bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-COVID dyspnea: prevalence, predictors, and outcomes in a longitudinal, prospective cohort
Authors: Grewal Japnam S. , Carlsten Christopher , Johnston James C. , Shah Aditi S. , Wong Alyson W. , Ryerson Christopher J. 
Published: March 2023

Abstract
Background
The pathophysiology, evolution, and associated outcomes of post-COVID dyspnea remain unknown. The aim of this study was to determine the prevalence, severity, and predictors of dyspnea 12 months following hospitalization for COVID-19, and to describe the respiratory, cardiac, and patient-reported outcomes in patients with post-COVID dyspnea.

Methods
We enrolled a prospective cohort of all adult patients admitted to 2 academic hospitals in Vancouver, Canada with PCR-confirmed SARS-CoV-2 during the first wave of COVID between March and June 2020. Dyspnea was measured 3, 6, and 12 months after initial symptom onset using the University of California San Diego Shortness of Breath Questionnaire.

Results
A total of 76 patients were included. Clinically meaningful dyspnea (baseline score > 10 points) was present in 49% of patients at 3 months and 46% at 12 months following COVID-19. Between 3 and 12 months post-COVID-19, 24% patients had a clinically meaningful worsening in their dyspnea, 49% had no meaningful change, and 28% had a clinically meaningful improvement in their dyspnea. There was worse sleep, mood, quality of life, and frailty in patients with clinically meaningful dyspnea at 12 months post-COVID infection compared to patients without dyspnea. There was no difference in PFT findings, troponin, or BNP comparing patients with and without clinically meaningful dyspnea at 12 months. Severity of dyspnea and depressive symptoms at 3 months predicted severity of dyspnea at 12 months.

Conclusions
Post-COVID dyspnea is common, persistent, and negatively impacts quality of life. Mood abnormalities may play a causative role in post-COVID dyspnea in addition to potential cardiorespiratory abnormalities. Dyspnea and depression at initial follow-up predict longer-term post-COVID dyspnea, emphasizing that standardized dyspnea and mood assessment following COVID-19 may identify patients at high risk of post-COVID dyspnea and facilitating early and effective management.
Prevalence and factors associated with hypothyroidism in children with sickle cell anemia aged 6 months − 17 years attending the Sickle Cell Clinic, Mulago Hospital, Uganda; a cross-sectional study
Authors: Kaudha Gloria , Piloya Thereza , Musiime Victor , Kuteesa Mary Goretty , Namugerwa Shamimu , Owomugisha Gloria , Wachepa Stella Alinafe , Lubwama Sanyu Kirabo , Kiguli Sarah , Tumwine James K 
Published: March 2023

AbstractPurposeHypothyroidism has been reported at a prevalence of 6% in children and adolescents with Sickle cell anemia. In this study, we determined the prevalence and factors associated with hypothyroidism among children with Sickle cell anemia attending the Sickle Cell Clinic, in Mulago hospital, Uganda.MethodsA cross-sectional study was conducted among children aged 6 months − 17 years with a confirmed diagnosis of Sickle Cell Anemia, with no prior diagnosis of hypothyroidism and in steady state attending the Sickle Cell Clinic in Mulago hospital. Data was collected using a structured questionnaire and a blood sample was used to measure thyroid stimulating hormone and free thyroxine.ResultsOf the 332 children enrolled, sixty (18.1%) participants had sub-clinical hypothyroidism (95% CI: 14.3 — 22.6). Factors associated with hypothyroidism included constipation [adjusted odds ratio: 3.1, 95% CI:1.0 — 9.0, p = 0.043] and male sex [adjusted odds ratio:2.0, 95% CI:1.1— 3.5, p = 0.025].ConclusionApproximately 1 in 5 children (18.1%) had sub-clinical hypothyroidism. Males and children who presented with constipation were more likely to have sub-clinical hypothyroidism.
The impact on patients of objections by institutions to assisted dying: a qualitative study of family caregivers’ perceptions
Authors: White Ben P. , Jeanneret Ruthie , Close Eliana , Willmott Lindy 
Published: March 2023

Abstract
Background
Voluntary assisted dying became lawful in Victoria, the first Australian state to permit this practice, in 2019 via the Voluntary Assisted Dying Act 2017 (Vic). While conscientious objection by individual health professionals is protected by the Victorian legislation, objections by institutions are governed by policy. No research has been conducted in Victoria, and very little research conducted internationally, on how institutional objection is experienced by patients seeking assisted dying.

