bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic relevance of demographic factors in cardiac magnetic resonance-proven acute myocarditis: A cohort study
Authors: Cannata Antonio , Bhatti Prashan , Roy Roman , Al-Agil Mohammad , Daniel Allen , Ferone Emma , Jordan Antonio , Cassimon Barbara , Bradwell Susie , Khawaja Abdullah , Sadler Matthew , Shamsi Aamir , Huntington Josef , Birkinshaw Alexander , Rind Irfan , Rosmini Stefania , Piper Susan , Sado Daniel , Giacca Mauro , Shah Ajay M. , McDonagh Theresa , Scott Paul A. , Bromage Daniel I. 
Published: October 2022

AimAcute myocarditis (AM) is a heterogeneous condition with variable estimates of survival. Contemporary criteria for the diagnosis of clinically suspected AM enable non-invasive assessment, resulting in greater sensitivity and more representative cohorts. We aimed to describe the demographic characteristics and long-term outcomes of patients with AM diagnosed using non-invasive criteria.Methods and resultsA total of 199 patients with cardiac magnetic resonance (CMR)-confirmed AM were included. The majority (n = 130, 65%) were male, and the average age was 39 ± 16 years. Half of the patients were White (n = 99, 52%), with the remainder from Black and Minority Ethnic (BAME) groups. The most common clinical presentation was chest pain (n = 156, 78%), with smaller numbers presenting with breathlessness (n = 25, 13%) and arrhythmias (n = 18, 9%). Patients admitted with breathlessness were sicker and more often required inotropes, steroids, and renal replacement therapy (p &lt; 0.001, p &lt; 0.001, and p = 0.01, respectively). Over a median follow-up of 53 (IQR 34–76) months, 11 patients (6%) experienced an adverse outcome, defined as a composite of all-cause mortality, resuscitated cardiac arrest, and appropriate implantable cardioverter defibrillator (ICD) therapy. Patients in the arrhythmia group had a worse prognosis, with a nearly sevenfold risk of adverse events [hazard ratio (HR) 6.97; 95% confidence interval (CI) 1.87–26.00, p = 0.004]. Sex and ethnicity were not significantly associated with the outcome.ConclusionAM is highly heterogeneous with an overall favourable prognosis. Three-quarters of patients with AM present with chest pain, which is associated with a benign prognosis. AM presenting with life-threatening arrhythmias is associated with a higher risk of adverse events.
The development of a decision aid for shared decision making in the Dutch implantable cardioverter defibrillator patient population: A novel approach to patient education
Authors: Yilmaz Dilek , Egorova Anastasia D. , Schalij Martin J. , Spierenburg Han A. M. , Verbunt Robert A. M. , van Erven Lieselot 
Published: October 2022

BackgroundCounseling of Implantable Cardioverter-defibrillator (ICD) patients with regard to individual risks and benefits is challenging. An evidence-based decision aid tailored to the needs of Dutch ICD patients is not yet available. The objective of this pilot project was to structurally evaluate the current clinical practice in The Netherlands and the ICD patient experience, in order to develop an online decision aid to facilitate shared decision making in ICD procedures.MethodsBetween June 2016 and December 2017, a Dutch web-based decision aid was developed according to the Patient Decision Aid Standards (IPDAS) using the RAND-UCLA/multi-stepped Delphi model. Development process consisted of 5 stages in which the Dutch clinical practice was reviewed (stage 1), patients’ needs and their history of decision making was structurally assessed (stages 2A and B) and a modified Delphi consensus process was performed with an expert panel consisting of representatives from different medical fields (stage 3). Results from stages 1–3 were used to design and structure the content of an online-based decision aid (stage 4) which was finally evaluated in a usability testing by patients in stage 5.Results and conclusionThis study describes the evidence-based approach to the development of the Dutch ICD decision aid. In our population, levels of shared decision-making experience were low. The ICD decision aid was structurally developed for the Dutch ICD patient population. Our upcoming multicenter stepped wedge clustered randomized trial will further evaluate the ICD decision aid in clinical practice.
Causal effects of genetically predicted type 2 diabetes mellitus on blood lipid profiles and concentration of particle-size-determined lipoprotein subclasses: A two-sample Mendelian randomization study
Authors: Chen Ken , Zheng Jilin , Shao Chunli , Zhou Qing , Yang Jie , Huang Tao , Tang Yi-Da 
Published: October 2022

