bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demyelinating diseases of the central nervous system registry for patients with traditional Chinese medicine: Rationale and design of a prospective, multicenter, observational study
Authors: Liu Jia , Zhang Chi , Xie Yao , Zhou Li , Guo Li , Li Bin , Jia Zhen , Zhang Jingze , Sugimoto Kazuo , Gao Ying 
Published: November 2022

Background: Traditional Chinese medicine (TCM), a main form of complementary and alternative medicine provides a potential possibility for demyelinating disease of the central nervous system (DDC) management and has been applied in considerable amounts of patients with this disorder. Nevertheless, powerful real-world evidences regarding the epidemiological and clinical characteristics, safety, and outcomes of TCM in DDC are lacking. The primary objective of the Demyelinating Diseases of the Central Nervous System Registry for Patients with Traditional Chinese Medicine (DATE-TCM) is to create an organized multicenter data collection structure to define integrative characteristics of DDC patients treated with TCM in an endeavor to fill these knowledge gaps to better inform clinical care and health policy.Method: This study provides a prospective and voluntary registry by using a web-based system. Baseline data will be recorded and subsequently regular follow-up visits will be implemented every 3–6 months for a total of 5 years. The primary outcome is Annualized Aggregate Relapse Rate at 5-year follow-up.Results: DATE-TCM is currently designed to capture the multidimensional (epidemiologic, demographic, clinical, etc.) features of DDC patients receiving TCM treatment, the type and long-term safety and efficacy of TCM intervenes in the DDC populations, as well as the interaction of TCM treatments and disease modifying therapies in the management of DDC, aiming to include 2000 eligible adult DDC patients with TCM intervenes from 35 participating centers, covering 77.4% of provincial administrative regions of mainland China.Conclusion: DATE-TCM is the first, largest, most geographically extensive, and standard registry-based observational study that systematically document the real-world data regarding the TCM application in the DDC populations, which will be extraordinarily important for clarifying the comprehensive characteristics and outcomes of TCM in DDC, further shed light on standardizing and optimizing the TCM measures for DDC management and establishing evidence-based clinical practice guidelines for TCM application in DDC.
Evaluation of therapeutic strategies targeting BCAA catabolism using a systems pharmacology model
Authors: Voronova Veronika , Sokolov Victor , Morias Yannick , Boezelman Malin Jonsson , Wågberg Maria , Henricsson Marcus , Hansson Karl , Goltsov Alexey , Peskov Kirill , Sundqvist Monika 
Published: November 2022

Background: Abnormal branched-chained amino acids (BCAA) accumulation in cardiomyocytes is associated with cardiac remodeling in heart failure. Administration of branched-chain α-keto acid dehydrogenase (BCKD) kinase inhibitor BT2 has been shown to reduce cardiac BCAA levels and demonstrated positive effects on cardiac function in a preclinical setting. The current study is focused on evaluating the impact of BT2 on the systemic and cardiac levels of BCAA and their metabolites as well as activities of BCAA catabolic enzymes using a quantitative systems pharmacology model.Methods: The model is composed of an ordinary differential equation system characterizing BCAA consumption with food, disposal in the proteins, reversible branched-chain-amino-acid aminotransferase (BCAT)-mediated transamination to branched-chain keto-acids (BCKA), followed by BCKD-mediated oxidation. Activity of BCKD is regulated by the balance of BCKDK and protein phosphatase 2Cm (PP2Cm) activities, affected by BT2 treatment. Cardiac BCAA levels are assumed to directly affect left ventricular ejection fraction (LVEF). Biochemical characteristics of the enzymes are taken from the public domains, while plasma and cardiac BCAA and BCKA levels in BT2 treated mice are used to inform the model parameters.Results: The model provides adequate reproduction of the experimental data and predicts synchronous BCAA responses in the systemic and cardiac space, dictated by rapid BCAA equilibration between the tissues. The model-based simulations indicate maximum possible effect of BT2 treatment on BCAA reduction to be 40% corresponding to 12% increase in LVEF. Model sensitivity analysis demonstrates strong impact of BCKDK and PP2Cm activities as well as total BCKD and co-substrate levels (glutamate, ketoglutarate and ATP) on BCAA and BCKA levels.Conclusion: Model based simulations confirms using of plasma measurements as a marker of cardiac BCAA changes under BCKDK inhibition. The proposed model can be used for optimization of preclinical study design for novel compounds targeting BCAA catabolism.
The effect of a pressure ventilatory support on quadriceps endurance is maintained after exercise training in severe COPD patients. A longitudinal randomized, cross over study
Authors: Labeix Pierre , Court Fortune Isabelle , Muti Daniela , Berger Mathieu , Chomette-Ballereau Stéphanie , Barthelemy Jean Claude , Féasson Léonard , Costes Frédéric 
Published: November 2022

