bluuebunny/crossref_metadata_2025_split huggingface dataset:
Admission Serum Calcium Level and Short-Term Mortality After Acute Ischemic Stroke: A Secondary Analysis Based on a Norwegian Retrospective Cohort
Authors: Lu Yuzhao , Ma Xin , Tazmini Kiarash , Yang Ming , Zhou Xiaobing , Wang Yang 
Published: June 2022

BackgroundDisturbed serum calcium levels are related to the risk of stroke. However, previous studies exploring the correlation between serum calcium and the clinical outcome of ischemic stroke (IS) have shown inconsistent results.ObjectThe study aimed to investigate the relationship between admission serum calcium and 30-day mortality in patients with IS.MethodsA total of 876 IS patients from a Norwegian retrospective cohort were included for secondary analysis. The exposure variable and the primary outcome were albumin-corrected serum calcium (ACSC) at baseline and all-cause mortality within 30 days after the first admission, respectively. Multivariable logistic regression analysis was used to estimate the risk of 30-day mortality according to ACSC levels. Moreover, the potential presence of a non-linear relationship was evaluated using two-piecewise linear regression with a smoothing function and threshold level analysis. The stability of the results was evaluated by unadjusted and adjusted models.ResultsThe result of multiple regression analysis showed that ACSC at baseline was positively associated with the incidence of 30-day mortality after adjusting for the potential confounders (age, gender, serum glucose, hypertension, atrial fibrillation/atrial flutter, renal insufficiency, heart failure, chronic obstructive pulmonary disease, pneumonia, paralysis, and aphasia) (OR = 2.43, 95% CI 1.43–4.12). When ACSC was translated into a categorical variable, the ORs and 95% CIs in the second to the fourth quartile vs. the first quartile were 1.23 (0.56, 2.69), 1.16 (0.51, 2.65), and 2.13 (1.04, 4.38), respectively (P for trend = 0.03). Moreover, the results of two-piecewise linear regression and curve-fitting revealed a linear relationship between ACSC and 30-day mortality.ConclusionACSC is positively associated with 30-day mortality in IS patients, and the relationship between them is linear.
Prevalence and Prognostic Impact of Malnutrition in Critical Patients With Acute Myocardial Infarction: Results From Chinese CIN Cohort and American MIMIC-III Database
Authors: Lu Jin , Huang Zhidong , Wang Junjie , Zhao Xiaoli , Yang Yanfang , Wu Bo , Kang Yu , Xiu Jiaming , Tu Jiabin , Pan Yuxiong , Chen Weihua , Bao Kunming , Chen Liling , Liu Jin , Liu Yong , Chen Shiqun , Fang Yong , Chen Kaihong 
Published: June 2022

