bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term effects of natalizumab on MRI activity and clinical outcomes in Japanese patients with relapsing-remitting multiple sclerosis
Authors: Saida Takahiko , Hao Qi , Kanda Michihiro , Tani Yumiko 
Published: August 2023

Abstract
Background
Relapsing-remitting multiple sclerosis (RRMS) is the most common phenotype of multiple sclerosis (MS), and its active stage is characterized by active T2 lesions with or without gadolinium (Gd) enhancement on magnetic resonance imaging (MRI). Natalizumab is indicated as monotherapy in adults with active RRMS in Japan. The main objective of this study was to investigate the long-term effect of natalizumab on disease progression in Japanese patients with RRMS using MRI data.

Methods
This retrospective, chart review study was conducted at a single center in Japan. The main study outcome was the yearly proportion of patients with active T2-weighted image lesions detected with or without Gd enhancement on brain MRI (incidence rate) after treatment initiation for up to 5 years. Additional endpoints included annual relapse rate (ARR) and expanded disability status scale (EDSS) score.

Results
This study included data from 85 patients with RRMS who had received natalizumab for ≥ 1 year; of these, 65 (76.5%) were female and the mean ± standard deviation (SD) age at baseline was 37.5 ± 10.0 years. The incidence rate of active T2 lesions was 52.9% (45/85) in the year prior to natalizumab treatment (Year − 1), which decreased to 2.4% and 1.6% in Year 0.5–1.5 and Year 1.5–2.5, respectively. No active T2 lesions were detected in Year 2.5–5.5 in patients who continued natalizumab treatment. EDSS score was stable, improved, and worsened in 61.8%, 26.3%, and 11.8% of patients, respectively. The median (range) EDSS score was 2.0 (0.0–7.0) at baseline (n = 85) and remained within a similar range (median score between 1.0 and 2.25 during Years 1–5). ARR decreased from 1.12 relapses per year at baseline to 0.12 relapses per year during Year 1 and remained below 0.15 relapses per year up to Year 5.

Conclusion
The results of this first long-term study evaluating the effect of natalizumab on MRI activity and clinical outcomes in Japanese patients with RRMS suggest that natalizumab markedly reduced disease activity and maintained effectiveness over several years.
Automated breast volume scanner based Radiomics for non-invasively prediction of lymphovascular invasion status in breast cancer
Authors: Li Yue , Wu Xiaomin , Yan Yueqiong , Zhou Ping 
Published: August 2023

Abstract
Purpose
Lymphovascular invasion (LVI) indicates resistance to preoperative adjuvant chemotherapy and a poor prognosis and can only be diagnosed by postoperative pathological examinations in breast cancer. Thus, a technique for preoperative diagnosis of LVI is urgently needed. We aim to explore the ability of an automated breast volume scanner (ABVS)-based radiomics model to noninvasively predict the LVI status in breast cancer.

Methods
We conducted a retrospective analysis of data from 335 patients diagnosed with T1-3 breast cancer between October 2019 and September 2022. The patients were divided into training cohort and validation cohort with a ratio of 7:3. For each patient, 5901 radiomics features were extracted from ABVS images. Feature selection was performed using LASSO method. We created machine learning models for different feature sets with support vector machine algorithm to predict LVI. And significant clinicopathologic factors were identified by univariate and multivariate logistic regression to combine with three radiomics signatures as to develop a fusion model.

Results
The three SVM-based prediction models, demonstrated relatively high efficacy in identifying LVI of breast cancer, with AUCs of 79.00%, 80.00% and 79.40% and an accuracy of 71.00%, 80.00% and 75.00% in the validation cohort for AP, SP and CP plane image. The fusion model achieved the highest AUC of 87.90% and an accuracy of 85.00% in the validation cohort.

Conclusions
The combination of radiomics features from ABVS images and an SVM prediction model showed promising performance for preoperative noninvasive prediction of LVI in breast cancer.
Predictor factors affecting emotional and behavioral problems in school-aged (6–12 years) children during the COVID-19 pandemic: a cross-sectional study
Authors: Mahmoodi Zohreh , Rostami Mahnoosh , Bahrami Giti , Rasouli Fatemeh , Ghavidel Nooshin 
Published: August 2023

Abstract
Objectives
The prolonged outbreak of COVID-19 has caused psychological problems in the community, especially in children. Given that limited studies have been conducted on this vulnerable group in Iran, we conducted this study to determine the predictor factors affecting emotional and behavioral problems in school-aged (6–12 years) children during the COVID-19 pandemic.

