bluuebunny/crossref_metadata_2025 huggingface dataset:
Silencing of EhAQP1, EhPTP2, and EhTK Genes in Ecytonucleospora Hepatopenaei Using RNA Interference: A Potential Strategy for Preventing and Treating EHP Infection in Shrimp
Authors: Liu Tingyue , Qiao Yi , Jiang Huiwen , Cao Xiaohui , Cheng Jie , Jiang Ge , Sun Xiaoman , Shen Hui
Published: February 2025

Ecytonucleospora hepatopenaei (EHP) is an obligate intracellular parasitic pathogen of shrimp, causing growth retardation and increased susceptibility to opportunistic infections. Currently, there are few reports on the prevention and treatment of EHP infection in shrimp, and research on its drug targets is limited. This article utilizes RNA interference (RNAi) technology to conduct knockdown verification studies on potential drug targets involved in EHP’s invasion mechanism and life cycle. Three target gene sequences from genome, and annotated as EhAQP1 (aquaporin 1), EhPTP2 (polar tube protein), and EhTK (thymidine kinase) were used to synthesize specific small interfering RNA (siRNA). These siRNAs were injected into EHP‐infected shrimp, and the hepatopancreas was sampled at 12, 24, 48, and 72 h postinjection to verify the interference effect and spore load. The results showed that RNAi exhibits varying inhibitory effects on different genes and is time‐dependent. For EhAQP1, interference was most effective in the early stages (12 to 24 h), while the interference effects for EhTK were more pronounced at 48 and 72 h, the expression of EhPTP2 was significantly downregulated (p < 0.001) only at 24 h. In the EhAQP1 and EhPTP2 interference group, the spore load decreased from 12 to 48 h, but increased at 72 h. In contrast, the EhTK interference group showed a continuous decrease in spore load from 12 to 72 h. In summary, this study provides a new strategy for prevention and treatment of shrimp EHP infection and lays the foundation for subsequent research on RNAi–based prevention and treatment of EHP infection.
The Value of Glycemic Gap for Predicting Mortality in ICU in Patients With and Without Diabetes
Authors: Lou Ran , Jiang Li , Wang Meiping , Wang Tingting , Si Quan , Su Weixue , Wang Nan , Liu Yuyan , Chen Ting , Jiang Qi , Zhu Bo
Published: February 2025

Objective: Dysglycemia is associated with poor outcomes; the actual status of dysglycemia of critically ill patients with diabetes should refer to background glycemia. We investigated the effect of difference between mean blood glucose and basic blood glucose upon outcomes.

Methods: Glycated hemoglobin A1c (HbA1c) was detected within the first 24 h and converted to A1C‐derived average glucose (ADAG) by the equation ADAG = [(HbA1c∗28.7) − 46.7]∗18−1; blood glucose measurements were fourth per day during the first 7 days after admission; the mean blood glucose level (Mean), standard deviation (SD), and coefficient of variation (CV) were calculated. GAP were calculated as admission blood glucose and Mean minus ADAG, respectively.

Results: Six hundred forty‐nine patients were recruited and 428 survived at 28 days; 302 patients with diabetes had greater ADAG, blood glucose at admission (BGadm), Mean, SD, CV, GAP, and hypoglycemia incidences. The GAP between Mean and ADAG had superior predictive power, which was decreased in patients with diabetes and increased in patients without diabetes. GAP7 was related to 28‐day mortality; the death risk was decreased in patients with diabetes. Patients with lower GAP tended to survive. Nonsurvivors with diabetes suffered higher rate of hypoglycemia than survivors which was the opposite in patients without diabetes.

Conclusion: The glycemic GAP between the mean level of blood glucose within the first 7 days in ICU and ADAG was independently associated with 28‐day mortality of critically ill patients, which was different between patients with and without diabetes. Hypoglycemia in patients with diabetes should be a concern.
Chronic Pain in Italy: Turning Numbers Into Actionable Solutions
Authors: Violini Alessia , Consoletti Leonardo , Finco Gabriele
Published: February 2025

Chronic pain (CP) is a condition that looms over the global social and health scenarios. After many years without having national data, an extensive overview of this disorder in Italy has been published in the first Rapporto Censis Grünenthal (Censis Grünenthal Pain Report). It confirms that 19.8% of the Italian adult population suffers from moderate or severe CP, and the vast majority of patients (86.2%) are not aware of the existence of pain management (PM) centers. Starting with the Rapporto Censis Grünenthal data analysis by the representatives of three Italian pain scientific societies, several unmet needs were highlighted for which affordable, innovative, and technological strategies were proposed. These solutions focused on interventions in three strategic areas: (1) information, education, and awareness about CP among patients and physicians; (2) organization of pain center networks to adequately cover the national territory, promoting a multimodal‐interdisciplinary approach; and (3) use of currently available novel technologies to foster access to treatment. For this purpose, the authors suggested feasible solutions, such as promoting public educational campaigns to raise awareness of the existence of pain centers and the right to receive a proper PM, as indicated in Italy by the pioneering law 38/2010. Regarding organizational gaps, the authors highlighted the possibility of drawing on international models to improve pain centers with completely dedicated staff and community‐based pain services while supporting the development of specialized procedural PM standards. Concerning technologies, investments in telehealth and digital tools would improve access to therapies throughout the territory, enabling efficient clinical assessment and helping deliver the most suitable treatments. Overall, greater awareness of the impact of CP and a better allocation of resources are needed to improve patient quality of life, thereby reducing costs for the healthcare system.
Optimizing Biomarker Models for Biologically-Heterogeneous Cancers: A Nested Model Approach for Lung Cancer
Authors: Woodhouse Palina , Jackson Laurel , Kammer Michael N. , Godfrey Caroline M. , Antic Sanja , Zou Yong , Meyers Patrick , Gawel Susan H. , Maldonado Fabien , Grogan Eric L. , Davis Gerard J. , Deppen Stephen A.
Published: February 2025