BackgroundMalnutrition is associated with poor prognosis in patients with acute myocardial infarction (AMI). However, the prognostic impact of malnutrition in critical patients with AMI has not been well addressed.MethodsWe analyzed two critical AMI cohorts from Cardiorenal ImprovemeNt (CIN) in China and Medical Information Mark for Intensive Care-III (MIMIC-III) in the United States. The primary outcome was all-cause mortality. Cox proportional hazards models were constructed to examine the risk of malnutrition for mortality in critical patients with AMI.ResultsThere were 2,075 critical patients with AMI (mean age, 62.5 ± 12.3 years, 20.00% were female) from the CIN cohort and 887 critical patients with AMI (mean age, 70.1 ± 12.9 years, 37.43% were female) from MIMIC-III included in this study. Based on the Controlling Nutritional Status (CONUT) score, of the Chinese patients with AMI, the prevalence was 47.5, 28.3, and 3.5% for mild, moderate, and severe malnutrition, respectively. The percentage of mild, moderate, and severe malnutrition was 41.60, 30.55, and 7.32% in the MIMIC-III cohort, respectively. Controlling for confounders, worse nutritional state was significantly associated with increased risk for all-cause mortality [an adjusted hazard ratio for mild, moderate, and severe malnutrition, respectively, 1.10 (95% confidence interval (CI): 0.76–1.59), 1.49 (95% CI: 1.02–2.19), and 1.70 (95% CI: 1.00–2.88) in the CIN cohort and 1.41 (95% CI: 0.95–2.09), 1.97 (95% CI: 1.32–2.95), and 2.70 (95% CI: 1.67–4.37) in the MIMIC-III cohort].ConclusionMalnutrition was independently associated with an increased risk of all-cause mortality in critical patients with AMI after full adjustments. Further trials are needed to prospectively evaluate the efficacy of nutritional interventions in critical patients with AMI.
Clinical Incidence and Characteristics of Newly Diagnosed Type 1 Diabetes in Chinese Children and Adolescents: A Nationwide Registry Study of 34 Medical Centers
Authors: Li Guo-Hua , Huang Ke , Dong Guan-Ping , Zhang Jian-Wei , Gong Chun-Xiu , Luo Fei-Hong , Luo Xiao-Ping , Wang Chun-Lin , Zhu Min , Li Pin , Wang Ling , Fu Jun-Fen ,   The T1DM China Study Group for Children Adolescents
Published: June 2022

ObjectiveTo investigate the clinical incidence and characteristics of type 1 diabetes mellitus (T1DM) of children and adolescents at the time of initial diagnosis in China.MethodsData on all pediatric patients with newly diagnosed T1DM were retrospectively collected from 34 medical centers in 25 major cities in China from January 2015 to January 2020. Patients were classified into three age groups: &lt;5 years, 5 to &lt;10 years, and ≥10 years of age. The same patient population was also categorized into diabetic ketoacidosis (DKA) and non-DKA groups based on clinical criteria.ResultsThe mean annual clinical incidence of T1DM was 3.16/100,000 from the years 2015 to 2019. A total of 6,544 patients with newly diagnosed T1DM aged 0–16 years (median 7.84 ± 3.8) were studied [ages &lt;5 years (29.3%), 5 to &lt;10 years (38.7%), and ≥10 years (32%)], 52.4% of them were women. In total, 90.5% of the cases were occurred in individuals without a family history. Patients had lower C-peptide (CP) and body mass index (BMI) z scores when compared with healthy children, 41.8% of them had measurable T1DM-related antibodies and 52.7% had DKA. Among all three age groups, the &lt;5 years group had the lowest BMI z score, CP, and glycated hemoglobin (HbA1c) on average, while it had the highest incidence rate of DKA (56.9%). Compared to the non-DKA group, the DKA group was significantly younger, with a lower BMI z score and CP, higher antibody positive rate, HbA1c, and the rate of insulin pump therapy.ConclusionThe clinical incidence of T1DM in children and adolescents in China was 3.16/100,000. Patients with DKA at the first diagnosis of T1DM have a worse β-cell function. Public health measures for the prevention and treatment of T1DM should focus on preschoolers (aged &lt;5 years) in particular, considering the severity and the highest frequency of DKA in this age group. More efforts should be dedicated to early screening and diagnosis of the T1DM.
Complex Inheritance of Rare Missense Variants in PAK2, TAP2, and PLCL1 Genes in a Consanguineous Arab Family With Multiple Autoimmune Diseases Including Celiac Disease
Authors: Alharthi Arwa Mastoor , Banaganapalli Babajan , Hassan Sabah M. , Rashidi Omran , Al-Shehri Bandar Ali , Alaifan Meshari A. , Alhussaini Bakr H. , Alsufyani Hadeel A. , Alghamdi Kawthar Saad , Nasser Khalda Khalid , Bin-Taleb Yagoub , Elango Ramu , Shaik Noor Ahmad , Saadah Omar I. 
Published: June 2022

