bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Serum Cystatin C With Cerebral Small Vessel Disease in Community-Based Population
Authors: Yao Dongxiao , Li Shan , Jing Jing , Cai Xueli , Jin Aoming , Yang Yingying , Wang Suying , Meng Xia , Lin Jinxi , Mei Lerong , Li Hao , Wei Tiemin , Wang Yongjun , Pan Yuesong , Wang Yilong 
Published: July 2022

Background:
The aim of this study was to investigate the relationship between serum cystatin C levels and the presence and severity of cerebral small vessel disease (CSVD).

Methods:
Community-dwelling residents in the Lishui city in China from the cross-sectional survey of the PRECISE (Poly-Vascular Evaluation for Cognitive Impairment and Vascular Events) cohort study were included in present study from 2017 to 2019. Total CSVD burden and modified total CSVD burden score, as well as the markers of CSVD on magnetic resonance imaging, including white matter hyperintensity, lacunes, cerebral microbleeds, and perivascular spaces, were assessed at baseline survey. Participants were divided into 4 groups according to the quartiles of cystatin C. The association of serum cystatin C with total CSVD burden and imaging markers was analyzed using ordinal or binary logistic regression models. Furthermore, 2-sample Mendelian randomization analysis was performed to investigate the genetically predicted effect of cystatin C on CSVD.

Results:
A total of 3061 participants were included in this study. The mean age of the participants was 61.2±6.7 years, and 1637 (53.5%) were women. Higher level of cystatin C was associated with an increased total CSVD burden and modified total CSVD burden (Q4 versus Q1: common odds ratio [OR], 1.30 [95% CI, 1.03–1.64] and 1.32 [95% CI, 1.01–1.73]) after adjustment for covariates. Further, compared with the first quartile of cystatin C, subjects in the last quartile had higher risk of lacunes (OR, 1.99 [95% CI, 1.05–3.76]), modified white matter hyperintensity burden (common OR, 1.42 [95% CI, 1.07–1.90]), and moderate-to-severe perivascular spaces (OR, 2.15 [95% CI, 1.29–3.59]) but not cerebral microbleeds. The Mendelian randomization analysis showed that a genetically predicted higher cystatin C level was associated with increased risk of lacunar stroke (OR, 1.16 [95% CI, 1.06–1.27]).

Conclusions:
In this community-based study, we found a possible association between cystatin C and CSVD, especially for lacunes, that was independent of estimated glomerular filtration rate.
Snatching Legal Victory: LGBTQ Rights Activism and Contestation in the Arab World
Authors: Anabtawi Samer 
Published: July 2022

Abstract
This article examines the relationship between emergent LGBTQ movements and the state in the Arab world over the past two decades. Focusing on the efforts of various LGBTQ social movements to confront the criminalization of homosexuality in the Arab region, the article puzzles over a cascade of legal victories for LGBTQ rights advocates in Lebanon in recent years in spite of a hostile justice sector mired with corruption. It interrogates a set of prevalent assumptions about the effect of regime type (democracy v. authoritarianism) on gay rights activism and litigation. This article explains how some LGBTQ Arab movements have successfully relied on strategic litigation to confront criminalization laws while others have had less success in pursuing overtly confrontational approaches. The paired comparison between Tunisia and Lebanon shifts our focus back to the agency of judges and social movement leaders in shaping legal outcomes for LGBTQ citizens.
Perception/Deception: Fictional Selves and the Peculiarly Digital Phenomenon of Catfishing
Authors: Dey Debolina 
Published: July 2022

Abstract
Catfishing is a peculiar digital phenomenon that involves a relationship using a fictional online persona. What distinguishes catfishing from other forms of digital production that deploy ‘misleading’ information or impersonation is that although this phenomenon might include such strategies, it is often employed for romantic scams. This paper looks at the alternative forms of intimacy afforded by digital platforms with their particular set of tools, especially in the context of digital cultures in India. By using catfishing as a lens to read intimacy in the digital, this study looks at unexpected possibilities of the digital as a mediatized space that in turn generates new types of relationalities.
The Role of Physical Activity in Opioid Substitution Therapy: A Systematic Review of Interventional and Observational Studies
Authors: Alpers Silvia Eiken , Furulund Einar , Pallesen Ståle , Mamen Asgeir , Dyrstad Sindre M , Fadnes Lars Thore 
Published: July 2022

