bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of delirium on mortality in patients hospitalized for heart failure
Authors: Ritchie Charlotte , Walters Ryan W. , Ramaswamy Sriram , Alla Venkata M 
Published: June 2021

Objective Heart Failure (HF) is one of the leading causes of hospitalization in the United States accounting for ≈800,000 hospital discharges and $11 billion in annual costs. Delirium occurs in approximately 30% of elderly hospitalized patients and its incidence is significantly higher among those admitted to the critical care units. Despite this, there has been limited exploration of the clinical and economic impact of delirium in patients hospitalized with acute HF. We hypothesized that delirium in HF is associated with excess mortality and hospital costs. Methods We queried the 2001-2014 Nationwide Inpatient Sample to identify hospitalizations that included a primary discharge diagnosis of HF (ICD-9-CM: 428.xx) and stratified them by presence or absence of delirium (ICD-9-CM: 239.0, 290.41, 293.0, 293.1, 348.31). Differences in in-hospital mortality, length of stay (LOS), and hospital costs were assessed using propensity-score matched cohorts. Results Major predictors of delirium included advanced age, Caucasian race, underlying dementia or psychiatric diagnoses, higher Elixhauser Comorbidity Index, renal failure, cardiogenic shock, and coronary artery bypass surgery. In the propensity-score matched analysis of 76,411 hospitalization with delirium compared to 76,612 without delirium, in-hospital mortality (odds ratio: 1.67, 95% CI: 1.51–1.77), LOS (rate ratio [RR]: 1.47, 95% CI: 1.45–1.51), and hospital costs (RR: 1.44, 95% CI: 1.41–1.48) were all statistically higher in the presence of delirium (all p < 0.001). Conclusion In patients hospitalized with HF, delirium is an independent predictor of increased in-hospital mortality, longer LOS, and excess hospital costs despite adjustment for baseline characteristics.
Lithium therapy in patients on dialysis: A systematic review
Authors: McGrane Ian R , Omar Faddy A , Morgan Natalie F , Shuman Michael D 
Published: June 2021

Background Lithium is a first-line pharmacotherapy for the treatment of bipolar disorder, but long-term use is associated with nephrotoxicity. However, as dialysis effectively eliminates lithium, it remains a pharmacotherapeutic option for patients on dialysis. This systematic review seeks to evaluate the dosing, safety, efficacy, and monitoring of lithium in patients receiving dialysis. Method A PubMed database search performed May 5th, 2020, identified 535 article titles. After exclusion criteria were applied, a total of 15 articles were included in this systematic review. Results In 18 patients receiving dialysis, lithium was primarily used for the treatment of mood disorders. The majority of patients received 300–900 mg lithium carbonate thrice-weekly following dialysis, but several alternative lithium salts and dosing strategies were utilized. The pharmacokinetic properties of lithium in dialysis are not well understood and can be complicated by a serum lithium “rebound effect” following dialysis, due to a two-compartment volume of distribution. Additionally, presence of residual diuresis in some patients may be reason to administer lithium more frequently than thrice-weekly following dialysis. Lithium was shown to be an effective pharmacotherapy in all patients, with many demonstrating rapid improvement after drug initiation. Five patients experienced an adverse event on lithium, but only one patient required lithium discontinuation. Conclusion Lithium may be used in patients on dialysis, with close monitoring of pre-dialysis serum lithium concentrations for at least two weeks after treatment initiation, followed by a lower frequency after stabilization to ensure therapeutic concentrations and reduce toxicity risk.
A pelvic mass 21 years after a Wilms tumour: late recurrence or new tumour?
Authors: Bonet Xavier , Oderda Marco , Campobasso Davide , Hoepffner Jean-Luc 
Published: June 2021