Methods
We conducted a cross-sectional study on 322 mothers of elementary school-aged children (6–12 years) from April 21 to June 21, 2021, in Karaj, Alborz, Iran. Sociodemographic checklist, socioeconomic status scale (SES), Depression, Anxiety, and Stress Scale (DASS-21), Corona Disease Anxiety Scale (CDAS), and the Rutter Children's Behavior Questionnaire (RCBQ) were used to evaluate the children's behavioral symptoms, the mental health of their mothers, and sociodemographic factors.

Results
In total, 17.7% of children (male = 27.0%, female = 11.7%) had behavioral problems. Results showed income (p-value = 0.007, 95%CI (-3.85- -0.607)), and physical activity of the child (p-value = 0.026, 95%CI (-1.03- -0.067)), were indirectly associated with children's behavioral symptoms. Having underlying disease (p-value = 0.00, 95%CI (1.712–5.949)), breastfeeding (p-value = 0.027, 95%CI (0.335–5.61)), corona-related anxiety (p-value = 0.00, 95%CI (0.158–0.318)), and DASS score (p-value = 0.00, 95%CI (0.149–0.334)) in the mothers, as well as male gender (p-value = 0.003, 95%CI (0.724–3.471)) were directly associated with children's behavioral symptoms. The most factors involved in the behavioral symptom score of children were corona-related anxiety (β = .298), DASS (β = 0.273), underlying disease of mothers (β = 0.163), income (β = -0.154), child's gender (β = 0.142) and physical activity (β = -0.101), and breastfeeding (β = 0.099) respectively.

Conclusion
Study findings showed that some factors affect the emotional and behavioral problems of school-aged (6–12 years) children during the COVID-19 pandemic. These data may help future researchers and policymakers with early intervention.
Body mass index and sex differences for mortality in hospitalized COVID-19 patients: a path analysis using a brazilian national database
Authors: dos Reis Erika Cardoso , de Freitas Monteiro Elma Lúcia , Meneguci Joilson , Rodrigues Phillipe , Palma Alexandre , Virtuoso Junior Jair Sindra , Passos Sonia Regina Lambert , Borges dos Santos Maria Angelica 
Published: August 2023

AbstractPrevious studies have shown that associations between obesity and other comorbidities favor worse outcomes in COVID-19. However, it is not clear how these factors interrelate and whether effects on men and women differ. We conducted an observational, cross-sectional study using a national COVID-19 inpatient database. We studied differences in direct and indirect effects of obesity and comorbidities according to sex and body mass index (BMI) categories in hospitalized COVID-19 patients in Brazil using path analysis models and logistic regression. For men, path analysis showed a direct association between BMI and death and a negative correlation of death and chronic cardiovascular disease (CCD). For women, the association of BMI and death was indirect, mediated by admission to the ICU and comorbidities and association with CCD was non-significant. In the logistic regression analyses, there was a positive association between death and BMI, age, diabetes mellitus, kidney and lung diseases and ICU admission. We highlight the need to consider the distinct impact of obesity and sex on COVID-19, of monitoring of BMI and of the design for specific male-targeted approaches to manage obesity.
Vitamin D in adolescent idiopathic scoliosis: a meta-analysis
Authors: Kim Dong Suk , Lee Jung Sub 
Published: August 2023

Abstract
Objective
The aim of this study was to compare serum vitamin D levels in girls with adolescent idiopathic scoliosis (AIS) and controls using meta-analysis methods. We searched Medline (via PubMed), Cochrane, Scopus, and Embase databases for studies evaluating outcomes in AIS, including patient age, body mass index, bone mineral density (BMD), and serum levels of parathyroid hormone (PTH), calcium, and phosphate, published between January 2000 and June 2020. We searched for studies that were limited to humans only. The inclusion criteria were a scoliosis study that measured vitamin D levels. We excluded duplicate publications such as review articles, case reports, and letters without original data. Two authors extracted data independently and resolved any discrepancies by consensus.

Results
Eight comparative studies were identified. Demographic characteristics, bone density, serum levels of vitamin D, parathyroid hormone, and phosphate levels were not significantly different between AIS group and controls, except for serum calcium levels. The serum calcium levels were lower in AIS group than in the controls.