Background: Use of physical activity in the treatment and follow-up of people receiving opioid substitution therapy is an understudied area of research. Therefore, the objective of this systematic review was to synthesize the currently available research on the role of physical activity in opioid substitution therapy and proper adaptions for the group. Methods: A systematic search was performed on PsycINFO, EMBASE, MEDLINE, CINAHL, and Web of Science until September 2021 (PROSPERO-reg.no: CRD42020109873). The inclusion criteria were studies involving physical activity interventions for opioid substitution patients. Reference lists of relevant studies were screened to identify additional relevant studies. Data extracted were compiled into tables and descriptively presented. Results: The search yielded 2105 unique records. A total of 10 studies were included, whose methodological quality ranged from satisfactory to very good. Study quality was assessed using a 7-/8-point quality score. The agreement between the reviewers, assessed with Cohen’s kappa, was 0.91. Overall, the results suggest that physical activity increases physical fitness of patients in opioid substitution therapy and decreases substance use. The minority of studies in this field are of high quality with sufficient power. Conclusions: The findings of this systematic review suggest beneficial effects of physical activity on physical fitness, substance use, and mental health for patients in opioid substitution therapy. Although the findings are quite consistent across studies, high-quality studies and sufficiently powered clinical trials are needed to confirm and validate the findings and to conclude on the degree of impact.
Quantification of aneurysm wall enhancement in intracranial fusiform aneurysms and related predictors based on high-resolution magnetic resonance imaging: a validation study
Authors: Peng Fei , Fu Mingzhu , Xia Jiaxiang , Niu Hao , Liu Lang , Feng Xin , Xu Peng , Bai Xiaoyan , Li Zhiye , Chen Jigang , Tong Xin , He Xiaoxin , Xu Boya , Chen Xuge , Liu Hongyi , Sui Binbin , Duan Yonghong , Li Rui , Liu Aihua 
Published: July 2022

Background: Aneurysm wall enhancement (AWE) in high-resolution magnetic resonance imaging (HR-MRI) has emerged as a new imaging biomarker of intracranial aneurysm instability. Objective: To determine a standard method of AWE quantification for predicting fusiform intracranial aneurysms (FIAs) stability by comparing the sensitivity of each parameter in identifying symptomatic FIAs. The predictors of AWE and FIA types were also identified. Methods: We retrospectively analyzed consecutive fusiform aneurysm patients who underwent HR-MRI from two centers. The aneurysm-to-pituitary stalk contrast ratio (CRstalk), aneurysm enhancement ratio, and aneurysm enhancement index were extracted, and their sensitivities in discriminating aneurysm symptoms were compared using the receiver-operating characteristic curve. Morphological parameters of fusiform aneurysm were extracted based on 3D vessel model. Uni- and multivariate analyses of related predictors for AWE, CRstalk, and FIA types were performed, respectively. Results: Overall, 117 patients (mean age, 53.3 ± 11.7 years; male, 75.2%) with 117 FIAs underwent HR-MRI were included. CRstalk with the maximum signal intensity (CRstalk-max) had the highest sensitivity in identifying symptomatic FIAs with an area under the curve value (0.697) and a cut-off value of 0.90. The independent predictors of AWE were aneurysm symptoms [(odds ratio) OR = 3.754, p = 0.003], aspirin use (OR = 0.248, p = 0.037), and the maximum diameter of the cross-section (OR = 1.171, p = 0.043). The independent predictors of CRstalk-max were aneurysm symptoms (OR = 1.289, p = 0.003) and posterior circulation aneurysm (OR = 1.314, p = 0.001). Transitional-type showed higher rates of hypertension and mural thrombus over both dolichoectatic- and fusiform-type FIAs. Conclusion: CRstalk-max may be the most reliable parameter to quantify AWE to distinguish symptomatic FIAs. It also has the potential to identify unstable FIAs. Several factors contribute to the complex pathophysiology of FIAs and need further validation in a larger cohort.
Effectiveness of Granular Lockdown as an Epidemic Control Strategy in Kerala, India
Authors: Hariharan Hariprasad Thazhathedath , Surendran Anish Thekkumkara 
Published: July 2022