Methods
28 semi-structured interviews were conducted with 32 family caregivers and one patient about the experience of 28 patients who sought assisted dying. Participants were interviewed during August-November 2021. Data from the 17 interviews (all with family caregivers) which reported institutional objection were analysed thematically.

Results
Participants reported institutional objection affecting eligibility assessments, medication access, and taking the medication or having it administered. Institutional objection occurred across health settings and was sometimes communicated obliquely. These objections resulted in delays, transfers, and choices between progressing an assisted dying application and receiving palliative or other care. Participants also reported objections causing adverse emotional experiences and distrust of objecting institutions. Six mediating influences on institutional objections were identified: staff views within objecting institutions; support of external medical practitioners and pharmacists providing assisted dying services; nature of a patient’s illness; progression or state of a patient’s illness; patient’s geographical location; and the capability and assertiveness of a patient and/or caregiver.

Conclusions
Institutional objection to assisted dying is much-debated yet empirically understudied. This research found that in Victoria, objections were regularly reported by participants and adversely affected access to assisted dying and the wider end-of-life experience for patients and caregivers. This barrier arises in an assisted dying system that is already procedurally challenging, particularly given the limited window patients have to apply. Better regulation may be needed as Victoria’s existing policy approach appears to preference institutional positions over patient’s choice given existing power dynamics.
Occupational quartz and particle exposure affect systemic levels of inflammatory markers related to inflammasome activation and cardiovascular disease
Authors: Hedbrant Alexander , Engström Christopher , Andersson Lena , Eklund Daniel , Westberg Håkan , Persson Alexander , Särndahl Eva 
Published: March 2023

Abstract
Background
The inflammatory responses are central components of diseases associated with particulate matter (PM) exposure, including systemic diseases such as cardiovascular diseases (CVDs). The aim of this study was to determine if exposure to PM, including respirable dust or quartz in the iron foundry environment mediates systemic inflammatory responses, focusing on the NLRP3 inflammasome and novel or established inflammatory markers of CVDs.

Methods
The exposure to PM, including respirable dust, metals and quartz were determined in 40 foundry workers at two separate occasions per worker. In addition, blood samples were collected both pre-shift and post-shift and quantified for inflammatory markers. The respirable dust and quartz exposures were correlated to levels of inflammatory markers in blood using Pearson, Kendall τ and mixed model statistics. Analyzed inflammatory markers included: 1) general markers of inflammation, including interleukins, chemokines, acute phase proteins, and white blood cell counts, 2) novel or established inflammatory markers of CVD, such as growth/differentiation factor-15 (GDF-15), CD40 ligand, soluble suppressor of tumorigenesis 2 (sST2), intercellular/vascular adhesion molecule-1 (ICAM-1, VCAM-1), and myeloperoxidase (MPO), and 3) NLRP3 inflammasome-related markers, including interleukin (IL)-1β, IL-18, IL-1 receptor antagonist (IL-1Ra), and caspase-1 activity.

Results
The average respirator adjusted exposure level to respirable dust and quartz for the 40 foundry workers included in the study was 0.65 and 0.020 mg/m3, respectively. Respirable quartz exposure correlated with several NLRP3 inflammasome-related markers, including plasma levels of IL-1β and IL-18, and several caspase-1 activity measures in monocytes, demonstrating a reverse relationship. Respirable dust exposure mainly correlated with non-inflammasome related markers like CXCL8 and sST2.