Introduction: Late Wilms tumour (WT) recurrences are rare events with poorly understood pathogenesis. They could be induced by previous chemo- and radiotherapy regimens, which can also prompt a rhabdomyomatous differentiation. Prostatic embryonal rhabdomyosarcoma (PER) is an extremely rare disease in adults, with an aggressive behaviour and abysmal prognosis. Radio-induced PER have been described. Case description: We report the case of a 29 years old man, with a history of WT, diagnosed with a symptomatic prostatic mass. Blastemic elements were shown at the transrectal biopsy, suggesting the possibility of a late WT recurrence. After laparoscopic resection, an unexpected pathologic diagnosis was reached: PER. Conclusion: We retrace and analyse the diagnostic and therapeutic path of the case that represents a mixture of two different conditions which might be unrelated or intertwined in a causal relationship. Among the differential diagnosis of a prostatic mass, the possibility of a prostatic sarcoma should not be overlooked, in presence of blastemic elements, even in a patient with a WT history.
Disrupting times in the wake of the pandemic: Dispositional time attitudes, time perception and temporal focus
Authors: Loose Tianna , Wittmann Marc , Vásquez-Echeverría Alejandro 
Published: June 2021

Introduction The COVID-19 pandemic has majorly disrupted many aspects of people’s lives, provoking psychosocial distress among students. People’s positive and negative attitudes towards the past, present and future were a dispositional pre–COVID-19 reality. Faced with a pandemic, people have reported disruptions in the speed of passing time. People can shift their attention more towards the past, present or future when major changes in society occur. These aspects of psychological time would be key to understanding the quality of psychosocial adjustment to the pandemic. We hypothesized that dispositional time attitudes impact psychosocial distress because they would trigger situational changes in our time perception and temporal focus. Methods One hundred and forty-four university students in Uruguay responded to self-report questionnaires online while in-person classes were cancelled. Students reported on shifts in temporal focus, changes in time awareness and dispositional time attitudes. Reactive psychological, social and learning environment distress were reported. Results Students reported substantial changes in time perception and temporal focus. A correlation matrix showed significant relationships between time attitudes, focus and awareness. For example, psychological distress was correlated with negative time attitudes, slower passage of time, boredom, blurred sense of time and shifting focus to the past. Mediation models were derived. The indirect effect of time attitudes on psychological distress was significant through past focus. Discussion Dispositional time attitudes would impact students’ capacity to cope with the pandemic. Situational shifts in temporal focus and perception were prevalent and can be viewed as temporal coping mechanisms in the wake of powerful societal change. Our mediation models showed that those with negative time attitudes experienced more psychological distress because they shifted their attention to the past. Future directions for research and practical implications are discussed.
The COVID-19 pandemic and obsessive–compulsive disorder in young people: Systematic review
Authors: Cunning Catherine , Hodes Matthew 
Published: June 2021

Background The COVID-19 pandemic has impacted the world since the first cases were reported in China in January 2020. The secondary mental health impacts of the pandemic are thought to be significant. Obsessive–compulsive disorder is a condition defined by recurrent obsessions and compulsions. It has been hypothesised that the focus on hygiene and contamination during the pandemic could exacerbate obsessive–compulsive symptoms in young people. Method A systematic literature review was conducted. Papers were sought looking at the effect of the pandemic on obsessive–compulsive disorder in young people. Results Six published cross-sectional and longitudinal studies were identified, of which four studies investigated clinic samples with a diagnosis of obsessive–compulsive disorder and two looked at community adolescent populations. Five out of the six studies found that obsessive–compulsive symptoms were exacerbated during the COVID-19 pandemic. Conclusion The COVID-19 pandemic appears to be associated with a worsening of obsessive–compulsive symptoms in young people. Being in treatment seems to have a protective effect. Maintaining mental health services during a pandemic is vital. It is important to be aware of the implications of pandemic on obsessive–compulsive symptoms in young people in order to allow them to access appropriate treatments. More research is needed in this area.
A Comparison of Fibula Pro-Tibia Fixation Versus Hindfoot Nailing for Unstable Fractures of the Ankle in Those Older Than 60 Years
Authors: Eyre-Brook Alistair Ian , Ring Joseph , Chadwick Carolyn , Davies Howard , Davies Mark , Blundell Chris 
Published: June 2021