BackgroundAutoimmune diseases (AIDs) share a common molecular etiology and often present overlapping clinical presentations. Thus, this study aims to explore the complex molecular basis of AID by whole exome sequencing and computational biology analysis.MethodsMolecular screening of the consanguineous AID family and the computational biology characterization of the potential variants were performed. The potential variants were searched against the exome data of 100 healthy individuals and 30 celiac disease patients.ResultA complex inheritance pattern of PAK2 (V43A), TAP2 (F468Y), and PLCL1 (V473I) genetic variants was observed in the three probands of the AID family. The PAK2 variant (V43A) is a novel one, but TAP2 (F468Y) and PLCL1 (V473I) variants are extremely rare in local Arab (SGHP and GME) and global (gnomAD) databases. All these variants were localized in functional domains, except for the PAK2 variant (V43A) and were predicted to alter the structural (secondary structure elements, folding, active site confirmation, stability, and solvent accessibility) and functional (gene expression) features. Therefore, it is reasonable to postulate that the dysregulation of PAK2, TAP2, and PLCL1 genes is likely to elicit autoimmune reactions by altering antigen processing and presentation, T cell receptor signaling, and immunodeficiency pathways.ConclusionOur findings highlight the importance of exploring the alternate inheritance patterns in families presenting complex autoimmune diseases, where classical genetic models often fail to explain their molecular basis. These findings may have potential implications for developing personalized therapies for complex disease patients.
The Traditional Mongolian Medicine Qiqirigan-8 Effects on Lipid Metabolism and Inflammation in Obesity: Pharmacodynamic Evaluation and Relevant Metabolites
Authors: Narenmandula  , Hongmei  , Ding Xiaoqing , Li Kexin , Hashentuya  , Yang Dezhi , Wendurige  , Yang Rui , Yang Dandan , Tana  , Wang Haisheng , Eerdunduleng  , Tegexibaiyin  , Wang Changshan , Bao Xilinqiqige , Menggenduxi  
Published: June 2022

Objective: Traditional Mongolian Medicine Qiqirigan-8 (MMQ-8) is a Chinese botanical drug with effective pharmacological properties in obesity. However, the pharmacological mechanism of MMQ-8 remains unclear. This study aimed to determine the active metabolites of MMQ-8 and its therapeutic effects on lipid metabolism and inflammation.Methods: The active metabolites of MMQ-8 were identified by ultrahigh-performance liquid chromatograph Q extractive mass spectrometry (UHPLC-QE-MS) assay and network analysis. An obesity rat model induced by high-fat diet was used in the study. Serum levels of lipids and inflammatory factors were detected using biochemical analysis and enzyme-linked immunosorbent assay (ELISA). Pathological analysis of liver tissues and arteries was conducted with hematoxylin and eosin (H&amp;E) staining and immunohistochemistry. Protein expression of the tumor necrosis factor (TNF) signaling pathway was investigated by Western-blot. Simultaneously, bone marrow cells were used for RNA sequencing and relevant results were validated by cell culture and quantitative real-time polymerase chain reaction (RT-qPCR).Results: We identified 69 active metabolites and 551 target genes of MMQ-8. Of these, there are 65 active metabolites and 225 target genes closely related to obesity and inflammation. In vivo, we observed that MMQ-8 had general decreasing effects on body weight, white adipose tissue weight, and serum lipids. MMQ-8 treatment notably decreased the liver function markers and hepatic steatosis, and significantly decreased inflammation. In serum, it notably decreased TNF-α, interleukin (IL)-6, and inducible nitric oxide synthase (INOS), while elevating IL-10 levels. MMQ-8 treatment also significantly inhibited proteins phosphorylation of nuclear factor-kappa B inhibitor alpha (IκBα), mitogen-activated protein kinase (p38), extracellular regulated kinase 1/2(ERK1/2), and stress-activated protein kinase/c-Jun N-terminal kinase (SAPK/JNK), and decreased vascular endothelium damage and macrophage infiltration and polarization to M1. These findings coincide with the RNA-sequencing data of bone marrow cells and results of in vitro experiments.Conclusion: We determined the pharmacological actions and relevant metabolites of MMQ-8 in obesity for the first time. Our study revealed MMQ-8 can optimize lipid metabolism and reduce chronic inflammation in obesity. However, more in-depth research is needed, for example, to understand the principle of compound compatibility and the inhibition effects on hepatic steatosis, T cell differentiation, and inflammatory signal transduction.
Validation of Diagnostic Codes to Identify Carbon Monoxide Poisoning in Taiwan’s Claims Data
Authors: Chiang Min-Ying , Shao Shih-Chieh , Liao Shu-Chen 
Published: June 2022

