 0.05). Additionally, age at diagnosis > 1 year (odds ratio (OR): 3.295, P < 0 .001), grades III–IV (OR: 26.228, P < 0 .001) and 5–10 cm tumours (OR: 1.781, P < 0 .001) increased the risk of bone metastasis of NB. Moreover, no surgical treatment (OR: 2.441, P < 0 .001) increased the risk of liver metastasis of NB.

Conclusion
Metastatic NB has unique clinicopathological features, with the bone and liver as the most common single metastatic sites of NB. Therefore, more aggressive treatment is recommended for high-risk children with NB displaying distant metastases.