Background: Ankle fractures in the elderly are an increasing problem, with poor outcomes reported. Operative options for patients with suspected osteoporosis and needing to bear weight to ambulate can include hindfoot intramedullary nail (IMN) or fibula pro-tibia fixation (FPT). FPT involves passing 2 or more screws through a lateral fibula plate, crossing the fibular into the tibia, with 1 or more screws proximal to the incisura. We compared the outcomes of these 2 techniques. Method: A retrospective review identified 68 patients aged over 60 years with unstable ankle fractures, treated with IMN or FPT. Primary outcome was surgical reoperation/revision rate, secondary outcomes included complications, length of stay, and functional status. Results: There were no significant differences in demographics between IMN and FPT. Revision rates were higher in IMN compared with FPT ( P < .0001). IMN patients postoperatively had longer hospital stays ( P = .02), longer follow-up times ( P = .008), and higher rates of delayed wound healing ( P = .03) and nonunion ( P = .001). Multivariate analysis identified fixation and age to affect revision rates. Conclusion: Outcomes were worse in the IMN group compared with FPT. We believe both techniques have a role in the management of elderly ankle fractures, but patient selection is key. We suggest that FPT should be the first-choice technique when soft tissues permit. Levels of Evidence: Level III
Frequency of myelin oligodendrocyte glycoprotein antibodies in a large cohort of neurological patients
Authors: Held Friederike , Kalluri Sudhakar Reddy , Berthele Achim , Klein Ana-Katharina , Reindl Markus , Hemmer Bernhard 
Published: June 2021

Background Myelin oligodendrocyte glycoprotein (MOG) antibody disease (MOG-AD) is recognized as a distinct nosological entity. IgG antibodies against MOG (MOG-Ab) overlap with neuromyelitis optica spectrum disorders (NMOSD) phenotype in adults. However, an increasing number of clinical phenotypes have been reported to be associated with MOG-Ab. Objective To investigate the seroprevalence of MOG-Ab under consideration of demographics, disease entities and time course in a large cohort of unselected neurological patients. Methods Blood samples of 2.107 consecutive adult neurologic patients admitted to our department between 2016-2017 were tested for MOG-Ab using a cell-based assay. MOG-Ab persistence was analyzed in follow-up samples. External validation was performed in two independent laboratories. Results We found MOG-Ab in 25 of 2.107 (1.2%) patients. High antibody ratios were mostly associated with NMOSD and MOG-AD phenotype (5/25). Low ratios occurred in a wide range of neurological diseases, predominantly in other demyelinating CNS diseases (5/25) and stroke (6/25). MOG-Ab persistence over time was not confined to NMOSD and MOG-AD phenotype. Conclusion The present study demonstrates the occurrence of MOG-Ab in a wide range of neurological diseases. Only high MOG-Ab ratios were associated with a defined clinical phenotype, but low MOG-Ab ratios were not. The diagnostic value of low MOG-Ab is thus highly limited.
Macrophage polarization by MSC-derived CXCL12 determines tumor growth
Authors: Babazadeh Shabnam , Nassiri Seyed Mahdi , Siavashi Vahid , Sahlabadi Mohadeseh , Hajinasrollah Mostafa , Zamani-Ahmadmahmudi Mohamad 
Published: June 2021

Abstract
Background
Phenotypic and functional heterogeneity of macrophages is known to be the main reason for their ability to regulate inflammation and promote tumorigenesis. Mesenchymal stem cells (MSCs) are one of the principal cells commonly found in the tumor stromal niche, with capability of macrophage phenotypic switching. The objective of this study was to evaluate the role of C-X-C motif chemokine ligand 12 (CXCL12) produced by marrow-derived MSCs in the phenotypic and functional pattern of bone marrow-derived macrophages (BMDMs).