Purpose: Previous studies identified the study cohort or outcome of carbon monoxide poisoning (COP) by using the relevant disease diagnosis codes in secondary databases, but the validity of diagnosis codes of COP is unclear in such secondary databases. This study aimed to evaluate the accuracy of case definitions for COP using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes in Taiwan’s health insurance claims data.Methods: We selected a 10% simple random sample from an original cohort of patients newly undergoing carboxyhemoglobin (COHb) testing under any clinical diagnosis at four Chang Gung Memorial Hospitals in Taiwan during 2011–2020. Two clinical doctors independently ascertained the COP diagnosis by reviewing the medical records as the reference standard. We estimated the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of various case definitions (e.g., ICD-9-CM code, ICD-10-CM code and the uses of hyperbaric oxygen therapy) in the claims data.Results: We randomly selected 557 cases from the original cohort of 5,571 cases newly receiving COHb test in the study hospitals. We found 90, 35, and 9 cases were true-positive, false-positive, and false-negative episodes of COP, respectively, among 278 cases with an ICD-9-CM code of 986. A further 111, 34, and 6 cases were true-positive, false-positive, and false-negative episodes of COP, respectively, among 279 cases with an ICD-10-CM code of T58. Using ICD-9-CM codes, the sensitivity, specificity, PPV and NPV for COP were 90.9, 80.4, 72, and 94.1%, respectively. Using ICD-10-CM codes they were 94.9, 79, 76.6, and 95.5%, respectively. PPV typically increased when COP was the primary diagnosis and could reach 100% if patients with ICD-CM code 986 or T58 also received hyperbaric oxygen therapy during hospitalization.Conclusion: The COP-related ICD-CM codes alone did not accurately identify COP patients, but accuracy improved after including oxygen therapy data with the ICD-CM codes in Taiwan’s claims data.
Assessment of Fasudil on Contrast-Associated Acute Kidney Injury Using Multiparametric Renal MRI
Authors: Wang Bin , Wang Yongfang , Tan Yan , Guo Jinxia , Chen Haoyuan , Wu Pu-Yeh , Wang Xiaochun , Zhang Hui 
Published: June 2022