Conclusions
This review includes eight comparative studies reporting serum vitamin D and/or parathyroid hormone levels in AIS. Due to heterogeneity, a limited number of meta-analyses have shown a weak correlation between serum vitamin D levels and the incidence of AIS. Larger, multicenter studies are therefore needed to validate the results.
Determinants of precancerous cervical lesion among HIV infected women on ART in Woldia comprehensive specialized hospital NorthEast Ethiopia
Authors: Dessie Tazeb Melkie , Kassaw Abebe Tarekegn , Alen Gedefaw Diress 
Published: August 2023

Abstract
Background
Precancerous cervical lesion is a priority public health problem that jeopardizes the life of enormous women. previous studies in Ethiopia were more focused on knowledge, attitude, and practices of Cervical cancer screening. studies on the risk factors of pre-cancerous cervical lesions among the risk population (HIV infected) relative to the general population were limited. This study aimed to identify the determinants of precancerous cervical lesions among HIV Infected Women in Woldia Comprehensive Specialized Hospital in Northeast Ethiopia, 2022.

Methods
Hospital-based unmatched case-control study was conducted in Woldia Comprehensive Specialized Hospital among HIV-infected women from June to August 2022. Data were collected from 104 cases and 208 controls using an interviewer-administered questionnaire and clinical data from the patient chart using Electronic Medical Record _ Anti-Retroviral Therapy Smart care database checklist. The binary logistic regression model was used to identify the determinants of the precancerous cervical lesion. An odds ratio with a 95% Confidence interval was used to measure the association and p-value < 0.05 were considered significant.

Results
Women who have two or more lifetime sexual partners (AOR = 3.21,95% CI: 1.71–6.04), history of sexually transmitted infection (AOR = 4.97, 95% CI: 2.78–8.78), early age at first sexual intercourse (< 18 years) (AOR = 4.35,95% CI: 2.48–7.67) and baseline CD4 count < 200 cells/mm3 (AOR = 1.89, 95% CI: 1–3.57) had a higher odd of developing a precancerous cervical lesion.

Conclusion
This study confirms that having a history of sexually transmitted infection, two or more lifetime sexual Partners, the initiation of sexual intercourse before the age of 18 years, and Baseline CD4 count < 200 cells/mm3 were determinants for precancerous cervical lesions. So it should be focused on prevention through early detection and treatment of sexually transmitted infections.
Efficacy and safety of self-administered acupressure on symptoms, quality of life and nasal mucosal function in patients with perennial allergic rhinitis: study protocol for a randomized controlled exploratory trial
Authors: Li Kai , Huang Wei , Li Rui-Jian , Feng Xiao-Cong , Chen Zong , Tan Shu-Yi , Xie Mei-Feng , Huang Jian-Peng , Liu Ru-Jia , Li Yun-Ying 
Published: August 2023

Abstract
Introduction
Allergic rhinitis is a global health problem that can potentially be managed through acupressure. Our clinical observations have identified Allergic Rhinitis Acupressure Therapeutic (ARAT) as a novel acupressure treatment acting on specific acupoints, which may enhance the effectiveness of acupressure. Therefore, we propose a three-arm randomized controlled trial will be conducted to investigate the efficacy and safety of ARAT for perennial allergic rhinitis (PAR).

Methods/design
In this trial, eligible 111 participants diagnosed with PAR will be randomly assigned to one of three groups: the ARAT group, the non-specific acupoints group, or the blank control group. The primary outcome will be the change in the total nasal symptom score, and the secondary outcomes will include: 1) changes in the scores of the standard version of Rhinoconjunctivitis Quality of Life Questionnaire (RQLQs); 2) acoustic rhinometry and anterior rhinomanometry; 3) changes in the scores of relief medication usage; 4) incidence of adverse events. Additionally, we will measure and compare the changes in cytokine levels (IL-5, IL-13, IFN-γ, and TSLP) in nasal secretions.
The RQLQs and primary outcomes will be assessed at the beginning, middle, and end stages of the treatment period, with monthly follow-ups conducted over a total of three months. The secondary outcomes and biomarkers in nasal secretions will be measured at the beginning and end of the treatment period. Any adverse events or need for rescue medication will be carefully noted and recorded.

Discussion
This study may produce a new acupressure treatment prescription that is easy to learn, more targeted, and adaptable. This trial represents the first clinical investigation comparing ARAT treatment for PAR with the non-specific acupoints group and blank control group. Our data is expected to provide evidence demonstrating the safety and efficacy of ARAT for PAR patients, while also exploring the functional mechanism underlying ARAT treatment, moreover, the results offer valuable insights for healthcare professionals in managing PAR symptoms.