Background: The heterogeneous biology of cancer subtypes, especially in lung cancer, poses significant challenges for biomarker development. Standard model building techniques often fall short in accurately incorporating various histological subtypes due to their diverse biological characteristics. This study explores a nested biomarker model to address this issue, aiming to improve lung cancer early detection. Materials: The study included 337 patients from two clinical sites. Blood biomarkers were analyzed, and various statistical methods employed to develop a nested model. This model was designed to account for the biological heterogeneity across histological subtypes, compared against traditional logistic regression models. Results: The patient cohort included a range of malignant and benign nodules and included different cancer subtypes reflecting lung cancer heterogeneity. The nested model had comparable performance overall to the Mayo Clinic Model and a standard logistic regression model with AUC of 77.6 (95%CI: 72.2, 83.0) in training and 77.3 (95%CI: 65.8, 88.9) in testing. The nested subtype versus benign model had the best performance in the training set overall and had a particular advantage for small cell subtype prediction. Conclusion: This study highlights the challenges cancer heterogeneity present for biomarker development and the potential for nested biomarker models to improve early cancer detection. Validation of this approach in larger cohorts is essential to prove its predictive benefit in biologically diverse cancers. Impact: This work addresses the challenge of biologic heterogeneity in biomarker development. A nested modeling approach may assist in developing more effective Multi-Cancer Early Detection strategies.
Table S1 from Expression Patterns of DLL3 across Neuroendocrine and Non-neuroendocrine Neoplasms Reveal Broad Opportunities for Therapeutic Targeting
Authors: Lozada John R. , Elliott Andrew , Evans Mark G. , Wacker James , Storey Kathleen M. , Egusa Emily A. , Zorko Nicholas A. , Kumar Akhilesh , Crymes Anthony , Heath Elisabeth I. , Carneiro Benedito A. , Soares Heloisa P. , Cichocki Frank , Miller Jeffrey S. , Lou Emil , Beltran Himisha , Antonarakis Emmanuel S. , Ryan Charles J. , Hwang Justin H.
Published: February 2025

DLL3-high versus -low hazard ratios across NEN anatomic sites
Table 1 from Expression Patterns of DLL3 across Neuroendocrine and Non-neuroendocrine Neoplasms Reveal Broad Opportunities for Therapeutic Targeting
Authors: Lozada John R. , Elliott Andrew , Evans Mark G. , Wacker James , Storey Kathleen M. , Egusa Emily A. , Zorko Nicholas A. , Kumar Akhilesh , Crymes Anthony , Heath Elisabeth I. , Carneiro Benedito A. , Soares Heloisa P. , Cichocki Frank , Miller Jeffrey S. , Lou Emil , Beltran Himisha , Antonarakis Emmanuel S. , Ryan Charles J. , Hwang Justin H.
Published: February 2025

Demographics of NEN samples by anatomic site
Immunosuppressive therapy-related cardiovascular risk factors in renal transplantation: a narrative review.
Authors: Paccagnella Chiara , Andreola Stefano , Gambaro Alessia , Gambaro Giovanni , Caletti Chiara
Published: February 2025

Background. Kidney transplantation is the best treatment for patients with chronic renal failure, capable of improving life expectancy and the risk of death from all causes, which, however, remains higher than in the general population. The leading cause of death in transplant patients is cardiovascular events, burdened by a significant impact brought about by anti-rejection therapy. Experimental and clinical studies to date show that in kidney transplant recipients, traditional cardiovascular risk factors (hypertension, diabetes, dyslipidemia, obesity, tobacco, etc.) may be exacerbated or worsened by the dysmetabolic effects of immunosuppressive drugs, which may also result in additional risk factors such as proteinuria, anemia, and arterial stiffness. The aim of this review is an in-depth evaluation of the effect of immunosuppressive treatments on cardiovascular risk factors.
Summary. We have investigated and described the main cardiovascular risk factors related to immunosuppressive drugs. We searched for relevant scientific articles in medicine, transplant, cardiologic and nephrological journals in major medical science libraries.
Key messages. Immunosuppressive drugs allow graft survival and successful bunking of the transplant; however, they are not without significant side effects, and should always be prescribed weighing the risk/benefit ratio and the individual patient's therapeutic needs.
Bridging Thrombolysis versus Direct Mechanical Thrombectomy in acute Basilar artery occlusion due to different stroke etiologies
Authors: Fan Ligen , Qu Chuanyong , Zhang Xiao , Chen Xuemei , Feng Junlin , Chen Peng , Han Zhiqiang , Sun Wen , Zheng Jinou
Published: February 2025