Methods
First, the CRISPR/Cas9 system was used for the CXCL12 gene knock-out in MSCs. Then, coculture systems were used to investigate the role of MSCsCXCL12−/− and MSCsCXCL12+/+ in determination of macrophage phenotype. To further analyze the role of the MSC-derived CXCL12 niche, cocultures of 4T1 mammary tumor cells and macrophages primed with MSCsCXCL12−/− or MSCsCXCL12+/+ as well as in-vivo limiting dilution assays were performed.

Results
Our results revealed that the expression of IL-4, IL-10, TGF-β and CD206 as M2 markers was significantly increased in macrophages co-cultured with MSCsCXCL12+/+ , whereas the expression of IL-6, TNF-α and iNOS was conversely decreased. The number and size of multicellular tumor spheroids were remarkably higher when 4T1 cells were cocultured with MSCCXCL12+/+-induced M2 macrophages. We also found that the occurrence of tumors was significantly higher in coinjection of 4T1 cells with MSCCXCL12+/+-primed macrophages. Tumor initiating cells were significantly decreased after coinjection of 4T1 cells with macrophages pretreated with MSCsCXCL12−/−.

Conclusions
In conclusion, our findings shed new light on the role of MSC-derived CXCL12 in macrophage phenotypic switching to M2, affecting their function in tumorigenesis.
Toxic effects of UV filters from sunscreens on coral reefs revisited: regulatory aspects for “reef safe” products
Authors: Miller Ingo B. , Pawlowski Sascha , Kellermann Matthias Y. , Petersen-Thiery Mechtild , Moeller Mareen , Nietzer Samuel , Schupp Peter J. 
Published: June 2021

Abstract
Background
Tropical coral reefs have been recognized for their significant ecological and economical value. However, increasing anthropogenic disturbances have led to progressively declining coral reef ecosystems on a global scale. More recently, several studies implicated UV filters used in sunscreen products to negatively affect corals and possibly contribute to regional trends in coral decline. Following a public debate, bans were implemented on several organic UV filters and sunscreen products in different locations including Hawaii, the U.S. Virgin Islands and Palau. This included banning the widely used oxybenzone and octinoxate, while promoting the use of inorganic filters such as zinc oxide even although their toxicity towards aquatic organisms had been documented previously. The bans of organic UV filters were based on preliminary scientific studies that showed several weaknesses as there is to this point no standardized testing scheme for scleractinian corals. Despite the lack of sound scientific proof, the latter controversial bans have already resulted in the emergence of a new sunscreen market for products claimed to be ‘reef safe’ (or similar). Thus, a market analysis of ‘reef safe’ sunscreen products was conducted to assess relevant environmental safety aspects of approved UV filters, especially for coral reefs. Further, a scientifically sound decision-making process in a regulatory context is proposed.

Results
Our market analysis revealed that about 80% of surveyed sunscreens contained inorganic UV filters and that there is a variety of unregulated claims being used in the marketing of ‘reef safe’ products with ‘reef friendly’ being the most frequently used term. Predominantly, four organic UV filters are used in ‘reef safe’ sunscreens in the absence of the banned filters oxybenzone and octinoxate. Analysis of safe threshold concentrations for marine water retrieved from existing REACH registration dossiers could currently also safeguard corals.

Conclusion
There is a substantial discrepancy of treatments of organic versus inorganic UV filters in politics as well as in the ‘reef safe’ sunscreen market, which to this point is not scientifically justified. Thus, a risk-based approach with equal consideration of organic and inorganic UV filters is recommended for future regulatory measures as well as a clear definition and regulation of the ‘reef safe’ terminology.
Vertical clinging and leaping induced evolutionary rate shifts in postcranial evolution of tamarins and marmosets (Primates, Callitrichidae)
Authors: Botton-Divet Léo , Nyakatura John A. 
Published: June 2021