Aims: To evaluate the utility of fasudil in a rat model of contrast-associated acute kidney injury (CA-AKI) and explore its underlying mechanism through multiparametric renal magnetic resonance imaging (mpMRI).Methods: Experimental rats (n = 72) were grouped as follows: controls (n = 24), CA-AKI (n = 24), or CA-AKI + Fasudil (n = 24). All animals underwent two mpMRI studies (arterial spin labeling, T1 and T2 mapping) at baseline and post iopromide/fasudil injection (Days 1, 3, 7, and 13 respectively). Relative change in renal blood flow (ΔRBF), T1 (ΔT1) and T2 (ΔT2) values were assessed at specified time points. Serum levels of cystatin C (CysC) and interleukin-1β (IL-1β), and urinary neutrophil gelatinase-associated lipocalin (NGAL) concentrations were tested as laboratory biomarkers, in addition to examining renal histology and expression levels of various proteins (Rho-kinase [ROCK], α-smooth muscle actin [α-SMA]), hypoxia-inducible factor-1α (HIF-1α), and transforming growth factor-β1 (TGF-β1) that regulate renal fibrosis and hypoxia.Results: Compared with the control group, serum levels of CysC and IL-1β, and urinary NGAL concentrations were clearly increased from Day 1 to Day 13 in the CA-AKI group (all p &lt; 0.05). There were significant reductions in ΔT2 values on Days 1 and 3, and ΔT1 reductions were significantly more pronounced at all time points (Days 1–13) in the CA-AKI + Fasudil group (vs. CA-AKI) (all p &lt; 0.05). Fasudil treatment lowered expression levels of ROCK-1, and p-MYPT1/MYPT1 proteins induced by iopromide, decreasing TGF-β1 expression and suppressing both extracellular matrix accumulation and α-SMA expression relative to untreated status (all p &lt; 0.05). Fasudil also enhanced PHD2 transcription and inhibition of HIF-1α expression after CA-AKI.Conclusions: In the context of CA-AKI, fasudil appears to reduce renal hypoxia, fibrosis, and dysfunction by activating (Rho/ROCK) or inhibiting (TGF-β1, HIF-1α) certain signaling pathways and reducing α-SMA expression. Multiparametric MRI may be a viable noninvasive tool for monitoring CA-AKI pathophysiology during fasudil therapy.
Biochemical and Physicochemical Changes in Spaghetti Meat During Refrigerated Storage of Chicken Breast
Authors: Tasoniero Giulia , Zhuang Hong , Bowker Brian 
Published: June 2022

This study investigated postmortem muscle protein degradation and myowater properties in broiler breasts afflicted with the Spaghetti Meat (SM) myopathy during 7 days of storage. Severe SM and unaffected (NORM) breast fillets were analyzed at days 0, 3, and 7 postmortem for TD-NMR myowater traits, myofibrillar protein profiles, calpain activity, free calcium, and desmin and troponin-T degradation patterns. Only at day 0, muscle histology, fiber size and sarcomere length were assessed on multiple fillet portions. In SM breasts, the intramyofibrillar water population exhibited longer relaxation times (p = 0.0172) and a lower proportion (p = 0.0118) compared to NORM. SM had a greater proportion of extramyofibrillar water (p = 0.0080) possessing a longer relaxation time (p = 0.0001). Overall, the SM myopathy had only a minor impact on the myofibrillar proteins profiles and did not affect either free calcium concentration, calpain activity, or the degradation of desmin and TnT, while storage time strongly affected all the traits measured. At microscopic level, muscle tissue from SM fillets exhibited the typical indicators of myodegeneration mostly in the superficial-cranial portion of the breast, while fiber size and sarcomere length were similar between the two muscle conditions irrespectively from the portion considered. The lack of overall significant interaction effects between muscle condition and storage period suggested that SM and NORM breast meat experience similar proteolytic and physical changes during the postmortem period.
Bidirectional Effects Between Parental Care and Depression Among Adolescent Boys: Results From the Chinese Family Panel Studies
Authors: Wang Jingyu , Jiao Jian 
Published: June 2022

BackgroundResearch has consistently shown the adverse effects of inappropriate parenting on adolescent depression. Meanwhile, interpersonal theories of depression suggest that depressed individuals elicit frustration and rejection from their relational partners.MethodUsing two-wave data from the Chinese Family Panel Studies (CFPS), the present study examined the prospective relationships between parental care and adolescent depression. Participant were 426 adolescents (54.9% male) born in 1999 (ages at T1 and T2 were 11 and 13).ResultsResults from the structural equation model showed that parental care prospectively and negatively predicted depression among both adolescent boys and girls. Inversely, adolescent boys’ depression, but not girls’ depression, negatively predicted subsequent parental care.ConclusionThe results suggest the interactive dynamic between parental care and adolescent depression as well as parents’ gendered responses to adolescent depression.
Workplace Violence and Turnover Intention Among Psychiatrists in a National Sample in China: The Mediating Effects of Mental Health
Authors: Chen Yanhua , Wang Peicheng , Zhao Lina , He Yanrong , Chen Nuoya , Liu Huanzhong , Liu Yuanli , Liu Tingfang , Tang Yi-lang , Jiang Feng , Zhu Jiming 
Published: June 2022