Background Lockdown is a time-tested methodology to cease infectious disease spread. The national and subnational lockdown effectively reduced the spread of COVID-19 in many countries, including India. The current article documents the effectiveness of lockdown at a more granular level, that is, the local self-government (LSG), the lowest administrative unit, in Kerala, a south Indian state. Methods We extracted all data pertaining to this study: the distribution of containment zones and the incidence of COVID-19 cases from official data sources of the Government of Kerala. As part of the study, we followed the progression of all LSGs as containment zones over the study period of 10 weeks (7/5/2020-15/7/2020). We created survival distributions characterizing the time to enter lockdown and the time to remain in lockdown for all the districts and the state. Finally, we conducted an interdistrict comparison of the cumulative incidence of COVID-19 per population for 6 months after the period of LSG containment was over to ascertain its effectiveness. Results Four northern districts of Kerala state had implemented lockdown strategy more rigorously both in the proportion of LSGs that has become a containment zone and in the period of containment compared to the rest of Kerala. As a result, the growth of COVID-19 cases in these 4 districts was less (7.5 times) than in the other districts (37 times) during the study period. However, the reduction in the disease incidence was not instantaneous; at the same time, it was not short-living as the difference continued to exist for 6 more months past lockdown. Conclusion Implementing granular lockdown strategies can effectively control the spread of disease only if it encompasses a sufficient area for an adequate period. We believe our research could help governments provide insights into the years-long and never-ending battle with the pandemic.
Overdominant expression of related genes of ion homeostasis improves K+ content advantage in hybrid tobacco leaves
Authors: Pi Kai , Luo Wen , Mo Zejun , Duan Lili , Ke Yuzhou , Wang Pingsong , Zeng Shuaibo , Huang Yin , Liu Renxiang 
Published: July 2022

Abstract
Background
Potassium(K+) plays a vital role in improving the quality of tobacco leaves. However, how to improve the potassium content of tobacco leaves has always been a difficult problem in tobacco planting. K+ content in tobacco hybrid is characterized by heterosis, which can improve the quality of tobacco leaves, but its underlying molecular genetic mechanisms remain unclear.

Results
Through a two-year field experiment, G70×GDH11 with strong heterosis and K326×GDH11 with weak heterosis were screened out. Transcriptome analyses revealed that 80.89% and 57.28% of the differentially expressed genes (DEGs) in the strong and weak heterosis combinations exhibited an overdominant expression pattern, respectively. The genes that up-regulated the overdominant expression in the strong heterosis hybrids were significantly enriched in the ion homeostasis. Genes involved in K+ transport (KAT1/2, GORK, AKT2, and KEA3), activity regulation complex (CBL-CIPK5/6), and vacuole (TPKs) genes were overdominant expressed in strong heterosis hybrids, which contributed to K+ homeostasis and heterosis in tobacco leaves.

Conclusions
K+ homeostasis and accumulation in tobacco hybrids were collectively improved. The overdominant expression of K+ transport and homeostasis-related genes conducted a crucial role in the heterosis of K+ content in tobacco leaves.
Determination of the median effective dose of sufentanil for inhibiting the laryngeal mask insertion response in geriatric patients: a prospective, double-blinded, dose–response trial
Authors: Wang ShiFang , Wang WeiBing , Xiao JinBo , Yu HongPing , Zhou Hui , Xu Huang 
Published: July 2022

Abstract
Background
Laryngeal mask airway(LMA) have been widely used in clinical practice. Irritation to the patient during the insertion of a laryngeal mask can cause hemodynamic fluctuations, which is particularly unsafe for geriatric patients. We used probit regression analysis to determine the median effective dose of sufentanil to inhibit the response to LMA insertion in geriatric patients.