Trial registration
Chinese Clinical Trial Registry, ChiCTR2300072292. Registered on June 08, 2023.
ApoE gene polymorphisms and metals and their interactions with cognitive function
Authors: Ye Zeyan , Tan Dechan , Luo Tingyu , Gou Ruoyu , Cai Jianshen , Wei Yanfei , He Kailian , Xiao Song , Mai Tingyu , Tang Xu , Liu Qiumei , Mo Xiaoting , Lin Yinxia , Huang Shenxiang , Li You , Qin Jian , Zhang Zhiyong 
Published: August 2023

Abstract
Objective
To analyze the relationship between plasma metal elements, ApoE gene polymorphisms and the interaction between the two and impaired cognitive function in elderly population.

Method
A stratified sample was drawn according to the age of the study population, and 911 subjects were included. Baseline information and health indicators were obtained, and cognitive function status was assessed by health examination, a general questionnaire and Mini-Mental Status Examination. Plasma metal elements were measured, and SNP typing was performed. Binary logistic regression was used to analyze the factors influencing cognitive function status and the association between the SNP genetic pattern of the ApoE gene and cognitive function.

Results
The differences in gene frequencies and genotype frequencies of the ApoE rs7412 and rs7259620 genotype frequencies were statistically different between the cognitive impairment group and the control group (P < 0.05). statistically differences were found for the codominant model in rs7412-TT compared with the CC genotype (OR = 3.112 (1.159–8.359), P = 0.024) and rs7259620-AA compared with the GG genotype (OR = 1.588 (1.007–2.504), P = 0.047). Statistically differences were found in the recessive models rs7412-TT compared with (CC + CT) (OR = 2.979 (1.112–7.978), P = 0.030), rs7259620-AA compared with (GG + GA), and rs405509-GG compared with (TT + TG) (OR = 1.548(1.022–2.344), P = 0.039) all of which increased the risk of developing cognitive impairment. The differences in plasma Fe, Cu, and Rb concentrations between the case and control groups were significant (P < 0.05). The regression results showed that the plasma Cd concentrations in the Q1 range was a protective factor for cognitive function compared with Q4 (0.510 (0.291–0.892), P = 0.018). Furthermore, there was a multiplicative interaction between the codominant and recessive models for the Q2 concentrations of Cd and the rs7259620 loci, and the difference was significant, indicating increased risk of developing cognitive impairment (codominant model OR = 3.577 (1.496–8.555), P = 0.004, recessive model OR = 3.505 (1.479–8.307), P = 0.004). There was also a multiplicative interaction between Cd and the recessive model at the rs405509 loci, and the difference was significant, indicating increased risk of developing cognitive impairment (OR = 3.169 (1.400-7.175), P = 0.006).

Conclusion
The ApoE rs7412, rs7259620 and rs405509 loci were associated with cognitive impairment in the elderly population, and there was an interaction between plasma metalloid Cd and the rs7259620 and rs405509 loci that increased the risk of cognitive impairment in the elderly population.
Human milk extracellular vesicles enhance muscle growth and physical performance of immature mice associating with Akt/mTOR/p70s6k signaling pathway
Authors: Meng Zitong , Zhou Dong , Lv Dan , Gan Quan , Liao Yuxiao , Peng Zhao , Zhou Xiaolei , Xu Shiyin , Chi Penglong , Wang Zhipeng , Nüssler Andreas K. , Yang Xuefeng , Liu Liegang , Deng Dongrui , Yang Wei 
Published: August 2023

AbstractExtracellular vesicles (EVs) play an important role in human and bovine milk composition. According to excellent published studies, it also exerts various functions in the gut, bone, or immune system. However, the effects of milk-derived EVs on skeletal muscle growth and performance have yet to be fully explored. Firstly, the current study examined the amino acids profile in human milk EVs (HME) and bovine milk EVs (BME) using targeted metabolomics. Secondly, HME and BME were injected in the quadriceps of mice for four weeks (1 time/3 days). Then, related muscle performance, muscle growth markers/pathways, and amino acids profile were detected or measured by grip strength analysis, rotarod performance testing, Jenner-Giemsa/H&E staining, Western blotting, and targeted metabolomics, respectively. Finally, HME and BME were co-cultured with C2C12 cells to detect the above-related indexes and further testify relative phenomena. Our findings mainly demonstrated that HME and BME significantly increase the diameter of C2C12 myotubes. HME treatment demonstrates higher exercise performance and muscle fiber densities than BME treatment. Besides, after KEGG and correlation analyses with biological function after HME and BME treatment, results showed L-Ornithine acts as a “notable marker” after HME treatment to affect mouse skeletal muscle growth or functions. Otherwise, L-Ornithine also significantly positively correlates with the activation of the AKT/mTOR pathway and myogenic regulatory factors (MRFs) and can also be observed in muscle and C2C12 cells after HME treatment. Overall, our study not only provides a novel result for the amino acid composition of HME and BME, but the current study also indicates the advantage of human milk on skeletal muscle growth and performance.
Police seizure of drugs without arrest among people who use drugs in Vancouver, Canada, before provincial ‘decriminalization’ of simple possession: a cohort study
Authors: Hayashi Kanna , Singh Kelsall Tyson , Shane Caitlin , Cui Zishan ,   Vancouver Area Network of Drug Users, Milloy M.-J. , DeBeck Kora , Kerr Thomas 
Published: August 2023