Introduction: Stroke etiology could influence treatment decisions. This study aims to evaluate the efficacy and safety of bridging thrombolysis (BT) compared to direct endovascular treatment (EVT) in patients with basilar artery occlusion (BAO), stratified by stroke subtype.
Methods: Data were collected from the PERSIST multicenter retrospective registry, enrolling patients with acute symptomatic BAO treated with EVT. Stroke subtypes were classified based on the TOAST criteria into large-artery atherosclerosis (LAA), cardioembolism (CE), and Others causes. A propensity score-matched analysis was performed to compare outcomes between patients receiving BT and those undergoing direct EVT. The primary outcome was a favorable functional outcome (mRS 0-3) at 90 days. Secondary outcomes included functional independence (mRS 0-2), 90-day mortality, and symptomatic intracranial hemorrhage (sICH).
Results: A total of 577 BAO patients were included, with 376 patients classified as LAA, 119 as CE, and 82 as other causes. In the LAA subgroup, BT was associated with a higher likelihood of favorable outcomes compared to EVT (53.8% vs. 34.4%; OR 1.29; 95% CI 1.02-1.65). In the CE subgroup, BT was associated with an increased likelihood of functional independence (mRS 0-2) at 90 days (OR 1.57; 95% CI 1.01-2.51). No significant increase in the risk of sICH or 90-day mortality was observed in any of the subgroups following BT.
Conclusion: BT appears to be an effective and safe treatment strategy in patients with BAO, particularly in those with LAA and CE etiologies. BT was associated with better functional outcomes compared to direct EVT without increasing the risk of hemorrhagic complications. These findings suggest that stroke subtype should be considered when tailoring treatment strategies for BAO patients. Further prospective randomized trials are needed to confirm these results.
Stage I Non-Seminomatous Testicular Cancer. Long-term follow-up with surveillance approach post-orchiectomy.
Authors: Martínez-Cedillo Jorge , Díaz-García Diego A. , Infante-González César , Mota-Vega Beatriz , Heredia David , Cabrera-Urbina Alejandro , Álvarez Avitia Miguel Ángel , Sobrevilla Nora , Jiménez-Ríos Miguel Ángel , Zinser-Sierra Juan W.
Published: February 2025

Introduction: Adjuvant treatment for patients with stage I non-seminomatous germ cell tumors (NSGCT) could be active surveillance (AS), chemotherapy, or retro-peritoneal lymph node dissection (RLND). AS is the preferred option in most cas-es. The aim of this study was to evaluate long-term survival and prognostic factors in our population with AS approach.
Methods: We collected information from patients with stage I NSGCT of the testis in medical records from 1995 to 2016. Patients had negative serum tumor mark-ers and imaging of chest, abdomen, and pelvis with no evidence of metastasis. At relapse, if occurs, patients were treated with chemotherapy, surgery, or both. Kaplan-Meier method was used to estimate survival. Relationships with outcomes were analyzed using multivariable Cox regression and log-rank analysis.
Results: 457 patients were included. The median age at diagnosis was 25 years. The median follow-up was 65.3 meses (range 12 to 270 months). Relapses were detected in 92 (20%) patients with a median time to recurrence of 7.1 months (range 1.1 to 123 months). Retroperitoneal lymph nodes were the most common site of relapsed (41.3%), and most patients presented biochemical and imaging recurrence (67.4%). Vascular invasion (VI) was significantly associated with re-currence [HR 2.38 (CI 95%, 1.24-4.56), p=0.008] in the multivariate analysis, and rete testis invasion in the univariate analysis (p=0.027). After salvage treatment, 83 patients (91.1%) were disease-free. The overall survival was 98.25% at 20 years.
Conclusions: AS is an effective non-adapted risk-based approach in patients with stage I NSGCT. Almost 100% are alive at 20 years. Nearly all relapses were cured with salvage therapy. Toxicity related to adjuvant treatments, as well as overtreatment, could be avoided.
The Association Between Tumor Necrosis Factor-Alpha Inhibitor Use and Dementia Risk in Patients with Rheumatoid Arthritis: A Systematic Review and Meta-analysis
Authors: Chung DaRae , Noh Yoo Jin , Yu Yun Mi , Ah Young-Mi
Published: February 2025

Introduction: Tumor necrosis factor-alpha inhibitors (TNFi), commonly prescribed for rheumatoid arthritis (RA), have been studied for their potential association with dementia risk. However, previous findings are inconclusive. This study aims to evaluate the impact of TNFi use on dementia in patients with RA.
Methods: Systematical search of MEDLINE, Embase, and CENTRAL databases from inception to October 1, 2023, was conducted. Longitudinal comparative studies investigating the association between TNFi use and risk of dementia in patients with RA were included. Pooled adjusted risks of dementia, and meta-analysis conducted to synthesize relative estimates with 95% confidence intervals (CIs).
Results: Seven observational studies involving 633,089 patients with RA were included, of which six were included in the meta-analysis. The pooled meta-analysis comparing the risk of dementia (hazard ratio [HR] = 0.77, 95% CI 0.64–0.93) and Alzheimer's disease (AD) (odds ratio = 0.31, 95% CI 0.23–0.43) between TNFi users and non-users showed a significant association. However, the pooled HR for AD risk was inconsistent. Also, the subgroup analyses indicated that TNFi use was associated with a decreased dementia risk in older adult patients with a mean age of ≥65 years at enrollment (HR = 0.86, 95% CI 0.80-0.92) and in TNFi new users (HR = 0.86, 95% CI 0.80-0.92).
Conclusions: Systematic review and meta-analysis suggest that lowering the level of systemic TNF-alpha by using TNFi could lower the risk of dementia. However, given the retrospective nature of the included studies, further prospective studies are needed to evaluate the role of TNFi in dementia onset.
Informing Management of Patients Developing Cardiogenic Shock at a Spoke and Being Transferred to a Hub
Authors: Kyriakopoulos Christos P. , Taleb Iosif , Sideris Konstantinos , Maneta Eleni , Hamouche Rana , Tseliou Eleni , Krauspe Ethan , Selko Sean , Carter Spencer , Jones Tara L. , Zhang Chong , Presson Angela P. , Dranow Elizabeth , Geer Laura , Stehlik Josef , Selzman Craig H. , Goodwin Matthew L. , Tonna Joseph E. , Hanff Thomas C. , Drakos Stavros G.
Published: February 2025

Background

Multidisciplinary teams and regionalized care systems have been suggested to improve cardiogenic shock (CS) outcomes. We sought to identify clinical factors associated with successful outcomes for patients developing CS at an outside healthcare facility (spoke) and being transferred to a quaternary medical center (hub).