BackgroundObservational studies have shown inconsistent results of the associations between type 2 diabetes mellitus (T2DM) and blood lipid profiles, while there is also a lack of evidence from randomized controlled trials (RCTs) for the causal effects of T2DM on blood lipid profiles and lipoprotein subclasses.ObjectivesOur study aimed at investigating the causal effects of T2DM on blood lipid profiles and concentration of particle-size-determined lipoprotein subclasses by using the two-sample Mendelian randomization (MR) method.MethodsWe obtained genetic variants for T2DM and blood lipid profiles including high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG), and total cholesterol (TC) from international genome-wide association studies (GWASs). Two-sample MR method was applied to explore the potential causal effects of genetically predicted T2DM on blood lipid profiles based on different databases, respectively, and results from each MR analysis were further meta-analyzed to obtain the summary results. The causal effects of genetically predicted T2DM on the concentration of different subclasses of lipoproteins that are determined by particle size were also involved in MR analysis.ResultsGenetically predicted 1-unit higher log odds of T2DM had a significant causal effect on a higher level of TG (estimated β coefficient: 0.03, 95% confidence interval [CI]: 0.00 to 0.06) and lower level of HDL-C (estimated β coefficient: −0.09, 95% CI: −0.11 to −0.06). The causality of T2DM on the level of TC or LDL-C was not found (estimated β coefficient: −0.01, 95% CI: −0.02 to 0.01 for TC and estimated β coefficient: 0.01, 95% CI: −0.01 to 0.02 for LDL-C). For different sizes of lipoprotein particles, 1-unit higher log odds of T2DM was causally associated with higher level of small LDL particles, and lower level of medium HDL particles, large HDL particles, and very large HDL particles.ConclusionEvidence from our present study showed causal effects of T2DM on the level of TG, HDL-C, and concentration of different particle sizes of lipoprotein subclasses comprehensively, which might be particularly helpful in illustrating dyslipidemia experienced by patients with T2DM, and further indicate new treatment targets for these patients to prevent subsequent excessive cardiovascular events from a genetic point of view.
Virtual conversational agents versus online forms: Patient experience and preferences for health data collection
Authors: Soni Hiral , Ivanova Julia , Wilczewski Hattie , Bailey Alexandra , Ong Triton , Narma Alexa , Bunnell Brian E. , Welch Brandon M. 
Published: October 2022

ObjectiveVirtual conversational agents, or chatbots, have emerged as a novel approach to health data collection. However, research on patient perceptions of chatbots in comparison to traditional online forms is sparse. This study aimed to compare and assess the experience of completing a health assessment using a chatbot vs. an online form.MethodsA counterbalanced, within-subject experimental design was used with participants recruited via Amazon Mechanical Turk (mTurk). Participants completed a standardized health assessment using a chatbot (i.e., Dokbot) and an online form (i.e., REDCap), each followed by usability and experience questionnaires. To address poor data quality and preserve integrity of mTurk responses, we employed a thorough data cleaning process informed by previous literature. Quantitative (descriptive and inferential statistics) and qualitative (thematic analysis and complex coding query) approaches were used for analysis.ResultsA total of 391 participants were recruited, 185 of whom were excluded, resulting in a final sample size of 206 individuals. Most participants (69.9%) preferred the chatbot over the online form. Average Net Promoter Score was higher for the chatbot (NPS = 24) than the online form (NPS = 13) at a statistically significant level. System Usability Scale scores were also higher for the chatbot (i.e. 69.7 vs. 67.7), but this difference was not statistically significant. The chatbot took longer to complete but was perceived as conversational, interactive, and intuitive. The online form received favorable comments for its familiar survey-like interface.ConclusionOur findings demonstrate that a chatbot provided superior engagement, intuitiveness, and interactivity despite increased completion time compared to online forms. Knowledge of patient preferences and barriers will inform future design and development of recommendations and best practice for chatbots for healthcare data collection.
The association of liver enzymes with diabetes mellitus risk in different obesity subgroups: A population-based study
Authors: Zheng Dinghao , Zhang Xiaoyun , You Lili , Li Feng , Lin Diaozhu , Sun Kan , Ren Meng , Yan Li , Wang Wei 
Published: October 2022