Methods
A total of 90 patients were selected for the study using the following inclusion criteria: age ≥ 65 years old, ASA grade I–III, and scheduled to undergo intravenous general anesthesia with LMA insertion. Each patient received a dose of sufentanil for anesthesia induction in one of six levels: 0.05, 0.1, 0.15, 0.2, 0.25, or 0.3 μg kg−1. LMA insertion was scored with a 3-point, 6-category scale, with scores ≥ 16 indicating effective LMA insertion, and < 16 indicating ineffective LMA insertion. Mean arterial blood pressure (MAP), heart rate (HR), and bispectral index (BIS) were recorded 1 min before induction (T1), 1 min after induction (T2), 1 min after LMA insertion (T3), and 5 min after LMA insertion (T4) in each group. In addition, the plasma norepinephrine (NE) levels and adverse reactions were measured at T2 and T3 in each dosage group.

Results
Probit regression analysis showed that the ED50 of sufentanil inhibiting the response to LMA insertion in geriatric patients was 0.18 μg kg−1 (95% CI: 0.16–0.21 μg kg−1), and the ED95 was 0.31 μg kg−1 (95% CI: 0.27–0.38 μg kg−1), and the probit(p) = -2.34 + 12.90 × ln(Dose)($$\chi^{2}$$

χ
2

= 0.725, p = 0.948). Among all the patients, the number of effective LMA insertions was 57 (group A), and the number of ineffective LMA insertions was 33 (group B). The MAP, HR, and NE in group B were significantly higher than in group A at T3.

Conclusions
Sufentanil can effectively inhibit the patient’s response to LMA insertion, with stable hemodynamics and small stress response. The ED50 and ED95 were 0.18 μg kg−1 (95% CI: 0.16–0.21 μg kg−1) and 0.31 μg kg−1(95% CI: 0.27–0.38 μg kg−1), respectively.

Trial registration
This study was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2100051827) on October 6, 2021.
A nomogram to predict left atrial appendage thrombus and spontaneous echo contrast in non-valvular atrial fibrillation patients
Authors: Sun Shikun , Su Bo , Lin Jia , Zhao Caiming , Ma Changsheng 
Published: July 2022

Abstract
Background
Non-valvular atrial fibrillation (NVAF) significantly increases the risk of stroke. Although there is availability of prediction models, their ability to predict the risk of stroke in NVAF patients remains suboptimal. Therefore, there is need to improve prediction of high-risk individuals, which is critical for efficient management of patients with NVAF.

Objective
The objective of our paper is to develop a nomogram for predicting the risk of left atrial appendage thrombus (LAAT) and spontaneous echo contrast (SEC), thereby replacing the risk of stroke in NVAF patients.

Design
This was a retrospective cohort study that analyzed clinical data and echocardiographic indices of 387 patients with NVAF from October 2018 to June 2021. Multivariable logistic regression was used to evaluate independent factors that were used to construct the prediction nomogram.

Analysis
The discriminative ability and calibration of the nomogram to predict LAAT/SEC were tested using C-statistic and calibration plot. The performance of the nomogram was assessed against the CHA2DS2 score, CHA2DS2-VASc score and ATRIA score using the receiver operating characteristic curve (ROC), decision curve analysis (DCA), integrated discrimination index (IDI) and net reclassification index (NRI).

Result
Out of the total 387 patients enrolled in this study, 232 had LAAT/SEC. Multivariable analyses demonstrated that N-terminal pro-B-type natriuretic peptide (NT-proBNP), albumin (ALB), LAA ejection fraction (LAAEF) and LAA global peak longitudinal strain (LAA GPLS) were independent predictors of LAAT/SEC. The constructed nomogram had good discriminative (C = 0.886) and calibration (0.876) abilities after bias correction by the C-index. Compared with other models, the decision curve analyses demonstrated that the nomogram had greater net benefits. Besides, the nomogram had significant improvement in predictive performance, sensitivity and reclassification for LAAT/SEC compared with the CHA2DS2 [(c-index: 0.886 vs. 0.576, p < 0.05), (NRI: 0.539, p < 0.05), (IDI: 0.432, p < 0.05)], CHA2DS2-VASc [(c-index: 0.886 vs0.579, p < 0.05), (NRI: 0.513, p < 0.05), (IDI: 0.432, p < 0.05)] or ATRIA [(c-index: 0.886 vs0.583, p < 0.05), (NRI: 0.546, p < 0.05), (IDI: 0.432, p < 0.05)].