Methods and Results

Consecutive patients with CS were evaluated (N=1162). Our study cohort comprised 412 patients developing CS at a spoke. Our primary end point was native heart survival (NHS) defined as survival to discharge without receiving advanced heart failure therapies. Secondary end points were survival to discharge, 30‐day and 1‐year survival after discharge, and adverse events. Association of clinical data with NHS was analyzed using logistic regression. Overall, 246 (59.7%) patients achieved NHS, 125 (30.3%) died, and 41 (10.0%) were discharged after advanced heart failure therapies. Of the 287 patients who were discharged (69.7%), 276 (67.0%) were alive at 30 days, and 250 (60.7%) at 1 year. Patients with NHS less commonly had bleeding or vascular complications or acute kidney injury requiring renal replacement therapy compared with patients who died or received advanced heart failure therapies. Significant multivariable factors associated with NHS likelihood included younger age; shorter length of stay and transfer from a secondary compared with a tertiary/quaternary level of care spoke; absence of cardiac arrest, intubation, or type 3 bleeding; lower vasoactive–inotropic score; higher left ventricular ejection fraction at admission to the hub; and shorter CS onset‐to‐temporary mechanical circulatory support deployment time.

Conclusions

We identified clinical factors reflecting disease severity and management practices including length of stay and spoke level of care, inotrope/vasopressor utilization, and CS onset‐to‐temporary mechanical circulatory support deployment time, that might inform the management of patients developing CS at a spoke.
Direct Oral Anticoagulants Compared With Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease Without Mechanical Valves
Authors: Dawwas Ghadeer K. , Lewis James D. , Cuker Adam
Published: February 2025

Background

Despite proven efficacy and safety of direct oral anticoagulants (DOACs) over warfarin in patients with atrial fibrillation (AF), data on patients with AF and valvular heart disease remain scarce. We aimed to evaluate the DOACs compared with warfarin among patients with AF and valvular heart disease.

Methods and Results

We conducted a retrospective cohort study of patients ≥18 years of age, who had AF and valvular heart disease, and were new users of DOACs or warfarin. The primary effectiveness outcomes were ischemic stroke or systemic embolism, and bleeding for safety. We used Cox proportional‐hazards regression after propensity score matching to estimate hazard ratios (HRs) and 95% CIs. In the matched cohort, DOAC use (versus warfarin) was associated with a lower rate of ischemic stroke or systemic embolism (HR, 0.70 [95% CI, 0.61–0.81]) and bleeding (HR, 0.72 [95% CI, 0.65–0.80]). We found a lower rate of ischemic stroke or systemic embolism with rivaroxaban (HR, 0.74 [95% CI, 0.62–0.89]) and apixaban (HR, 0.62 [95% CI, 0.52–0.74]) but not dabigatran (HR, 0.89 [95% CI, 0.63–1.26]). We found a lower rate of bleeding with rivaroxaban (HR, 0.84 [95% CI, 0.74–0.95]), apixaban (HR, 0.60 [95% CI, 0.53–0.68]), dabigatran (HR, 0.75 [95% CI, 0.58–0.97]), and edoxaban (HR, 0.21 [95% CI, 0.05–0.83]). We were unable to obtain estimates for the effectiveness outcome with edoxaban due to the small number of events.

Conclusions

In this study of patients with AF and valvular heart disease, DOAC treatment was associated with a lower risk of ischemic stroke or systemic embolism and bleeding compared with warfarin.
Unveiling the Genetic Landscape of Coronary Artery Disease Through Common and Rare Structural Variants
Authors: Iyer Kruthika R. , Clarke Shoa L. , Guarischi‐Sousa Rodrigo , Gjoni Ketrin , Heath Adam S. , Young Erica P. , Stitziel Nathan O. , Laurie Cecelia , Broome Jai G. , Khan Alyna T. , Lewis Joshua P. , Xu Huichun , Montasser May E. , Ashley Kellan E. , Hasbani Natalie R. , Boerwinkle Eric , Morrison Alanna C. , Chami Nathalie , Do Ron , Rocheleau Ghislain , Lloyd‐Jones Donald M. , Lemaitre Rozenn N. , Bis Joshua C. , Floyd James S. , Kinney Gregory L. , Bowden Donald W. , Palmer Nicholette D. , Benjamin Emelia J. , Nayor Matthew , Yanek Lisa R. , Kral Brian G. , Becker Lewis C. , Kardia Sharon L. R. , Smith Jennifer A. , Bielak Lawrence F. , Norwood Arnita F. , Min Yuan‐I , Carson April P. , Post Wendy S. , Rich Stephen S. , Herrington David , Guo Xiuqing , Taylor Kent D. , Manson JoAnn E. , Franceschini Nora , Pollard Katherine S. , Mitchell Braxton D. , Loos Ruth J. F. , Fornage Myriam , Hou Lifang , Psaty Bruce M. , Young Kendra A. , Regan Elizabeth A. , Freedman Barry I. , Vasan Ramachandran S. , Levy Daniel , Mathias Rasika A. , Peyser Patricia A. , Raffield Laura M. , Kooperberg Charles , Reiner Alex P. , Rotter Jerome I. , Jun Goo , de Vries Paul S. , Assimes Themistocles L.
Published: February 2025

Background

Genome‐wide association studies have identified several hundred susceptibility single nucleotide variants for coronary artery disease (CAD). Despite single nucleotide variant‐based genome‐wide association studies improving our understanding of the genetics of CAD, the contribution of structural variants (SVs) to the risk of CAD remains largely unclear.

