bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inflammatory Markers and Measures of Cardiovascular Autonomic Neuropathy in Type 1 Diabetes
Authors: Ang Lynn , Gunaratnam Sejal , Huang Yiyuan , Dillon Brendan R. , Martin Catherine L. , Burant Aaron , Reiss Jacob , Blakely Pennelope , Vasbinder Alexi , Zhao Lili , Mizokami‐Stout Kara , Tang Yaling , Feldman Eva L. , Doria Alessandro , Spino Cathie , Banerjee Mousumi , Hayek Salim S. , Pop‐Busui Rodica 
Published: December 2024

Background
Cardiovascular autonomic neuropathy (CAN) and inflammation predict more severe outcomes in type 1 diabetes (T1D). However, the link between CAN and inflammation in T1D remains unclear. We examined associations between CAN measures and inflammatory biomarkers in individuals with T1D.

Methods and Results

In a cross‐sectional study, we measured cardiovascular autonomic reflex tests and heart rate variability (established CAN measures) and a panel of 39 inflammatory biomarkers, including soluble urokinase plasminogen activator receptor (suPAR), in T1D participants of the TINSAL‐T1DN (Targeting Inflammation with Salsalate in Individuals with T1D Neuropathy) trial (n=57, discovery), and the PERL (Preventing Early Renal Loss in Diabetes) trial (n=468, validation). Amongst 39 inflammatory biomarkers measured in TINSAL‐T1DN, suPAR levels had the strongest negative correlations with CAN measures: expiration/inspiration (
r
=−0.48), Valsalva (
r
=−0.28), 30:15 (
r
=−0.37), SD of the normal RR interval (
r
=−0.37), and root mean square of differences of successive RR intervals (
r
=−0.31) (all
P
<0.05). Findings were validated in PERL. In unadjusted analyses, median suPAR levels significantly differed between the lowest and highest SD of the normal RR interval tertiles (3.79 versus 3.12 ng/mL,
P
<0.001) and root mean square of differences of successive RR intervals (3.76 versus 3.17 ng/mL,
P
<0.001). After adjusting for covariates (age, sex, hemoglobin A1c, and estimated glomerular filtration rate), median suPAR values remained significantly elevated in the lowest tertiles of SD of the normal RR interval (
P
=0.004) and root mean square of differences of successive RR intervals (
P
=0.006).

Conclusions
Amongst several inflammatory biomarkers, suPAR, an immune‐mediated glycoprotein, has a singular association with CAN measures. The potential of targeting suPAR as a disease‐modifying approach for CAN in T1D warrants further exploration.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT02936843, NCT02017171.
Tropical High Cloud Feedback Relationships to Climate Sensitivity
Authors: Dawson Emma , Schiro Kathleen A. 
Published: December 2024

Abstract
Clouds constitute a large portion of uncertainty in predictions of equilibrium climate sensitivity (ECS). While low cloud feedbacks have been the focus of intermodel studies due to their high variability among global climate models, tropical high cloud feedbacks also exhibit considerable uncertainty. Here, we apply the cloud radiative kernel technique of Zelinka et al. to 22 models across the CMIP5 and CMIP6 ensembles to survey tropical high cloud feedbacks and analyze their relationship to ECS. We find that the net high cloud feedback and its altitude and optical depth feedback components are significantly positively correlated with ECS in the tropical mean. On the other hand, the tropical mean high cloud amount feedback is not correlated with ECS. These relationships are most pronounced outside of areas of strong climatological ascent, suggesting the importance of thin cirrus feedbacks. Finally, we explore connections between high cloud feedbacks, climate sensitivity, and mean state high cloud properties. In general, high ECS models are cloudier in the upper troposphere but have a thinner high cloud population. Moreover, we find that having more thin cirrus in the mean state relates to more positive high cloud altitude and optical depth feedbacks, and it either amplifies or dampens the high cloud amount feedback depending on the large-scale dynamical regime (amplifying in descent and dampening in ascent). In summary, our analysis highlights the importance of tropical high cloud feedbacks for driving intermodel spread in ECS and suggests that mean state high cloud characteristics might provide a unique opportunity for observationally constraining high cloud feedbacks.