Purpose: In severe chronic obstructive pulmonary disease (COPD) patients, the application of an inspiratory pressure support (IPS) during exercise increases exercise tolerance and the benefit of exercise training during pulmonary rehabilitation (PR). Moreover, it improves quadriceps endurance after a session of cycling exercise suggesting a reduced muscle fatigue. We looked for the persistence of this effect after PR and sought an association between the improved quadriceps endurance with IPS and the training load during PR.Patients and methods: We studied 20 patients with severe COPD (6 in stage 3and 14 in stage 4 of GOLD) before and after PR. As part of a PR program, patients completed 16 cycling sessions over 6 weeks with the addition of IPS during exercise. As a surrogate of muscular fatigue, quadriceps endurance was measured at 70% of maximal strength in a control condition, after a constant work rate exercise test (CWR) with IPS (TlimQ IPS) or with a sham ventilation (TlimQsham), in a random order. These tests were repeated similarly at the end of PR.Results: PR was associated with a significant increase in maximal power output, cycling endurance, quadriceps strength and endurance. Session training load (power output x duration of the session) increased by 142% during the course of the program. Before PR, CWR duration increases with IPS compared to sham ventilation (Δtime = +244s, p = 0.001). Compared to control condition, post-exercise TlimQ reduction was lower with IPS at isotime than at the end of CWR or than with sham ventilation (−9 ± 21%, −18 ± 16% and −23 ± 18%, respectively, p = 0.09, p &lt; 0.0001 and p &lt; 0.0001). After PR, the post-exercise decrease of TlimQ was reduced after IPS compared to sham (−9 ± 18% vs. −21 ± 17%, respectively, p = 0.004). No relationship was found between the prevention of quadriceps fatigue and the training load.Conclusion: In severe COPD patients, the beneficial effect of a ventilator support on quadriceps endurance persisted after PR with IPS. However, it was not related to the increase in training load, and could not predict the training response to non-invasive ventilation during exercise.
Running economy and lower extremity stiffness in endurance runners: A systematic review and meta-analysis
Authors: Liu Bowen , Wu Jinlong , Shi Qiuqiong , Hao Fengwei , Xiao Wen , Yu Jingxuan , Yu Fengyu , Ren Zhanbing 
Published: November 2022

Background: Lower extremity stiffness simulates the response of the lower extremity to landing in running. However, its relationship with running economy (RE) remains unclear. This study aims to explore the relationship between lower extremity stiffness and RE.Methods: This study utilized articles from the Web of Science, PubMed, and Scopus discussing the relationships between RE and indicators of lower extremity stiffness, namely vertical stiffness, leg stiffness, and joint stiffness. Methodological quality was assessed using the Joanna Australian Centre for Evidence-Based Care (JBI). Pearson correlation coefficients were utilized to summarize effect sizes, and meta-regression analysis was used to assess the extent of this association between speed and participant level.Result: In total, thirteen studies involving 272 runners met the inclusion criteria and were included in this review. The quality of the thirteen studies ranged from moderate to high. The meta-analysis results showed a negative correlation between vertical stiffness (r = −0.520, 95% CI, −0.635 to −0.384, p &lt; 0.001) and leg stiffness (r = −0.568, 95% CI, −0.723 to −0.357, p &lt; 0.001) and RE. Additional, there was a small negative correlation between knee stiffness and RE (r = −0.290, 95% CI, −0.508 to −0.037, p = 0.025). Meta-regression results showed that the extent to which leg stiffness was negatively correlated with RE was influenced by speed (coefficient = −0.409, p = 0.020, r2 = 0.79) and participant maximal oxygen uptake (coefficient = −0.068, p = 0.010, r2 = 0.92).Conclusion: The results of this study suggest that vertical, leg and knee stiffness were negatively correlated with RE. In addition, maximum oxygen uptake and speed will determine whether the runner can take full advantage of leg stiffness to minimize energy expenditure.
Sex-related differences in clinical characteristics of children with ASD without ID: Results from the ELENA cohort
Authors: Dellapiazza Florine , Michelon Cécile , Rattaz Cécile , Picot Marie-Christine , Baghdadli Amaria 
Published: November 2022