Method and Results

We leveraged SVs detected from high‐coverage whole genome sequencing data in a diverse group of participants from the National Heart Lung and Blood Institute's Trans‐Omics for Precision Medicine program. Single variant tests were performed on 58 706 SVs in a study sample of 11 556 CAD cases and 42 907 controls. Additionally, aggregate tests using sliding windows were performed to examine rare SVs. One genome‐wide significant association was identified for a common biallelic intergenic duplication on chromosome 6q21 (
P
=1.54E‐09, odds ratio=1.34). The sliding window‐based aggregate tests found 1 region on chromosome 17q25.3, overlapping
USP36
, to be significantly associated with coronary artery disease (
P
=1.03E‐10).
USP36
is highly expressed in arterial and adipose tissues while broadly affecting several cardiometabolic traits.

Conclusions

Our results suggest that SVs, both common and rare, may influence the risk of coronary artery disease.
Relationship Between Health Care Team Segregation and Receipt of Care by a Cardiologist According to Patient Race in a Midwestern State
Authors: Quintero Bisonó Janina , Knapp Shannon M. , Trabue Dalancee , Yee Ryan , Williamson Francesca , Johnson Adedoyin , Watty Stephen , Pool Natalie , Hebdon Megan , Moore Wanda , Yankah Ekow , Ezema Nneamaka , Kimbrough Nia , Lightbourne Karen , Tucker Edmonds Brownsyne , Capers Quinn , Brown David , Johnson Denee , Evans Jalynn , Foree Brandi , Holman Anastasia , Blount Courtland , Nallamothu Brahmajee , Hollingsworth John M. , Breathett Khadijah
Published: February 2025

Background

Segregation index (SI) has been associated with worsened health. However, the relationship between SI within health care teams (degree of heterogeneity between teams caring for Black compared with White patients) and cardiovascular care is unclear among adequately insured populations. We sought to assess the relationship between health care team SI, patient race, receipt of care by a cardiologist, 1‐year survival, and 30‐day readmission rates for Black compared with White patients admitted with heart failure, ischemic heart disease, or valvular heart disease.

Methods

Using Optum's de‐identified Clinformatics Data Mart Database (CDM) from 2009 to 2020, generalized linear mixed‐effects were used to analyze effects of patient race and SI on receipt of care by a cardiologist, and care by a cardiologist on 1‐year survival and 30‐day readmission.

Results

Among 6572 patients (17.1% Black), the odds of receiving care by a cardiologist were 31.3% less for Black than White patients (adjusted odds ratio 0.687 [95% CI, 0.545–0.872];
P
=0.001). However, there was no statistically significant association of SI on receipt of care by a cardiologist (
P
=0.14). For those seen by a cardiologist, the adjusted odds ratio (Black‐to‐White) of 1‐year survival increased with increasing SI (
P
=0.02). SI had no statistically significant effect on 30‐day readmission (
P
=0.86).

Conclusions

Among patients hospitalized for heart failure, ischemic heart disease, or valvular heart disease, segregation of health care teams was not associated with receipt of care by cardiologists in Indiana hospitals. When cardiologists were included, the odds of 1‐year survival increased for Black versus White patients with increasing segregation of clinicians, and segregation was not associated with 30‐day readmission.
Self/other: Guiding distinction for the social theory of the self
Authors: Morales Francisco X.
Published: February 2025

This article introduces Niklas Luhmann’s systems theory into contemporary debates on the social dimension of the self. It focuses on the relevance of self/other relationships, as the guiding distinction in both micro-sociological and phenomenological approaches to the social self. Following a review of Dan Zahavi’s critiques of social constructivism, the article proposes an alternative account of the self from a systemic perspective. Two key arguments are presented: First, intersubjectivity theory observes the social dimension from a hierarchical use of the self/other distinction, treating the ‘other’ side as subordinate to the ‘self’ side of the distinction. Luhmann’s approach addresses this issue by rejecting the primacy of the subject and reinterpreting the self/other distinction through the concepts of meaning and double contingency. Second, Zahavi’s notion of the minimal self may be translated into systemic terms as the autopoiesis of the psychic system, although this requires a revision of some of Luhmann’s assumptions regarding self-referential identity. Moreover, a comprehensive systemic theory of the self must move beyond the autopoietic level of consciousness to incorporate the social dimension through interpenetration between social systems and human beings.
Guiding distinctions of social theory: Results from two online brainstormings and one quantitative analysis of the ISA Books of the XX Century corpus
Authors: Roth Steffen , Watson Steve , Möller Sören , Clausen Lars , Žažar Krešimir , Dahms Harry , Sales Augusto , Lien Vincent
Published: February 2025

In this article, we report on the results of two online brainstormings that have collected over 480 and over 219 guiding distinctions of social theory, respectively. We draw on the results of these brainstormings as well as on a quantitative analysis of the Top 100 sociological groundworks as listed in the ISA Books of the XX Century ranking to identify the most influential distinctions of social theory and show that the bulk of these guiding distinctions consists of ‘false’ or analogue distinctions. We further demonstrate how systematic explorations of these distinction may facilitate a still pending digital transformation of social theory, defined as (a) the translation of analogue into digital social theories, (b) the design of new digital social theories and (c) the design of digital theory platforms useful for quality checks and the debugging of existing and future social theories. This article concludes that such a digital transformation of social theory is needed as the digital transformation of society and the relentlessly growing amount of digital data are revolutionising the processes of research and knowledge production in the social sciences, whereas social theory development still follows rather conservative, analogue patterns, thus lagging behind the social phenomena and methodological innovations it aims to reflect upon.
Amor Fati, Mindful Coping, and Psychological Adjustment in Adults: A Test of a Mediation Model
Authors: Chang Edward C.
Published: February 2025