Significance Statement
Clouds play an important role in modulating the effects of climate change through feedback processes involving changes to their amount, altitude, and opacity. In this study, we seek to understand how changes to tropical high clouds under warming are related to the magnitude of warming that global climate models simulate. We find that tropical high cloud feedbacks robustly relate to the amount of warming a model predicts and that warmer models tend to have a thinner tropical high cloud climatology. Our results highlight a potential opportunity to form a new constraint using these relationships in order to narrow the spread of warming estimates among global climate models.
Synoptic Cross-Shore Movements of Outer Salinity Fronts in China’s Changjiang River Plume
Authors: Ma Yameng , Yin Wenbin , Huang Daji , Xuan Jiliang , He Yuqing , Meng Qicheng , Wei Yi , Zhou Feng , Chen Jianfang 
Published: December 2024

Abstract
Remote sensing observations reveal strong differences in winter cross-shore movements of the outer salinity fronts between the midfield and far-field regions outside China’s Changjiang River plume. However, the characteristics, mechanisms, and associated water exchanges of these outer fronts remain unclear. Based on 7-yr buoy salinity observations and a high-resolution model, we investigate periods of synoptic (∼9–13 days) variation and the spring–neap tidal cycle for outer fronts in the midfield and far field. Their cross-shore movements manifest as oscillations in the midfield and an alternation of single and double fronts in the far field. In the midfield, the cross-shore frontal oscillations occur with in-phase salinity variations on opposite sides of the front, indicating a balance between brackish plume water and offshore saline water. The replenishment of low-salinity water from the near field to this region induces significant stratification of seawater, making the entire surface layer highly buoyant and susceptible to modulation by tidal and wind-driven advection. In the far field, the alternations of single and double fronts are accompanied by antiphase salinity variations on opposite sides of the front. During strong downwelling winds, a single front occurs when coastal salinity decreases due to the southward expansion of plume, and offshore salinity increases due to wind-driven onshore transport. During weak downwelling winds, a double front is generated by the combined action of advection and vertical mixing. The salinity in the coastal branch of the double front increases at this time, providing evidence that saline Taiwan warm water can intrude into the coastal area when the offshore branch spreads further offshore.

Significance Statement
The Changjiang River plume extends to the whole coastal area of the East China Sea due to the wintertime downwelling wind, resulting in a widespread outer salinity front zone of more than 300 km from the midfield to far field. Such outer fronts’ natural movements and synoptical variation in their locations signal the transport of water masses and nutrients, which is crucial for shelf ecology. In this study, buoy data and a high-resolution model show that midfield and far-field regions differ strongly in the characteristics and mechanisms of front movement, as well as the associated water exchanges. Accordingly, we divide the outer fronts into an advective front in midfield mainly driven by advection and a mixing front in the far field additionally driven by mixing.
Functional Liver Imaging Score (FLIS) as imaging parameter for predicting post-hepatectomy complications in patients with liver cirrhosis
Authors: Ji Yea Hee , Son Il Wan , Hong Seung Baek , Lee Nam Kyung , Kim Suk , Seo Hyung Il , Noh Byeong Gwan 
Published: December 2024

Background Liver dysfunction has been reported as a risk factor for predicting complications after hepatectomy. In patients with liver cirrhosis (LC) who underwent hepatectomy, a Functional Liver Imaging Score (FLIS), derived from gadoxetic acid–enhanced magnetic resonance imaging (MRI), has never been investigated as a predictor of clinically significant post-hepatectomy complications. Purpose To evaluate whether FLIS can predict post-hepatectomy complications in patients with LC. Material and Methods A retrospective review was conducted of patients with LC who underwent gadoxetic acid–enhanced MRI and hepatectomy. Univariable and multivariable logistic regression was used to identify clinicopathological and radiologic findings associated with the development of major complication (Clavien–Dindo classification [CDC] ≥ III). Receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff value of FLIS for predicting CDC ≥ III. Results Of the finally included 106 patients (77 men; mean age = 62.5 ± 8.3 years), 12 patients had a CDC ≥ III. Multivariable analysis showed that only FLIS independently predicted post-hepatectomy complications (odds ratio = 0.02; P = 0.01). ROC analysis suggested the FLIS ≤ 4 was the optimal cutoff for predicting CDC ≥ III (AUC value = 0.94; sensitivity = 91.67%; specificity = 95.74%; positive likelihood ratio = 21.54; and negative likelihood ratio = 0.09). Conclusion In patients with LC, FLIS was an independent predictor of post-hepatectomy complications. FLIS showed excellent diagnostic performance in predicting post-hepatectomy complications.
The predictive factors for in-stent restenosis after interventional treatment of chronic carotid artery occlusion
Authors: Pan Song , Cao Yue-zhou , Zhou Chun , Jia Zhenyu , Zhao Lin-bo , Shi Hai-bin , Liu Sheng 
Published: December 2024