ObjectiveThe literature on sex related-clinical differences for children with autism spectrum disorder (ASD) is highly contradictory, whereas this topic has major clinical implications. We aimed to investigate sex-related clinical differences in children with ASD without intellectual disability (ID).Materials and methodsWe compared 319 boys and 65 girls with ASD without ID, aged from 2 to 12 years, recruited from a multiregional cohort on their clinical profiles based on the scores for the Vineland-II, the SRS-2, the ADOS calibrated severity score, sensory processing, aberrant behaviors, and comorbidity rates.ResultsOur results confirm a high sex ratio of 4.9 males/females. Many similarities were found in the clinical profiles. However, we found that girls had higher SRS-2 total scores. In addition, there was a negative correlation between the SRS-2 total score and the intellectual quotient level (IQ) for girls only.ConclusionWe confirm the higher rates of boys with ASD without ID. A comparison between the girls and boys showed them to have similar clinical profiles, except for the SRS- 2 total scores, which were higher among girls, suggesting more severe social impairment perceived by parents. Our findings that the cognitive level is related to ASD severity in girls should be taken into account during the diagnostic procedure in the clinical interpretation of gold-standard measures of ASD, and additional clinical observations are necessary.Clinical trial registration[ClinicalTrials.gov], identifier [NCT02625116s].
The impacts of COVID-19 on China insurance industry—An empirical analysis based on event study
Authors: Wu Xuan , Wang Chan , Wen Hong-xing , Nie Pu-yan , Ye Jin-fa 
Published: November 2022

IntroductionAt the end of 2019, the sudden outbreak of COVID-19 pneumonia has developed from a mass health event to a global epidemic disaster. Its impact extends from human health to social, economic, political, international relations and global governance. In the process of fighting against the epidemic in China, almost all economic sectors were affected, and the insurance industry with epidemic sensitive characteristics was particularly affected.MethodsIn order to identify the impacts of COVID-19 on China's insurance industry, this paper uses the event study method to calculate the changes in the cumulative abnormal return rate and the cumulative excess return of Chinese listed insurance companies before and after the outbreak of COVID-19. In the empirical analysis, five different typical events are examined, including the first outbreak of COVID-19 in China, the closure of Wuhan, the dredging of Wuhan, and the listing of vaccines in China.ResultsThe results show that the return rate of listed companies in the insurance industry showed an “inverted N” curve with the “decreasing, rising and then decreasing.” The epidemic mainly has negative effects on the insurance industry in terms of premium income and indemnity expenditure. According to the supply shock theory of the new supply economics, the epidemic has a negative impact on the insurance industry in the short term and a positive impact in the long term.DiscussionIn this context, insurance enterprises should attach importance to the change of business model, strengthen the development model of public-private joint venture insurance, promote product innovation and the application of insurance technology, and the experience and practice of the insurance industry in responding to the impact of the epidemic are of great significance to the transformation of China's insurance industry.
Epidemiology and prediction model of patients with carcinosarcoma in the United States
Authors: Chen Mingjing , He Xiandong , Yang Qiao , Zhang Jia , Peng Jiayi , Wang Danni , Tong Kexin , Huang Wenxiang 
Published: November 2022