AbstractBackgroundCallitrichids comprise a diverse group of platyrrhine monkeys that are present across South and Central America. Their secondarily evolved small size and pointed claws allow them to cling to vertical trunks of a large diameter. Within callitrichids, lineages with a high affinity for vertical supports often engage in trunk-to-trunk leaping. This vertical clinging and leaping (VCL) differs from horizontal leaping (HL) in terms of the functional demands imposed on the musculoskeletal system, all the more so as HL often occurs on small compliant terminal branches. We used quantified shape descriptors (3D geometric morphometrics) and phylogenetically-informed analyses to investigate the evolution of the shape and size of the humerus and femur, and how this variation reflects locomotor behavior within Callitrichidae.ResultsThe humerus of VCL-associated species has a narrower trochlea compared with HL species. It is hypothesized that this contributes to greater elbow mobility. The wider trochlea in HL species appears to correspondingly provide greater stability to the elbow joint. The femur in VCL species has a smaller head and laterally-oriented distal condyles, possibly to reduce stresses during clinging. Similarly, the expanded lesser trochanters visible in VCL species provide a greater lever for the leg retractors and are thus also interpreted as an adaptation to clinging. Evolutionary rate shifts to faster shape and size changes of humerus and femur occurred in theLeontocebusclade when a shift to slower rates occurred in theSaguinusclade.ConclusionsBased on the study of evolutionary rate shifts, the transition to VCL behavior within callitrichids (specifically theLeontocebusclade) appears to have been an opportunity for radiation, rather than a specialization that imposed constraints on morphological diversity. The study of the evolution of callitrichids suffers from a lack of comparative analyses of limb mechanics during trunk-to-trunk leaping, and future work in this direction would be of great interest.
Buffalo sperm surface proteome profiling reveals an intricate relationship between innate immunity and reproduction
Authors: Batra Vipul , Bhushan Vanya , Ali Syed Azmal , Sarwalia Parul , Pal Ankit , Karanwal Seema , Solanki Subhash , Kumaresan Arumugam , Kumar Rakesh , Datta Tirtha Kumar 
Published: June 2021

AbstractBackgroundLow conception rate (CR) despite insemination with morphologically normal spermatozoa is a common reproductive restraint that limits buffalo productivity. This accounts for a significant loss to the farmers and the dairy industry, especially in agriculture-based economies. The immune-related proteins on the sperm surface are known to regulate fertility by assisting the spermatozoa in their survival and performance in the female reproductive tract (FRT). Regardless of their importance, very few studies have specifically catalogued the buffalo sperm surface proteome. The study was designed to determine the identity of sperm surface proteins and to ascertain if the epididymal expressed beta-defensins (BDs), implicated in male fertility, are translated and applied onto buffalo sperm surface along with other immune-related proteins.ResultsThe raw mass spectra data searched against anin-housegenerated proteome database from UniProt using Comet search engine identified more than 300 proteins on the ejaculated buffalo sperm surface which were bound either by non-covalent (ionic) interactions or by a glycosylphosphatidylinositol (GPI) anchor. The singular enrichment analysis (SEA) revealed that most of these proteins were extracellular with varied binding activities and were involved in either immune or reproductive processes. Flow cytometry using six FITC-labelled lectins confirmed the prediction of glycosylation of these proteins. Several beta-defensins (BDs), the anti-microbial peptides including the BuBD-129 and 126 were also identified amongst other buffalo sperm surface proteins. The presence of these proteins was subsequently confirmed by RT-qPCR, immunofluorescence and in vitro fertilization (IVF) experiments.ConclusionsThe surface of the buffalo spermatozoa is heavily glycosylated because of the epididymal secreted (glyco) proteins like BDs and the GPI-anchored proteins (GPI-APs). The glycosylation pattern of buffalo sperm-surface, however, could be perturbed in the presence of elevated salt concentration or incubation with PI-PLC. The identification of numerous BDs on the sperm surface strengthens our hypothesis that the buffalo BDs (BuBDs) assist the spermatozoa either in their survival or in performance in the FRT. Our results suggest that BuBD-129 is a sperm-surface BD that could have a role in buffalo sperm function. Further studies elucidating its exact physiological function are required to better understand its role in the regulation of male fertility.