Background In-stent restenosis (ISR) is a potential severe complication that occurs in patients with severe carotid artery narrowing after carotid angioplasty and stent placement. However, this phenomenon has not been fully studied in the context of interventional treatment for chronic internal carotid artery occlusion (CICAO). Purpose To quantify the ISR rate and identify the risk factors leading to this event. Material and Methods This study included 69 patients with symptomatic CICAO who underwent successful intravascular recanalization at our institution. Clinical information, outcomes, and prognosis of the patients were recorded. The related factors of ISR were analyzed through univariate and multivariate analysis. Results A total of 11 (15.9%) patients developed a significant ISR > 70% during the follow-up period. Among them, five patients with ISR experienced symptomatic restenosis. Our study found hyperlipidemia ( P = 0.017), contralateral internal carotid artery occlusion ( P = 0.041), and prolonged radiologic occlusion to recanalization time ( P = 0.049) could contribute to the risk of ISR in patients with CICAO. Conclusion ISR is not rare in patients with CICAO after successful intervention. Hyperlipidemia, contralateral ICA occlusion, and prolonged radiologic occlusion to recanalization time are the risk factors for ISR after treatment in patients with CICAO.
Factors influencing the colorectal surveillance adherence in Lynch Syndrome: A retrospective monocentric study
Authors: Ferrari Davide , Rausa Emanuele , Lauricella Sara , Brignola Clorinda , Zaccara Antonio , Signoroni Stefano , Ricci Maria Teresa 
Published: December 2024

Background: Lynch syndrome (LS), an autosomal dominant disorder resulting from germline pathogenic variants in DNA mismatch repair genes, poses an elevated risk of developing different types of cancer, particularly colorectal and endometrial. Early identification of LS individuals is vital for implementing preventive measures. This study aims to assess the adherence rate of LS individuals to colorectal surveillance and identify influencing factors. Methods: Data from the Hereditary Digestive Tumors Registry at Fondazione IRCCS Istituto Nazionale dei Tumori of Milan from 1995 to 2018 were analyzed. The study included 397 LS patients, as categorized based on adherence to surveillance. Statistical analyses, including multivariable logistic regression, were employed to identify factors influencing adherence. Results: Out of 397 LS patients, 305 (76.8%) completed surveillance, and 92 (23.2%) were lost during surveillance. Fifty-two patients developed colorectal cancer during the surveillance: 34 among patients who completed the surveillance and 18 among those who did not (p<0.036). Factors positively influencing adherence included genetic counseling and higher education, while the distance from the referral center had a negative impact. The survival rate was 83.5% at 240-months. Conclusions: This study emphasizes the importance of adhering to a regular colorectal surveillance program for LS individuals. Genetic counseling and higher education emerged as a crucial factor positively affecting adherence. The negative impact was observed for geographical distance from the referral center.
Mothers’ Gender-role Ideologies and Exclusive Breastfeeding in Western Rural China: A Cross-Sectional Study
Authors: Nie Jingchun , Li Yangyuan , Wang Nan , Liu Yunjie , Wu Junhao , Ye Jinbiao , Reheman Zulihumaer , Yang Jie , Xue Hao , Shi Yaojiang 
Published: December 2024