Abstract
Background
Several jurisdictions in Canada have recently considered decriminalizing possession of illicit drugs for personal use (henceforth, simple possession) as part of their responses to the ongoing drug toxicity/overdose crisis. In this context, we sought to examine an early implementation case of a de facto depenalization policy of simple possession offences in Vancouver, Canada, that was enacted in 2006. Specifically, we characterized experiences of people who use drugs (PWUD) whose drugs were discretionally seized by police without arrest.

Methods
Data were derived from three prospective cohorts of community-recruited PWUD in Vancouver over 16 months in 2019–2021. We conducted multivariable generalized estimating equations analyses to determine the prevalence of and factors associated with drug seizure. Sub-analyses used data collected in 2009–2012 and examined the trends over time.

Results
Among 995 participants who were interviewed in 2019–2021, 63 (6.3%) had their drugs seized by police at least once in the past 6 months. In multivariable analyses, factors significantly associated with drug seizure included: homelessness (adjusted odds ratio [AOR]: 1.98; 95% confidence interval [CI] 1.09–3.61), working in the unregulated drug market (AOR: 4.93; 95% CI 2.87–8.49), and naloxone administration (AOR: 2.15; 95% CI 1.23–3.76). In 2009–2012, 67.8% reported having obtained new drugs immediately after having their drugs seized by police. Odds of drug seizure were not significantly different between the two time periods (2019–2021 vs. 2009–2012) (AOR: 0.93; 95% CI: 0.64–1.35).

Conclusions
Despite the depenalization policy, the Vancouver Police Department has continued to seize illicit drugs from PWUD, even in cases where no arrest occurred. This policing practice may create health and safety risks for PWUD as it forces PWUD to increase the engagement with the unregulated illicit drug market. Our findings support calls for abolishing this often-undocumented discretionary policing practice that may exacerbate ongoing health inequities and interfere with peer-based overdose prevention efforts.
Successes and challenges of China’s health care reform: a four-decade perspective spanning 1985—2023
Authors: Jakovljevic Mihajlo , Chang Hanyu , Pan Jay , Guo Chao , Hui Jin , Hu Hao , Grujic Danko , Li Zhong , Shi Lizheng 
Published: August 2023

AbstractChinese health system remains the crucial one for understanding the wider healthcare landscape across the Global South and in particular the leading Emerging Markets. Purpose of our observation was to understand the inner dynamics of mainland Chinese health reforms adopting a lengthy time horizon. We have analysed the public reports and seminal evidence on Chinese of multiple waves of national health reforms taking place since 1980s in terms of medical care and pharmaceuticals provision and financing. Chinese international trade with ASEAN nations and wider South-East Asia is accelerating its growth after the recovery of trade routes. In terms of health sector this means that global demand and supply of medical goods, services and pharmaceuticals remains largely driven by Chinese domestic developments. Furthermore, Chinese domestic manufacturing and sales of decent quality medical devices and services have grown exponentially. Some temporary pitfalls and increasing in rural–urban inequalities in equity of access and affordability of medical care and pharmaceuticals did take place. Despite these difficulties to generate a balanced development strategy for the largest global market, this is a clear path upwards. Further upcoming improvements expanding health insurance coverage are in strong demand for certain layers of the society. Domestic bottleneck weaknesses yet remain manufacturing, import and market penetration of cutting-edge pharmaceuticals such as monoclonal antibodies and targeted oncology agents. Yet some of these obstacles are likely to be overcome in foreseeable future with the adoption of responsible strategies by governmental agencies in health care arena.