Conclusions
The finding that NLRP3 inflammasome-related markers correlated with PM and quartz exposure suggest that this potent inflammatory cellular mechanism indeed is affected even at current exposure levels in Swedish iron foundries. The results highlight concerns regarding the safety of current exposure limits to respirable dust and quartz, and encourage continuous efforts to reduce exposure in dust and quartz exposed industries.
Homeobox D9 drives the malignant phenotypes and enhances the Programmed death ligand-1 expression in non-small cell lung cancer cells via binding to Angiopoietin-2 promoter
Authors: He Jiabei , Jiang Mengjia , Liu Jing , Zhu Ruiping , Lv Weipeng , Lian Ruiqing , Yang Yang , Wang Ruoyu 
Published: March 2023

AbstractNon-small cell lung cancer (NSCLC) is the leading cause of cancer-related death worldwide. Homeobox D9 (HOXD9), a member of the HOX family of transcription factors, plays a driver role in development of multiple cancers. Angiopoietin-2 (ANGPT2) is reportedly to facilitate angiogenesis, growth and metastasis in various cancers, including lung cancer. In addition, blocking ANGPT2 can effectively improve cancer immunotherapy via downregulation of Programmed death ligand-1 (PD-L1). The purpose of this study was to elucidate the role of HOXD9 in NSCLC and whether ANGPT2 is required for HOXD9-mediated malignant behaviors of NSCLC cells. By performing a series of in vitro functional experiments, we found that knockdown of HOXD9 induced proliferative inhibition, cell cycle G1 arrest, apoptosis, migratory suppression and invasive repression of NSCLC cells. Reduced PD-L1 expression in NSCLC cells was observed after HOXD9 silencing. Besides, HOXD9 deletion decreased the expression of ANGPT2 in NSCLC cells. In line with this, HOXD9 overexpression led to opposite alteration in NSCLC cells. Mechanistically, ANGPT2 was transcriptionally activated by HOXD9. Forced expression of ANGPT2 significantly regulated HOXD9-mediated malignant phenotypes, and enhanced PD-L1 expression of NSCLC cells. Our results expressing HOXD9 may function as an oncogene in NSCLC via trans-activation of ANGPT2.
Outcomes of total hip arthroplasty with a standard prosthesis for the affected hip in patients with poliomyelitis sequelae: a mid-term retrospective follow-up study
Authors: Shi Lihan , Che Guangwei , Huang Yong , Yi Min , Kang Pengde 
Published: March 2023

Abstract
Introduction
Total hip arthroplasty for poliomyelitis sequelae could be a technical challenge due to the higher risk for prosthetic dislocation and degenerative changes in the affected limbs. This study aimed to analyse the mid-term outcomes of primary total hip arthroplasty on the affected hip with standard prosthesis.

Materials and Methods
From January 2008 to January 2018, 32 patients with poliomyelitis sequelae underwent total hip arthroplasty on the affected hip with standard prosthesis. Clinical and radiographical outcomes, complications, and prosthesis survival rates were evaluated.

Results
After a mean follow-up of 7.9 (4.4–13.1) years, the Harris Hip Score, University of California Los Angeles activity level rating, and 12-item Short Form Health Survey Questionnaire scale score significantly improved. The abduction and flexion motions of the hip joint improved dramatically, and the visual analogue scale pain score decreased significantly. The leg length discrepancy was effectively corrected. During the follow-up, one patient experienced prosthetic dislocation, one underwent revision surgery due to acetabular component loosening, two had osteolysis, four had heterotopic ossification, two experienced transient sciatic nerve palsy, and one had intermuscular vein thrombosis. The prosthesis survival rate was 96.9% at 5 years postoperatively. No periprosthetic infection occurred.

Conclusion
Total hip arthroplasty with standard prosthesis could be an effective treatment for hip arthropathy on the affected hip of patients with poliomyelitis sequelae, resulting in good clinical outcomes and few complications. Constrained liner and dual mobility articulation are not recommended unless the hip muscle strength of the abductor is < III.
Re-analysis of ventilator-free days (VFD) in acute respiratory distress syndrome (ARDS) studies
Authors: Verghis Rejina Mariam , McDowell Cliona , Blackwood Bronagh , Lee Bohee , McAuley Daniel F. , Clarke Mike 
Published: March 2023

Abstract
Background

Over recent decades, improvements in healthcare have reduced mortality and morbidity rates in many conditions. This has resulted, in part, from the identification of effective interventions in randomised trials, and in conducting such trials, a composite outcome measure (COM) with multiple components will increase event rates, which allows study completion with a smaller sample size. In critical care research, the COM “ventilator-free days” (VFD) combines mortality and duration of mechanical ventilation (MV) into a single continuous measure, which can be analysed in a variety of ways. This study investigates the usefulness of Poisson and two-part Poisson models compared to t-distribution for the analysis of VFD.