BackgroundCarcinosarcoma is a rare biphasic tumor composed of both carcinoma and sarcoma elements, which occurs at various sites. Most studies are case reports or small population-based studies for a single disease site, so comprehensive evaluations of epidemiology and prognostic factors for carcinosarcoma are needed.MethodsSurveillance, Epidemiology, and End Results (SEER)-8 (1975–2019) provided data for the epidemiological analysis. SEER-17 (2000–2019) provided data on the primary tumor sites, initial treatment, construction, and validation of the nomogram.ResultsThe age-adjusted incidence per 100,000 persons of carcinosarcoma increased significantly from 0.46 to 0.91 [1975–2019; average annual percent change (AAPC): 1.3%, P = 0.006], with localized stage increasing from 0.14 to 0.26 [2005–2015; annual percent change (APC): 4.2%]. The 20-year limited-duration prevalence per 100,000 increased from 0.47 to 3.36 (1999–2018). The mortality per 100,000 increased significantly from 0.16 to 0.51 (1975–2019; AAPC: 1.9%, P &lt; 0.001). The 5-year relative survival was 32.8%. The greatest number of carcinosarcomas were from the uterus (68.7%), ovary (17.8%), lung and bronchus (2.3%). The main treatment is comprehensive treatment based on surgery; however, surgery alone is preferred in older patients. In multivariate analysis (N = 11,424), age, sex, race, year of diagnosis, disease stage, tumor site, and treatment were associated with survival. A nomogram was established to predict 1-, 3-, and 5-year survival, and the C-indexes were 0.732 and 0.748 for the training and testing sets, respectively. The receiver operating characteristic curve demonstrated that the nomogram provided a comprehensive and accurate prediction [1-year area under the curve (AUC): 0.782 vs. 0.796; 3-year AUC: 0.771 vs. 0.798; 5-year AUC: 0.777 vs. 0.810].ConclusionsIn this study, the incidence, prevalence, and mortality of carcinosarcoma have increased over the past decades. There was a rapid rise in the incidence of localized stage in recent years, which reflected improved early detection. The prognosis of carcinosarcoma remains poor, signifying the urgency of exploring targeted cancer control treatments. Explicating distribution and gender disparities of carcinosarcoma may facilitate disease screening and medical surveillance. The nomogram demonstrated good predictive capacity and facilitated clinical decision-making.
Stakeholder engagement in gender and climate change policy processes: Lessons from the climate change, agriculture and food security research program
Authors: Mulema Annet Abenakyo , Cramer Laura , Huyer Sophia 
Published: November 2022

IntroductionWith the rapid increase in climate shocks and hazards, policies governing climate change have proliferated while the integration of gender considerations to address gender-differentiated needs and impacts has remained a challenge. Stakeholder engagement is touted as a critical ingredient in climate change decisions and governance at different levels to achieve equitable outcomes. However, effective methods and outcomes of gender-responsive stakeholder engagement processes for climate change policy development are rarely published.MethodsWe apply the framework of 10 principles for effective agricultural research for development programs to analyze the stakeholder engagement processes in the context of the CGIAR's Research Program on Climate Change, Agriculture and Food Security gender and climate change policy projects. We analyze both primary and secondary data to understand the categories of stakeholders engaged, methods of engagement, the outcomes and lessons learned across five regions.Results and discussionOur results show that analysis of the existing policies and programs is a very critical entry point for identifying the points of leverage, the types of stakeholders to engage and how to engage them in the processes that focus on integrating gender in climate policies. Co-learning and co-development of knowledge products cultivate interest and commitment among stakeholders to address gender dynamics, although systematic monitoring and evaluation remains a challenge. This has implications for effective stakeholder engagement in mainstreaming gender in climate policies and evidence-based policy formulation for sustainable agriculture and food systems. Working with influential stakeholders, with the capacity and interest to address gender considerations yields more positive results. Mechanisms to address power relations need to be in place for gender considerations to be voiced and integrated and include women in decision-making processes.
Prevalence and Associated Factors of Delayed Diagnosis of Type 2 Diabetes Mellitus in a Tertiary Hospital: A Retrospective Cohort Study
Authors: Dulyapach Kotchakorn , Ngamchaliew Pitchayanont , Vichitkunakorn Polathep , Sornsenee Phoomjai , Choomalee Kittisakdi 
Published: November 2022