Background: Shifts in women’s maternal roles may contribute to the global low prevalence of exclusive breastfeeding. Research Aim: To investigate the association between maternal gender-role ideologies and exclusive breastfeeding in rural China. Methods: Cross-sectional studies were conducted in 10 counties in Shaanxi Province using random sampling in 2021 and 2023. Data on breastfeeding practices, maternal gender-role ideology, and expected educational attainment from 586 rural participants were collected through structured questionnaires. Multivariable regression analysis was employed to explore the association between maternal gender-role ideology and exclusive breastfeeding. Results: The prevalence of exclusive breastfeeding within 6 months in rural western China was 18.8%. Women with more egalitarian gender-role ideologies were more likely to engage in exclusive breastfeeding ( OR = 1.34, 95% CI [1.04, 1.72]), particularly for female infants ( OR = 1.63, 95% CI [1.09, 2.43]). Furthermore, women with stronger egalitarian gender-role ideologies were found to exhibit a greater propensity for financial investment in their children ( Beta = 0.20, 95% CI [0.01, 0.40]) and hold higher educational expectations for their daughters ( OR = 1.50, 95% CI [1.00, 2.25]). Conclusion: Maternal gender-role ideology positively correlates with exclusive breastfeeding. More policies should be implemented on gender equality in rural China, and cultural perspectives should be incorporated into the analysis of breastfeeding practice.
Understanding Stakeholder Priorities in Dupuytren Disease: A Qualitative Study
Authors: Karpinski Marta , Hircock Caroline , Gallo Lucas , Dunn Emily , Murphy Jessica , Kaur Manraj N. , Thoma Achilles 
Published: December 2024

Background: Currently, there is no recommended standard set of outcomes to report in Dupuytren disease treatment studies, nor are there guidelines on how the outcomes themselves should be reported. This study aimed to elicit the most salient issues for patients living with and undergoing treatment for Dupuytren disease, as well as for the hand surgeons, occupational therapists, and physical therapists caring for these patients. Methods: A qualitative, interpretive description study employing one-on-one semi-structured interviews was conducted. Ten surgeons, 12 occupational and physical therapists, and 10 patients were interviewed. Results: Priorities related to Dupuytren disease treatment and recovery differed by stakeholder group. Surgeons prioritized range of motion, recovery time, and recurrence. Physical and occupational therapists frequently mentioned range of motion, grip strength, activities of daily living, return to meaningful activities, wound healing, edema, lack of sensation, and pain as important treatment outcomes. Patients described extension deficit, activities of daily living, holding objects, and lack of sensation. Conclusions: Through the present study, we have identified outcomes of high importance to patients, hand surgeons, occupational therapists, and physical therapists. These results can be used to inform the development of a core outcome set for Dupuytren contracture.
Association between women empowerment and contraceptive utilization in Ethiopia
Authors: Abebe Yonas , Berhanu Robera Demissie , Kajela Lencho , Bayane Yadeta Babu 
Published: December 2024

Background: Women’s empowerment is essential for achieving sustainable development goals. It involves enabling women to take control of their lives by giving them the agency, resources, and opportunities they need to make their own choices and reach their full potential. If more women are empowered to use modern contraceptives, greater reductions in maternal mortality will follow. By understanding this association, we can identify key women empowerment dimensions that have an association with family planning utilization and consider ways forward to improve reproductive health outcomes for women. Objective: This study aimed to investigate the association between women’s empowerment and modern contraceptive utilization among married mothers in Ethiopia. Design: A facility-based quantitative study was employed. Methods: A facility-based quantitative cross-sectional study was employed among 305 mothers selected by systematic random sampling at Jimma Town Public Hospital from July 1 to August 31, 2022. The interviewer-administered questionnaire was used for data collection. The collected data were entered into EpiData Manager, version 4.6.0.6, and then exported to SPSS, version 26. Bivariate and multivariate logistic regression analyses were used to investigate the associations between the dependent and independent variables. Results: Among a total of 305 study subjects, 301 were used in the analysis. Approximately 65% (95% CI = 59.8, 70.8) of the women utilized modern contraceptive methods. High general self-efficacy (AOR = 4.17; 95% CI = 2.11, 8.23), an internal locus of control (AOR = 3.92; 95% CI = 2.01, 7.65), labor work participation (AOR = 4.53; 95% CI = 1.99, 10.31), and enrollment in elementary education (AOR = 8.30; 95%; CI = 2.96, 23.27) have a statistically significant association with modern contraceptive utilization. Conclusion: Numerous dimensions of women’s empowerment are significantly associated with modern contraceptive utilization. The dimension of women’s empowerment needs considerable focus from stakeholders to empower women and enable them to utilize contraceptives and other maternal healthcare services.
Chronic urinary tract infections cause persistent microglial changes in a humanized ɑ-synuclein mouse model
Authors: Mercado Gabriela , Clabout Ann-Céline , Howland Vanessa , Arkin Ehsan , Janer Anna Barber , Plessers Dieter , Steiner Jennifer A , Smith Wanli W , Hannan Tom , Brundin Patrik , Peelaerts Wouter 
Published: December 2024