Methods
Data from four studies (ALbuterol for the Treatment of ALI (ALTA), Early vs. Delayed Enteral Nutrition (EDEN), Hydroxymethylglutaryl-CoA reductase inhibition with simvastatin in Acute Lung Injury (ALI) to reduce pulmonary dysfunction (HARP-2), Statins for Acutely Injured Lungs from Sepsis (SAILS)) were used for analysis, with the VFD results summarised using mean, standard deviation (SD), median, interquartile range (25th and 75th percentiles) and minimum and maximum values. The statistical analyses that are compared used the t-test, Poisson, zero-inflated Poisson (ZIP) and two-part Logit-Poisson hurdle models. The analyses were exploratory in nature, and the significance level for differences in the estimates was set to 0.05.

Results
In HARP-2, which compared simvastatin and placebo, the mean (SD) VFD for all patients was 12.0 (10.2), but this mean value did not represent the data distribution as it falls in a zone between two peaks, with the lowest frequency of occurrence. The mean (SD) VFD after excluding patients who died before day 28 and patients who did not achieve unassisted breathing were 15.9 (8.7) and 18.2 (6.6), respectively. The mean difference (95% CI) between the two groups was 1.1 (95% CI: 0.7 to 2.8; p = 0.20) based on an independent t-test. However, when the two-part hurdle model was used, the simvastatin arm had a significantly higher number of non-zero values compared to the placebo group, which indicated that more patients were alive and free of mechanical ventilation in the simvastatin group. Similarly, in ALTA, this model found that significantly more patients were alive and free of MV in the control group. In EDEN and SAILS, there was no significant difference between the control and intervention groups.

Conclusion
Our analyses show that the t-test and Poisson model are not appropriate for bi-modal data (such as VFD) where there is a large number of zero events. The two-part hurdle model was the most promising approach. There is a need for future research to investigate other analysis techniques, such as two-part quantile regression and to determine the impact on sample size requirements for comparative effectiveness trials.
SMPD1 expression profile and mutation landscape help decipher genotype–phenotype association and precision diagnosis for acid sphingomyelinase deficiency
Authors: Wang Ruisong , Qin Ziyi , Huang Long , Luo Huiling , Peng Han , Zhou Xinyu , Zhao Zhixiang , Liu Mingyao , Yang Pinhong , Shi Tieliu 
Published: March 2023

Abstract
Background
Acid sphingomyelinase deficiency (ASMD) disorder, also known as Niemann–Pick disease (NPD) is a rare genetic disease caused by mutations in SMPD1 gene, which encodes sphingomyelin phosphodiesterase (ASM). Except for liver and spleen enlargement and lung disease, two subtypes (Type A and B) of NDP have different onset times, survival times, ASM activities, and neurological abnormalities. To comprehensively explore NPD’s genotype-phenotype association and pathophysiological characteristics, we collected 144 NPD cases with strict quality control through literature mining.

Results
The difference in ASM activity can differentiate NPD type A from other subtypes, with the ratio of ASM activity to the reference values being lower in type A (threshold 0.045 (4.45%)). Severe variations, such as deletion and insertion, can cause complete loss of ASM function, leading to type A, whereas relatively mild missense mutations generally result in type B. Among reported mutations, the p.Arg3AlafsX76 mutation is highly prevalent in the Chinese population, and the p.R608del mutation is common in Mediterranean countries. The expression profiles of SMPD1 from GTEx and single-cell RNA sequencing data of multiple fetal tissues showed that high expressions of SMPD1 can be observed in the liver, spleen, and brain tissues of adults and hepatoblasts, hematopoietic stem cells, STC2_TLX1-positive cells, mesothelial cells of the spleen, vascular endothelial cells of the cerebellum and the cerebrum of fetuses, indicating that SMPD1 dysfunction is highly likely to have a significant effect on the function of those cell types during development and the clinicians need pay attention to these organs or tissues as well during diagnosis. In addition, we also predicted 21 new pathogenic mutations in the SMPD1 gene that potentially cause the NPD, signifying that more rare cases will be detected with those mutations in SMPD1. Finally, we also analysed the function of the NPD type A cells following the extracellular milieu.