BackgroundWorkplace violence (WPV) in healthcare has received much attention worldwide. However, scarce data are available on its impact on turnover intention among psychiatrists, and the possible mechanisms between WPV and turnover intention have not been explored in China.MethodsA cross-sectional survey was conducted among psychiatrists in 41 tertiary psychiatric hospitals from 29 provinces and autonomous regions in China. A stress-strain-outcome (SSO) model was adopted to examine the effects of WPV on mental health and turnover intention. The association and mediation by burnout and stress were examined by multivariate logistic regression (MLR) and generalized structure equation modeling (GSEM).ResultsWe invited 6,986 psychiatrists to participate, and 4,520 completed the survey (64.7% response rate). The prevalence of verbal and physical violence against psychiatrist in China was 78.0 and 30.7%, respectively. MLR analysis showed that psychiatrists who experienced verbal violence (OR = 1.15, 95% CI = 1.10–1.21) and physical violence (OR = 1.15, 95% CI = 1.07–1.24) were more likely to report turnover intention. GSEM analysis showed that burnout (β = 4.00, p &lt; 0.001) and stress (β = 1.15, p &lt; 0.001) mediated the association between verbal violence and turnover intention; similarly, burnout (β = 4.92, p &lt; 0.001) and stress (β = 1.80, p &lt; 0.001) also mediated the association between physical violence and turnover intention.ConclusionsExperience of WPV is a significant contributor to turnover intention among psychiatrists. Mental health status, such as burnout and stress level significantly mediated the association. Policy makers and hospital administrators need to be aware of this association. Action is needed to promote mental health among the psychiatrists to improve morale and workforce sustainability.
Traditional Chinese Medicine for Post-stroke Sleep Disorders: The Evidence Mapping of Clinical Studies
Authors: Su Qing , Zou Danmei , Gai Nuo , Li Huishan , Kuang Zhuoran , Ni Xiaojia 
Published: June 2022

Background and PurposeRecently, there are a number of clinical studies on traditional Chinese medicine (TCM) for post-stroke sleep disorders (PSSDs). This study aimed to map the current clinical studies and identify gaps to inform future study agendas.MethodsPubMed, Embase, Cochrane Library, and Chinese databases, including SinoMed, CNKI, and Wanfang, were searched for clinical studies on PSSDs treated with TCM from their inception to September 2021. Evidence sources, number of studies, types of PSSDs, intervention categories, effectiveness, and quality assessment were graphically displayed.ResultsThe evidence map involved 810 clinical studies, of which the earliest report was dated back to 1993, and an advanced growth of the whole evidence was observed in 2012. Randomized controlled trials (RCTs) were the most common type of study design (78.15%), and post-stroke insomnia was the most common type of sleep disorders (65.80%). The benefits of Chinese herbal medicine (CHM) and acupuncture therapies for post-stroke insomnia have been widely reported in RCTs (81.60% and 75.38%, respectively). However, the benefits of CHM interventions were assessed using a global approach rather than being based on a specific formula, and the highest level of evidence supporting the effectiveness of acupuncture therapies was of low methodological quality. In addition, evidence from primary studies was insufficient in the areas of TCM for post-stroke sleep-related breathing disorders (SBDs) and Chinese mind-body exercises for post-stroke insomnia.ConclusionsPSSDs treated with TCM have been widely assessed in clinical studies. For better evidence translation, clinical trials on specific CHM interventions and high-quality systematic reviews on acupuncture for post-stroke insomnia should be conducted. For a better solution to clinical questions, TCM on SBDs after stroke and the benefits of Chinese mind-body exercises for post-stroke insomnia should be explored in future clinical studies.