The present study examined how amor fati, defined as a positive attitude of joyfully embracing all of one’s life, both the good and the bad, was associated with psychological adjustment through mindful coping behaviors in adults. A sample of 160 (113 female and 47 male) adults from the United States completed measures of amor fati, mindful coping, and psychological adjustment. Components of mindful coping behaviors (viz., awareness, distraction, preventing negative emotions, and constructive self-assertion) were evaluated as potential mediators of the association between amor fati and psychological adjustment (viz., positive affect, happiness, negative affect, and stress). Results indicated that amor fati was indirectly associated with positive affect and stress through preventing negative emotions. Noteworthy, the direct associations involving amor fati with indices of psychological adjustment remained significant in the models tested. Although preliminary, the present findings suggest that amor fati might help mitigate negative emotions from arising in adults given their “balanced” acceptance of the good and bad of life, which in turn can help foster experiences of positive psychological adjustment, and help deter experiences of negative psychological adjustment.
Strategies and Outcomes of Age-Friendly Health System Implementation in Outpatient Settings: A Systematic Review
Authors: Howe Rebecca J. , Rieke Katherine , Bayer Thomas , Ja Mai Htun , Sullivan Jennifer L. , Driver Jane A. , Rickard Taylor , Trikalinos Thomas A. , Rudolph James , McCreedy Ellen , Jutkowitz Eric
Published: February 2025

The Age-Friendly Health System (AFHS) movement has spread widely in recent years, with nearly 5000 healthcare organizations across the country recognized as Age-Friendly. Despite this broad recognition, there is little focus on how AFHS are implemented and the impact of implementation. The objectives of this study were to describe the strategies employed to support AFHS implementation in outpatient settings and to identify the measures used to evaluate implementation and effectiveness. We conducted a systematic review of literature from multiple databases spanning 2015 to March 2024, identified eligible studies using predefined inclusion/exclusion criteria, and extracted key data (eg, study design, study population, implementation strategies, outcomes/measures). We identified ten eligible studies from primary care clinics (N = 8), convenient care clinics (N = 1) and a cancer center (N = 1). The studies employed over 65 implementation strategies and 98 outcomes or measures. The vast majority of measures mapped to components of the 4Ms (Mobility, Mentation, Medication, What Matters), with up to ten measures per M category. Five of ten studies had reporting discrepancies and four did not fully define outcomes. The ten included studies serve as clear examples for the need for more evidence to support AFHS implementation in outpatient settings. Existing research lacks strategy specification and standardization of measures. We present gaps and opportunities to advance from AFHS “recognition” to impact.
Relationship Between the Frequency of Energy Drink Consumption and Sleep Time by Sex Among Korean Adolescents: A Secondary Analysis Using National Survey Data
Authors: Choi Yumi , Lee Su Jung , Seo Hyun-Ju
Published: February 2025

Background:

Energy drinks are becoming increasingly popular among adolescents despite potential adverse health effects. This study addresses the research question: “Is there an association between the frequency of energy drink consumption and insufficient sleep by sex?”

Purpose:

This study aimed to assess the frequency of energy drink consumption by sex among Korean adolescents aged 12 to 18 years and investigate its relationship with insufficient sleep.

Methods:

We analyzed secondary data using data from the 18th Korea Youth Risk Behavior Survey (2022). The study included 36 361 middle- and high school students. Complex sample logistic regression analysis examined the relationship between energy drink consumption and insufficient sleep by sex.

Results:

Among the respondents, 9.0% of male and 9.2% of female students reported consuming energy drinks frequently. In complex sample logistic regression analyses, those who reported consuming frequent energy drinks had significantly higher odds of insufficient sleep than the no-consumption group, controlling for potential confounding variables (adjusted odds ratio (OR) 2.15, 95% confidence interval (CI) 1.76-2.61 in male students; adjusted OR 3.25, 95% CI 2.39-4.41 in female students). Notably, female students who frequently consume energy drinks pose a substantial concern regarding insufficient sleep.

Conclusions:

Frequent energy drink consumption was associated with insufficient sleep time in both male and female adolescents. This highlights the need for public health policy interventions to reduce energy drink consumption and promote appropriate amounts of sleep among adolescents.
Women Entrepreneurs and Changing Social Structure of KSA
Authors: Saleem Imran , Arafat Mohd. Yasir , Saleem Anjila
Published: February 2025