Conclusions
Our study is the first to elucidate the effects of SMPD1 mutation on cell types and at the tissue level, which provides new insights into the genotype-phenotype association and can help in the precise diagnosis of NPD.
A retrospective epidemiological study of the World Health Organization (WHO)-classified primary brain and other Central Nervous System (CNS) tumors from a tertiary health care center in Northeast India
Authors: Barua Navanil , Borah Nabajyoti , Haque Inamul , Borah Adityendra Lal , Saikia Birinchi Kumar , Barman Ananya , Ahmed Shabnam Akhtar 
Published: March 2023

Abstract
Background
Brain and other central nervous systems (CNS) tumors are a heterogeneous group of neoplasms that are prevalent in all age groups and gender. The study aimed to investigate the pattern of distribution of World Health Organization (WHO) classified primary brain and other CNS tumors among different age groups and gender at a tertiary care center in Northeast India. This is the first study of CNS tumors from this region of the country. The data obtained can be useful for correct diagnosis, timely treatment, and management of CNS tumors in this area. It can also provide relevant information concerning research and funding for this disease. Data collection was done retrospectively from January 1996 to March 2022. Distribution frequency as per age, gender, histopathology type, and tumor location was estimated. Data analysis was performed using the SPSS software.

Results
A total of 1441 primary brain and other CNS tumors were examined in the study. There were 232 pediatric cases (16.1%) and 1209 adult cases (83.9%). The ratio of males to females was 1.4. The majority of the cases in the overall cohort were meningiomas (n = 346; 24%). Among the pediatric cohort, the maximum occurrence of gliomas, glioneuronal, and neuronal tumors (n = 68; 29.3%) was seen while meningiomas (n = 336; 27.8%) showed the highest prevalence in the adult cohort. There were 248 other distinct cases of CNS (17.2%) of which 62 (26.7%) were identified within the pediatric cohort and the remaining 186 (15.4%) were detected among the adult population. Most of the tumor sites was supratentorial areas (n = 759; 52.7%) with the next being spinal cord (n = 258; 18%).

Conclusion
This is the first study from Northeast India that highlights the prevalence of WHO-classified CNS tumors. With newer and advanced health care and diagnostic facilities, there is an increased incidence of CNS tumors in developing countries. Our study may help in understanding the epidemiological aspects and highlight the need for research, funding, and maintenance of a hospital-based tumor registry for this particular ailment.
Surgical and laser treatment for juvenile psammomatoid ossifying fibroma in an oncological patient: a rare case report
Authors: Abreu Juliano Pacheco , Tholt Beatriz , Molena Kelly Fernanda , Pretel Hermes , Veiga Eugenia Velludo 
Published: March 2023

Abstract
Background
Juvenile psammomatoid ossifying fibroma is a rare variant of conventional ossifying fibroma that affects the maxillofacial complex in children and adolescents. It is a benign fibro-osseous neoplasm with aggressive clinical behavior and high recurrence rates, confirming the importance of early diagnosis and intervention to minimize undesirable aesthetic and functional possibilities resulting from surgical management, and added to the use of laser therapy, it can bring a better postoperative prognosis.

Aim
To present the surgical removal of a juvenile psammomatoid ossifying fibroma, with the associated use of low-intensity laser and photodynamic therapy in a oncological patient.

Case presentation
This case describes a senile cancer patient diagnosed with rapidly progressive and painful juvenile ossifying fibroma involving the inter-radicular region of the right maxilla. The treatment was excision with total tumor resection, photodynamic therapy and low-intensity laser follow-up of 48 months.

Conclusions
Juvenile psammomatoid ossifying fibroma is a lesion with a high rate of recurrence and aggressive growth. Thus, early detection and treatment are essential. In this case, the use of photodynamic therapy after surgery and long-term follow-up with low-intensity laser brought a favorable prognosis in an oncology patient.