Conclusion
Taken together, our data demonstrated that the developed nomogram was effective and had potential clinical application in the prediction of LAAT/SEC in patients with NVAF.
Comparison of dimethyl fumarate and interferon outcomes in an MS cohort
Authors: Sattarnezhad Neda , Healy Brian C. , Baharnoori Moogeh , Diaz-Cruz Camilo , Stankiewicz James , Weiner Howard L. , Chitnis Tanuja 
Published: July 2022

Abstract
Background
To compare the effectiveness of dimethyl fumarate (DMF) with subcutaneous interferon beta-1a (IFNβ-1a) in controlling disease activity in patients with relapsing–remitting Multiple Sclerosis (MS).

Methods
Clinical and imaging data from patients treated with either IFNβ-1a or DMF for at least one year were reviewed. The proportion of patients with at least one clinical relapse within 3–15 months after treatment onset, the proportion of patients with new T2 or gadolinium-enhancing lesions, and the proportion of subjects who achieved no evidence of disease activity (NEDA) status were assessed.

Results
Three hundred sixteen (98 on IFNβ-1a, 218 on DMF) subjects were included. Baseline demographics were comparable between groups except for age, disease duration, and the number of previous treatments being higher and relapse rate in the prior year being lower in the DMF-treated group. The proportion of patients having a clinical relapse (24.5% vs. 9.6%; OR = 3.04; P < 0.001) or a new MRI lesion (28.6% vs. 8.7%; OR = 4.19, P < 0.001) at 15 months were higher on IFNβ-1a. 79.9% of the patients achieved NEDA status at 15 months on DMF (vs. 51.1% for IFNβ-1a; OR = 0.26, P < 0.001). Further adjustment for demographics, disease characteristics, treatment and relapse history, and subgroup analyses confirmed these findings.

Conclusion
DMF was associated with less clinical and radiological disease activity compared to IFNβ-1a.
Identifying transient ischemic attack (TIA) patients at high-risk of adverse outcomes: development and validation of an approach using electronic health record data
Authors: Myers Laura J. , Perkins Anthony J. , Zhang Ying , Bravata Dawn M. 
Published: July 2022

Abstract
Background
Risk-stratification tools that have been developed to identify transient ischemic attack (TIA) patients at risk of recurrent vascular events typically include factors which are not readily available in electronic health record systems. Our objective was to evaluate two TIA risk stratification approaches using electronic health record data.

Methods
Patients with TIA who were cared for in Department of Veterans Affairs hospitals (October 2015—September 2018) were included. The six outcomes were mortality, recurrent ischemic stroke, and the combined endpoint of stroke or death at 90-days and 1-year post-index TIA event. The cohort was split into development and validation samples. We examined the risk stratification of two scores constructed using electronic health record data. The Clinical Assessment Needs (CAN) score is a validated measure of risk of hospitalization or death. The PREVENT score was developed specifically for TIA risk stratification.

Results
A total of N = 5250 TIA patients were included in the derivation sample and N = 4248 in the validation sample. The PREVENT score had higher c-statistics than the CAN score across all outcomes in both samples. Within the validation sample the c-statistics for the PREVENT score were: 0.847 for 90-day mortality, 0.814 for 1-year mortality, 0.665 for 90-day stroke, and 0.653 for 1-year stroke, 0.699 for 90-day stroke or death, and 0.744 for 1-year stroke or death. The PREVENT score classified patients into categories with extreme nadir and zenith outcome rates. The observed 1-year mortality rate among validation patients was 7.1%; the PREVENT score lowest decile of patients had 0% mortality and the highest decile group had 30.4% mortality.

Conclusions
The PREVENT score had strong c-statistics for the mortality outcomes and classified patients into distinct risk categories. Learning healthcare systems could implement TIA risk stratification tools within electronic health records to support ongoing quality improvement.

Registration
ClinicalTrials.gov Identifier: NCT02769338.