BackgroundNumerous observational studies have shown that liver enzymes correlated with diabetes mellitus (DM) risk significantly, but limited studies showed whether different obesity subgroups present the same correlation. Our objective was to evaluate the association of liver enzymes with DM risk in different obesity subgroups based on a middle-aged Chinese population.MethodsWe conducted a population-based cross-sectional study and surveyed 9,916 people aged 40 years and above. A two-slope linear regression model was used to analyze the cutoff points of obesity in DM risk. Restricted cubic splines were used to analyze the correlation between liver enzymes and DM risk in different obesity categories. The odds ratios and 95% confidence intervals (CIs) were calculated using the logistic regression model.ResultsThe cutoff points of body mass index (BMI) and waist circumference were 30.55 kg/m2 and 98.99 cm for DM risk, respectively. The serum gamma-glutamyl transferase (GGT) concentration was positively correlated with DM risk in the subgroups with waist circumference &lt;98.99 cm [OR = 1.04, 95% CI (1.03–1.05)], BMI &lt;30.55 kg/m2 [OR = 1.04, 95% CI (1.03–1.05)], and BMI ≥30.55 kg/m2 [OR = 1.18, 95% CI (1.04–1.39)], but not in the subgroup with waist circumference ≥98.99 cm. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations have no significant correlation with the risk of diabetes in all groups.ConclusionThe results showed that serum GGT concentration was correlated with DM risk but not with AST or ALT in the middle-aged population. However, the correlation disappeared when waist circumference was over 98.99 cm, and serum GGT concentration had a limited value for DM risk in waist circumference over 98.99 cm.
Multi-timescale analysis of air pollution spreaders in Chinese cities based on a transfer entropy network
Authors: Hu Han , Tan Zhanglu , Liu Chan , Wang Ze , Cai Xiaomei , Wang Xing , Ye Zihan , Zheng Shuxian 
Published: October 2022

Cross-regional air pollutant spillovers aggravate air pollution in China. To mitigate air pollution, identifying and monitoring air pollution spreaders (APS) is a vital strategy that helps locate the source of air pollution and guides the Joint Prevention and Control of Air Pollution. In this paper, we define an APS as a city with a high spillover impact (CHSI) of air pollution and propose a transfer entropy network to investigate the APS from a multi-timescale analysis perspective. Taking the time series of PM2.5 concentration of 358 Chinese cities from 1 January 2015 to 31 December 2020 as the sample, they are decomposed into short, medium, and long timescales, corresponding to an average period of 12, 111, and 530 days, respectively. Then, we use transfer entropy networks to analyze APS’s spatial distribution and temporal variation patterns on each timescale. The results demonstrate that air pollution spillover widely exists in Chinese cities, and the short-term air pollution spillover dominates all spillovers. The CHSIs form large agglomeration areas in Central and East China on short and medium timescales, while the results of the undecomposed data show a more discrete distribution. In addition, the cities’ air pollution spillover impact is usually high in winter and spring and low in summer. Moreover, the spillover impacts of half of the cities have a lead-lag relationship between short and medium timescales. All results suggest that combining short-term controls and longer-term strategies helps China mitigate air pollution and develop sustainably.
Anti-SRP immune-mediated necrotizing myopathy: A critical review of current concepts
Authors: Ma Xue , Bu Bi-Tao 
Published: October 2022

Purpose of reviewThis review aims to describe clinical and histological features, treatment, and prognosis in patients with anti-signal recognition particle (SRP) autoantibodies positive immune-mediated necrotizing myopathy (SRP-IMNM) based on previous findings.Previous findingsAnti-SRP autoantibodies are specific in IMNM. Humoral autoimmune and inflammatory responses are the main autoimmune characteristics of SRP-IMNM. SRP-IMNM is clinically characterized by acute or subacute, moderately severe, symmetrical proximal weakness. Younger patients with SRP-IMNM tend to have more severe clinical symptoms. Patients with SRP-IMNM may be vulnerable to cardiac involvement, which ought to be regularly monitored and cardiac magnetic resonance imaging is the recommended detection method. The pathological features of SRP-IMNM are patchy or diffuse myonecrosis and myoregeneration accompanied by a paucity of inflammatory infiltrates. Endoplasmic reticulum stress-induced autophagy pathway and necroptosis are activated in skeletal muscle of SRP-IMNM. Treatment of refractory SRP-IMNM encounters resistance and warrants further investigation.SummaryAnti-SRP autoantibodies define a unique population of IMNM patients. The immune and non-immune pathophysiological mechanisms are involved in SRP-IMNM.
Tumor-associated macrophages in tumor progression and the role of traditional Chinese medicine in regulating TAMs to enhance antitumor effects
Authors: Zhang Jiatong , Gao Jiafeng , Cui Jingwen , Wang Yongqiang , Jin Yipeng , Zhang Di , Lin Degui , Lin Jiahao 
Published: October 2022