The effectiveness of enterprises operated by women was a major focus of earlier studies on women entrepreneurs. However, this study examines variables influencing Indian women’s propensity for entrepreneurship through social capital and cognitive perspective. This research aims to steer the understanding of women entrepreneurs at a niche level. Many different theories have been proposed to explain the elements impacting women’s entrepreneurship. These approaches have, however, faced criticism for methodological, conceptual and predictive strength flaws. The explanation of entrepreneurship has recently shifted to include cognitive and social capital views. For this, the Adult Population Survey (APS), created and sponsored by the Indian team of Global Entrepreneurship Monitor (GEM), has been used to gather data from 1,305 women from the Kingdom of Saudi Arabia (KSA). Given that the dependent variable is binary, the data were analysed using logistic regression. The findings indicate that women’s proclivity for entrepreneurship is influenced by perception regarding starting a business. We examined two factors, cognitive and social capital, where perceived capability and opportunity perception significantly influence women’s propensity to entrepreneurship whilst risk perception hinders it. Additionally, social networks and informal investment encourage, but the entrepreneurial propensity of women of KSA who have financed other businesses stands to be negative. This prompts entrepreneurship researchers to examine the factors responsible for mobilizing and inhibiting entrepreneurial initiatives among women, reasserting entrepreneurial attitude in the existing literature and studying the cognitive and social capital variables in an integrated framework. This article provides, insights for policymakers to formulate effective policies supports women’s initiatives and their decision to start a business. It is one of the pioneering initiatives that demonstrate social capital and cognitive variables affect women’s likelihood of entrepreneurship in Saidi Arabia’s evolving social environment.
Towards more sustainable oceans: A review of the pressing challenges posed by marine plastic litter
Authors: Leal Filho Walter , Barbir Jelena , May Julia , May Marta , Swart Julia , Yang Peter , Dinis Maria Alzira Pimenta , Aina Yusuf A , Bettencourt Sara , Charvet Patricia , Azadi Hossein
Published: February 2025

Marine littering is a global challenge and a significant threat to a sustainable planet, requiring comprehensive and effective mechanisms to address it in a comprehensive manner. This study reports on a bibliometric analysis that has identified the extent to which the topic has been explored in the international literature, by focusing on geographical scope, the emphasis on (micro)plastic litter and on policy measures. Additionally, as a complement to the assessment of the recent literature on marine plastic litter, this study reviews some case studies, identifying some trends on how to cope with this problem. The findings underscore the imperative for heightened research efforts in the context of marine littering. The literature reveals that unsustainable practices, the absence of robust policies and inadequate enforcement substantially contribute to the prevalence of marine plastic litter. Consequently, urgent action is essential, demanding the implementation of effective policies and frameworks. Encouraging nations to transition towards marine sustainability, particularly in terms of prevention and environmental awareness, is of paramount importance. To pave the way for a cleaner ocean for future generations, this study not only highlights the root causes but also offers suggested solutions. These solutions serve as valuable insights for researchers, innovators and policymakers worldwide, charting a course towards a more sustainable and litter-free marine environment.
A field methodology to assess the performance of rail cleaning, using a new portable tribometer
Authors: White Ben , Watson Michael , Jaffe Joseph , Lewis Roger
Published: February 2025

Low adhesion between wheel and rail can be caused by autumn leaf fall, reacting and adhering with the steel, resulting in signals passed at danger, station overruns or in worst cases derailments and collisions. Various methods to remove this layer or increase friction have been developed including water jetting, abrasive cleaning, traction gels and chemical treatments, new interventions are trialled each year. However, representative low friction conditions are difficult to generate repeatedly and measure, as such the efficacy of these interventions remains difficult to establish. Twenty years ago British Rail Research stated “Paradoxically it has been the lack of low adhesion that has hindered the development of low adhesion remedies”. This still remains largely true today. In this paper a method is proposed to form a representative organic layer, by placing powdered leaf material on the railhead and rolling with a vehicle until it has blackened and bonded to the underlying steel. The layers were visually inspected using industry guidelines and their friction was measured using the new Rivelin Rail PRT300 tribometer. The method was found to be capable of reliably producing contamination levels from light to heavy as required for testing by varying the quantity of leaves added. Friction coefficients for medium and heavily contaminated rails were all below 0.05, these would typically be described as ultra-low adhesion. As an illustration of the method, a trial of a new (anonymised) railhead cleaning technique is included in this work as a case study. The layer formation and measurement methodology proposed could be adopted by the wider rail industry to provide a more data-driven approach to understanding friction enhancer and railhead cleaning technology performance, through optimising current treatments and assessing the performance of novel technology.
SPIN-IT and Quit It: A Nurse-Driven Protocol to Improve Inpatient Interventions for Tobacco Use Disorder
Authors: DeMarco James T.
Published: February 2025

Introduction

Tobacco smoking remains a leading cause of preventable disease and death in the U.S., with a high prevalence among individuals with mental health disorders (MHD). Despite regulatory efforts to increase tobacco use disorder (TUD) treatment in psychiatric inpatient units (an ideal setting), compliance of offering and using these interventions remains suboptimal.

Aims

This project aims to examine the effectiveness of a nurse-driven protocol, Smoking treatment Protocol for Inpatients via Nurse-driven Interventions & Teaching (SPIN-IT), on improving compliance with evidence-based TUD treatment interventions in an inpatient psychiatric unit.

Methods

SPIN-IT was developed and implemented in a 20-bed inpatient psychiatric unit. The protocol allowed registered nurses (RNs) to deliver TUD counseling and prescribe nicotine replacement medication based on an algorithm without an independently licensed provider (LIP). Data on compliance with CMS tobacco measures (TOB-2 and TOB-2a) were collected for 12 months before and after SPIN-IT implementation and analyzed for statistical significance.

Results

The project included 835 patients over 2 years. Postintervention TOB-2 compliance increased significantly from 84.7% to 99.3% ( p < .001), and TOB-2a compliance rose from 24% to 56% ( p < .001). The protocol resulted in more patients being offered and receiving TUD treatment counseling and medications.