Background Urinary tract infections (UTIs) have recently been linked to the onset of multiple synucleinopathies including Parkinson's disease (PD) and multiple system atrophy (MSA). UTIs are more common in people with PD or MSA, than in the general population and within these patient groups the incidence of UTIs is evenly distributed between men and women. UTIs are especially common during disease, but also in the years before clinical diagnosis. Objective The mechanisms by which UTIs may contribute to the development and progression of PD or MSA are not well understood. In this work, we evaluate the neuroinflammatory effects of recurrent UTIs on the brain. Methods In a humanized mouse model of ɑ-synuclein, we find that repeated administration of uropathogenic E. coli result in sustained UTIs, or a non-resolving chronic UTI phenotype with persistent bacteriuria. Using this model, we investigate the effects of repeated chronic UTIs on neuroinflammation and synucleinopathy in the brain. Results Recurrent UTIs lead to behavioral motor changes and are accompanied by persistent neuroinflammatory changes in multiple brain areas. Affected regions with microglial changes involve multiple lower brainstem areas responsible for sickness behavior, including the dorsal vagal complex, and the cingulate cortex. Conclusions These results suggests that recurrent UTIs can have lasting impact on the brain, and it warrants further investigation of the potential role of UTIs in the disease progression of synucleinopathies and related neurological disorders.
Pointing in the right direction: Greater motor improvements with directional versus circular subthalamic nucleus deep brain stimulation for Parkinson's disease
Authors: Hurt Christopher P , Kuhman Daniel J , Moll Alyson , Guthrie Barton L , Olson Joseph W , Nakhmani Arie , Wade Melissa , Brinkerhoff Sarah A , Holland Marshall T , Walker Harrison C 
Published: December 2024

Background Directional deep brain stimulation (DBS) provides more precise control of current spread than conventional ring-shaped electrodes. Whether this enhanced flexibility improves motor function is unclear. Objective Here we examine whether directional and circular stimulation differentially impact motor performance in patients with Parkinson's disease. Methods Motor behaviors were assessed in 31 patients who underwent unilateral subthalamic nucleus brain stimulation surgery (SUNDIAL, NCT03353688). Eight configurations, including 6 directional contacts and their corresponding rings), were evaluated during device activation. Objective measures of motor performance related to limb dexterity, gait, and overall mobility were evaluated in a double-blind fashion in the “off” medication state versus preoperative baseline, with stimulus amplitude at the center of the therapeutic window. Results Significant changes in performance were observed across each of five motor tasks between the best and worst directional contacts on a given DBS row (p < 0.001 each task). Certain stimulation directions led to functional declines versus baseline, whereas the best direction yields greater improvement than ring stimulation (p = 0.005, p = 0.001, p = 0.007, p < 0.001, respectively, across tasks). Directional DBS improves therapeutic window and side effect thresholds versus ring stimulation (0.40 ± 0.94 and 0.35 ± 0.51 mA, p < 0.001, respectively), but these variables correlated only modestly with motor performance at a given stimulation site. Conclusions Optimized directional subthalamic nucleus DBS yields better group-level motor performance than ring stimulation, in addition to its known advantages related to tolerability. Prospective studies should evaluate whether these improvements persist over longer time intervals.