PurposeTo emphasize the importance of tumor-associated macrophages (TAMs) in tumor immunity and to describe the ways in which extracts from Traditional Chinese Medicine (TCM) achieve tumor therapy by modulating macrophages.SignificanceBy summarizing these available data, this review focused on TAMs and TCM and can build the foundation for future research on antitumor therapeutics.MethodsIn this review, we summarized the key functions of TAMs in cancer development and overviewed literature on TCM targeting TAMs together with other immune cells aiming to enhance antitumor immunity.ConclusionsWith an indispensable role in antitumor immunity, TAMs contribute to tumor progression, migration, invasion, angiogenesis, lymphangiogenesis, and immunosuppressive microenvironment. In recent years, TCM has gradually gained attention as a potential antitumor adjunctive therapy in preclinical and clinical trials. TCM is also a regulator of cytokine secretion and cell surface molecule expression in balancing the tumor microenvironment (TME), especially macrophage activation and polarization. Therefore, it is believed that TCM could serve as modifiers with immunomodulatory capability.
The role of radiotherapy-related autophagy genes in the prognosis and immune infiltration in lung adenocarcinoma
Authors: Gao Jingyan , Lu Fei , Yan Jiawen , Wang Run , Xia Yaoxiong , Wang Li , Li Lan , Chang Li , Li Wenhui 
Published: October 2022

BackgroundThere is a close relationship between radiotherapy and autophagy in tumors, but the prognostic role of radiotherapy-related autophagy genes (RRAGs) in lung adenocarcinoma (LUAD) remains unclear.MethodsData used in the current study were extracted from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Weighted gene co-expression network analysis (WGCNA) was executed to recognize module genes associated with radiotherapy. The differentially expressed genes (DEGs) between different radiotherapy response groups were filtered via edgeR package. The differentially expressed radiotherapy-related autophagy genes (DERRAGs) were obtained by overlapping the module genes, DEGs, and autophagy genes (ATGs). Then, prognostic autophagy genes were selected by Cox analyses, and a risk model and nomogram were subsequently built. Gene Set Enrichment Analysis (GSEA) and single-sample Gene Set Enrichment Analysis (ssGSEA) were performed to investigate potential mechanisms through which prognostic autophagy signatures regulate LUAD. Radiotherapy-resistant cell lines (A549IR and PC9IR) were established after exposure to hypo-fractionated irradiation. Ultimately, mRNA expression was validated by quantitative real-time PCR (qRT-PCR), and relative protein levels were measured in different cell lines by western blot.ResultsA total of 11 DERRAGs were identified in LUAD. After Cox analyses, SHC1, NAPSA, and AURKA were filtered as prognostic signatures in LUAD. Then, the risk score model was constructed using the prognostic signatures, which had a good performance in predicting the prognosis, as evidenced by receiver operating characteristics curves. Furthermore, Cox regression analyses demonstrated that risk score was deemed as an independent prognostic factor in LUAD. Moreover, GSEA and ssGSEA results revealed that prognostic RRAGs may regulate LUAD by modulating the immune microenvironment and affecting cell proliferation. The colony formation assay showed that the radiosensitivity of radiation-resistant cell lines was lower than that of primary cells. The western blot assay found that the levels of autophagy were elevated in the radiotherapy-resistant cell lines. Moreover, the expression of DERRAGs (SHC1, AURKA) was higher in the radiotherapy-resistant cells than in primary cells.ConclusionOur study explored the role of RRAGs in the prognosis of LUAD and identified three biomarkers. The findings enhanced the understanding of the relationship between radiotherapy, autophagy, and prognosis in LUAD and provided potential therapeutic targets for LUAD patients.
Age- and gender-related characteristics of astigmatism in a myopic population
Authors: Yang Shan , Jiang Yang , Cui Ge , Li Ying 
Published: October 2022