Conclusion

The SPIN-IT protocol significantly improved TUD treatment compliance in an inpatient psychiatric setting. It supports the effectiveness of nurse-driven protocols in enhancing patient outcomes and adherence to TUD treatment measures. Further research is needed to evaluate the long-term impact on TUD treatment and to explore the perceptions of nursing staff, physicians, and patients related to the protocol.
Preoperative Peripheral Blood Serotonin and Kynurenine Levels Are Associated With Oncological Outcomes in Glioblastoma IDH-wt Patients
Authors: Snider Silvia , Gagliardi Filippo , De Domenico Pierfrancesco , Comai Stefano , Bertazzo Antonella , Nasini Sofia , Barzon Benedetta , Ruban Angela , Roncelli Francesca , Mortini Pietro
Published: February 2025

Background:

In recent years, there has been a growing interest in exploring the potential contribution of tryptophan (TRP) metabolism via the kynurenine (KP) and serotonin (SP) pathways in Glioblastoma (GBM) biology. This study aims to address the association between pre-operative peripheral blood levels of TRP, kynurenine (KYN), 5-hydroxy-tryptophan (5-HTP), and serotonin (5-HT) and relevant oncological outcomes in GBM IDH-wt patients.

Methods:

This is a single-center, retrospective clinical study. Serum from 62 adult patients undergoing maximal safe resection of newly diagnosed glioblastoma WHO-grade 4 IDH-wt (GBM) and n = 27 healthy controls were analyzed. The variables of interest were dichotomized via maximally selected rank statistics. Kaplan Meier and Cox multivariate regression analysis were conducted to explore the single contributions of these parameters in building a predictive model of overall survival (OS) and progression-free survival (PFS) in these patients.

Results:

The mean baseline serum levels of 5-HT, KYN, and 5-HTP were significantly lower in GBM when compared to n = 27 healthy individuals ( P < .001). Patients with 5-HT <78 ng/mL had a median OS of 14.4 months compared to 22.5 months in patients with increased levels ( P = .01). Shorter OS was observed in patients with KYN <18 ng/mL (9.8 vs 17.5 months, P = .002), KYN/TRP <2.55 (11.4 vs 17.1, P = .002), 5-HTP/TRP <0.89 (11.5 vs 17.6 months, P = .02), and 5-HT/TRP <5.78 (13.4 vs 19.1 months, P = .002) compared to patients with high levels. Shorter PFS in patients with 5-HT <78 ng/mL ( P = .04), KYN <18 ng/mL ( P = .02), 5-HT/TRP <5.78 ( P = .001), KYN/TRP <2.55 ( P = .005). Reduced KYN, 5-HTP, and 5-HT were independent predictors of poor OS.

Conclusions:

This study highlights an intriguing association between the degradation of TRP along the KP and SP and median survival times in GBM. Decreased KYN, 5-HTP, and 5-HT levels were associated with shorter OS.
Effects of tirofiban in preventing neurological deterioration in acute ischemic stroke with intracranial artery stenosis: A post hoc analysis of the TREND Trial
Authors: Wang Jing , Qiao Yue , Li Sijie , Li Chuanhui , Wu Chuanjie , Wang Pingping , Yang Ting , Ji Xunming , Ma Qingfeng , Zhao Wenbo
Published: February 2025

Introduction:

The degree of culprit artery stenosis affects the risk of early neurological deterioration (END) after acute ischemic stroke (AIS). The TREND trial demonstrated the efficacy of tirofiban in preventing END in patients with AIS. We aimed to investigate whether the degree of intracranial artery stenosis affects the efficacy of tirofiban in preventing END in patients with AIS.

Patients and Methods:

We conducted a post hoc analysis of the TREND trial, which enrolled patients within 24 h of onset and randomly allocated to receive intravenous tirofiban or oral aspirin. We stratified the stenosis degrees into three subgroups: no stenosis, mild-to-moderate stenosis (stenosis <70%), and severe stenosis or occlusion (stenosis ⩾70%). The primary endpoint is END4 defined as an increase of the NIHSS ⩾4 within 72 h after randomization. Secondary outcomes include END2 (defined as an increase of NIHSS ⩾2) within 72 h after randomization, the proportion of mRS 0–1 and 0–2 at 90 days.

Results:

A total of 296 patients were analyzed. In patients with severe stenosis or occlusion, tirofiban significantly reduced the incidence of END4 (5.7% vs 30.8%, adjusted OR 0.156, 95% CI 0.028–0.873, adjusted p = 0.034), whereas its effects in preventing END4 were similar to those of aspirin in patients with no stenosis (2.4% vs 4.6%, adjusted OR 0.193, 95% CI 0.018–2.083, adjusted p = 0.175) or mild-to-moderate stenosis (2.9% vs 10.0%, adjusted OR 0.171, 95% CI 0.015–1.943, adjusted p = 0.155). The p value for interaction between stenosis subgroups and treatment was 0.513. Furthermore, tirofiban significantly reduced the incidence of END2 in patients with mild-to-moderate stenosis (5.9% vs 22.5%, OR 0.146, 95% CI 0.022–0.951, adjusted p = 0.044) and severe stenosis or occlusion (11.4% vs 43.6%, adjusted OR 0.140, 95% CI 0.036–0.540, adjusted p = 0.004). A significant improvement in favorable outcomes with a 90-day mRS of 0–1 was observed only in patients with mild-to-moderate stenosis (85.3% vs 70.0%, adjusted OR 4.617, 95% CI 1.077–19.798, adjusted p = 0.039).

Discussion and conclusion:

Tirofiban may significantly reduce the incidence of END in patients with severe arterial stenosis or occlusion. Further studies are required to confirm the effects of intracranial artery stenosis on the benefits of intravenous tirofiban.

Trial registration:

ClinicalTrials.gov; identifier: NCT04491695.