Objective: To determine the prevalence and associated factors of delayed diagnosis of type 2 diabetes mellitus (DM) among outpatients in a tertiary hospital.Methods: This retrospective cohort study was conducted among outpatients aged ≥35 years with twice fasting plasma glucose (FPG) levels ≥126 mg/dl between 1 January 2018, and 31 December 2020. The prevalence and pattern of delayed diagnosis of DM were defined using the Thai Clinical Practice Guideline (CPG) for Diabetes, 2017, and the American Diabetes Association (ADA) 2017. The cut-off time for FPG level confirmation of 3 months was used to evaluate delayed diagnoses and associated factors. Multiple logistic regression was used to identify variables associated with delayed diagnoses.Results: Of 260 participants, 96.9% and 85.4% had delayed diagnoses as defined by the Thai CPG and the ADA, respectively. Factors significantly associated with delayed diagnosis were hypertension, non-cash insurance, and &gt;10 years of physician experience.Conclusion: Undiagnosed diabetes and diagnosis delay should be a concern in tertiary settings. Senior physicians should focus on patients with higher FPG levels, particularly those who have hypertension, and use non-cash insurance schemes.
Genome-Wide Identification and Expression Analysis of the Aquaporin Gene Family in Lycium barbarum during Fruit Ripening and Seedling Response to Heat Stress
Authors: He Wei , Liu Mingyu , Qin Xiaoya , Liang Aihua , Chen Yan , Yin Yue , Qin Ken , Mu Zixin 
Published: November 2022

Plant–water relations mediated by aquaporins (AQPs) play vital roles in both key plant growth processes and responses to environmental challenges. As a well-known medicinal and edible plant, the harsh natural growth habitat endows Lycium plants with ideal materials for stress biology research. However, the details of their molecular switch for water transport remain unclear. In the present work, we first identified and characterized AQP family genes from Lycium (L.) barbarum at the genome scale and conducted systemic bioinformatics and expression analyses. The results showed that there were 38 Lycium barbarum AQPs (LbAQPs) in L. barbarum, which were classified into four subfamilies, including 17 LbPIP, 9 LbTIP, 10 LbNIP, and 2 LbXIP. Their encoded genes were unevenly distributed on all 12 chromosomes, except chromosome 10. Three of these genes encoded truncated proteins and three genes underwent clear gene duplication events. Cis-acting element analysis indicated that the expression of LbAQPs may be mainly regulated by biotic/abiotic stress, phytohormones and light. The qRT-PCR assay indicated that this family of genes presented a clear tissue-specific expression pattern, in which most of the genes had maximal transcript levels in roots, stems, and leaves, while there were relatively lower levels in flowers and fruits. Most of the LbAQP genes were downregulated during L. barbarum fruit ripening and presented a negative correlation with the fruit relative water content (RWC). Most of their transcripts presented a quick and sharp upregulation response to heat stress following exposure of the 2-month-old seedlings to a 42 °C temperature for 0, 1, 3, 12, or 24 h. Our results proposed that LbAQPs were involved in L. barbarum key development events and abiotic stress responses, which may lay a foundation for further studying the molecular mechanism of the water relationship of Lycium plants, especially in harsh environments.
Relationships between the Visual Quality and Color Patterns: Study in Peri-Urban Forests Dominated by Cotinus coggygria var. cinerea Engl. in Autumn in Beijing, China
Authors: Cao Yujuan , Li Yanming , Li Xinyu , Wang Xing , Dai Ziyun , Duan Minjie , Xu Rui , Zhao Songting , Liu Xiuping , Li Jiale , Xie Junfei 
Published: November 2022

The spatial pattern of color patches plays a crucial role in affecting the visual quality of peri-urban forests dominated by Cotinus coggygria var. cinerea Engl. in autumn. The impact mechanism has been studied to facilitate algorithm-based automatic visual quality estimation. The color patterns of 120 photographs were calculated after color quantization and automatic color substitution. The scenic beauty of the forest was estimated by 698 respondents. Multiple correlations between visual quality and color pattern metrics were explored with stepwise regression. Principal component analysis (PCA) was also employed to investigate the impact mechanism of color patterns on visual quality. Number of patches (NP), largest patch index (LPI), mean patch area (AREA_MN), patch size standard deviation (AREA_SD), and Shannon’s evenness index (SHEI) were the main factors affecting the visual quality of the Cotinus coggygria forest. AREA_MN correlated positively with visual quality, while NP, LPI, AREA_SD, and SHEI correlated negatively. Moreover, AREA_SD had the most significant impact on the visual quality of the landscape, while SHEI, LPI, and AREA_MN had the second-highest impact. The evenness and the size of color patches significantly affected the visual quality of the forest landscapes. Balancing the diversity and evenness of color patches plays a decisive role in creating a forest landscape with high visual quality.