PurposeTo explore age- and gender-related differences of refractive and corneal astigmatism in myopic patients looking for refractive surgery.DesignA retrospective cross-sectional study.Materials and methodsThe medical files of candidates looking for corneal refractive surgery between 2019 and 2021 were reviewed, demographic and refractive parameters including age, gender, refractive status, and corneal parameters were analyzed.ResultsA total of 1,417 eyes of 1,417 patients (453 males and 964 females) were included. Males had thicker cornea than females, while females had steeper cornea than males, there was no gender-related difference in refractive and corneal astigmatism depending on patients’ age. There was no difference in refractive astigmatism among different age group from 18 to 50 years, while corneal astigmatism had a shift from with-the rule (WTR) to against-the-rule (ATR) with increasing age. Age, central corneal thickness (CCT), sphere, refractive astigmatism (RA), and corneal curvature (Km) were correlated with corneal astigmatism (CA) (standardized coefficients of are 0.006, p = 0.011 for age, −0.001, p = 0.004 for CCT, and −0.027, p &lt; 0.001 for sphere, 0.61, p &lt; 0.001 for RA, −0.05, p &lt; 0.001 for corneal curvature).ConclusionRefractive astigmatism is stable until the age of 50 years in myopic patients looking for refractive surgery, while corneal astigmatism showed a shift from WTR to ATR with advancing age. Age, CCT, sphere, refractive astigmatism and corneal curvature (Km) were correlated with corneal astigmatism.
PEGylation of the antimicrobial peptide LyeTx I-b maintains structure-related biological properties and improves selectivity
Authors: Moreira Brito Júlio César , Carvalho Lucas Raposo , Neves de Souza Amanda , Carneiro Guilherme , Magalhães Paula Prazeres , Farias Luiz Macêdo , Guimarães Natália Rocha , Verly Rodrigo Moreira , Resende Jarbas Magalhães , Elena de Lima Maria 
Published: October 2022

The biological activity of antimicrobial peptides and proteins is closely related to their structural aspects and is sensitive to certain post-translational modifications such as glycosylation, lipidation and PEGylation. However, PEGylation of protein and peptide drugs has expanded in recent years due to the reduction of their toxicity. Due to their size, the PEGylation process can either preserve or compromise the overall structure of these biopolymers and their biological properties. The antimicrobial peptide LyeTx I-bcys was synthesized by Fmoc strategy and coupled to polyethylene glycol 2.0 kDa. The conjugates were purified by HPLC and characterized by MALDI-ToF-MS analysis. Microbiological assays with LyeTx I-bcys and LyeTx I-bPEG were performed against Staphylococcus aureus (ATCC 33591) and Escherichia coli (ATCC 25922) in liquid medium. MIC values of 2.0 and 1.0 µM for LyeTx I-bcys and 8.0 and 4.0 µM for LyeTx I-bPEG were observed against S. aureus and E. coli, respectively. PEGylation of LyeTx I-bcys (LyeTx I-bPEG) decreased the cytotoxicity determined by MTT method for VERO cells compared to the non-PEGylated peptide. In addition, structural and biophysical studies were performed to evaluate the effects of PEGylation on the nature of peptide-membrane interactions. Surface Plasmon Resonance experiments showed that LyeTx I-b binds to anionic membranes with an association constant twice higher than the PEGylated form. The three-dimensional NMR structures of LyeTx I-bcys and LyeTx I-bPEG were determined and compared with the LyeTx I-b structure, and the hydrodynamic diameter and zeta potential of POPC:POPG vesicles were similar upon the addition of both peptides. The mPEG-MAL conjugation of LyeTx I-bcys gave epimers, and it, together with LyeTx I-bPEG, showed clear α-helical profiles. While LyeTx I-bcys showed no significant change in amphipathicity compared to LyeTx I-b, LyeTx I-bPEG was found to have a slightly less clear separation between hydrophilic and hydrophobic faces. However, the similar conformational freedom of LyeTx I-b and LyeTx I-bPEG suggests that PEGylation does not cause significant structural changes. Overall, our structural and biophysical studies indicate that the PEGylation does not alter the mode of peptide interaction and maintains antimicrobial activity while minimizing tissue toxicity, which confirmed previous results obtained in vivo. Interestingly, significantly improved proteolytic resistance to trypsin and proteinase K was observed after PEGylation.